HIV/AIDS continues to be the highest cause of poor health and social outcomes, especially among adolescents and youths. Poor Sexual and Reproductive Health (SRH) conditions are part of the root causes while also being a resultant effect of HIV/AIDS. Gaining in prominence is MHM as a basic human right, gender equality issue and health concern for girls and women.

Girls and women in low and middle income countries (LMICs) largely lack access to appropriate education, affordable and accessible menstrual hygiene care products and adequate sanitation and often suffer social exclusion and discrimination emanating from various misconceptions and myths. 

Use of poor quality and dirty materials exposes girls and women to heath hazards such as bacterial vaginosis, toxic shock syndrome among others. A culture of silence regarding MHM as a taboo at family, school, community and political levels exacerbates the situation. 

Reddressing the situation has often been not fully informed by solid empirical data.         

The overall objective of the study—Community based interventions to improve HIV outcomes in youth: a cluster randomised trial in Zimbabwe (CHIEDZA)—is to measure the impact of an integrated community-based package of SRH and HIV services addressing the whole HIV care cascade on HIV viral load among youth (defined as those aged 16-24 years) at population level.

The goal of the sub-study is to demonstrate the optimum MHM option/s that are relevant and cost-effective for women aged 16-24 years for improved MHM practices. This will be done through investigating the acceptability, uptake, and effectiveness of MHM interventions.

30’000 male and female adolescents and young people aged between 10 and 24 years. 

These are from urban or peri-urban settings (as population densities in rural areas are very low for clustering).

• To investigate the preferred MHM option/s, product acceptability and use or discontinuation patterns
• To investigate MHM social constructs, perceptions, stigma and discrimination
• To investigate the effect of the MHM intervention on pain management during menstruation

Expected results:  

• Provision and promotion of MHM products (16’250 menstrual cups, 32’500 reusable pads, 363’750 disposable pads and 32’500 period pants)
• Scheduled interactive MHM information sessions
• Improved pain management during menstruation among young women
• MHM educational material
• Provision of pain medication (analgesia) and information

Results from previous phases:  

This is the first phase with no previous phases. However, a pilot study was done to shape the main study’s tools and research design. 

The pilot study saw an increased number of girls and young women cumulatively reaching 700 individuals visiting CHIEDZA with the provision of Menstrual Health (MH) products. This suggests the existence of an unmet need for MH services.  

• Ministry of Health and Child Welfare
• London School of Hygiene and Tropical Medicine
  
• University of Zimbabwe

Phase 1 15.09.2019 - 31.12.2021   (Completed)