Exploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally.

<h4>Background</h4>Girls and women need effective, safe, and affordable menstrual products. Single-use menstrual pads and tampons are regularly provided by agencies among resource-poor populations. Reusable menstrual pads (RMPs: fabric layers sewn together by an enterprise for manufactur...

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Autores principales:	Anna Maria van Eijk, Naduni Jayasinghe, Garazi Zulaika, Linda Mason, Muthusamy Sivakami, Holger W Unger, Penelope A Phillips-Howard
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6c2261c5e4b146f7b5dab58359007171
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spelling	oai:doaj.org-article:6c2261c5e4b146f7b5dab583590071712021-12-02T20:08:00ZExploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally.1932-620310.1371/journal.pone.0257610https://doaj.org/article/6c2261c5e4b146f7b5dab583590071712021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257610https://doaj.org/toc/1932-6203<h4>Background</h4>Girls and women need effective, safe, and affordable menstrual products. Single-use menstrual pads and tampons are regularly provided by agencies among resource-poor populations. Reusable menstrual pads (RMPs: fabric layers sewn together by an enterprise for manufacture of menstrual products) may be an effective alternative.<h4>Methods</h4>For this review (PROSPERO CRD42020179545) we searched databases (inception to November 1, 2020) for quantitative and qualitative studies that reported on leakage, acceptability, or safety of RMPs. Findings were summarised or combined using forest plots (random-effects meta-analysis). Potential costs and environmental savings associated with RMPs were estimated.<h4>Results</h4>A total of 44 studies were eligible (~14,800 participants). Most were conducted in low- and middle-income countries (LMIC, 78%), and 20% in refugee settings. The overall quality of studies was low. RMP uptake in cohort studies ranged from 22-100% (12 studies). One Ugandan trial among schoolgirls found leakage with RMPs was lower (44.4%, n = 72) compared to cloths (78%, n = 111, p<0.001). Self-reported skin-irritation was 23.8% after 3 months among RMP-users in a Ugandan cohort in a refugee setting (n = 267), compared to 72.8% at baseline with disposable pad use. There were no objective reports on infection. Challenges with washing and changing RMP were reported in LMIC studies, due to lack of water, privacy, soap, buckets, and sanitation/drying facilities. Among 69 brands, the average price for an RMP was $8.95 (standard deviation [sd] $5.08; LMIC $2.06, n = 10, high-income countries [HIC] $10.11), with a mean estimated lifetime of 4.3 years (sd 2.3; LMIC 2.9, n = 11; HIC 4.9 years, n = 23). In 5-year cost-estimates, in LMICs, 4-25 RMPs per period would be cheaper (170-417 US$) than 9-25 single-use pads, with waste-savings of ~600-1600 single-use pads. In HICs, 4-25 RMPs would be cheaper (33-245 US$) compared to 20 single-use tampons per period, with waste-savings of ~1300 tampons.<h4>Conclusion</h4>RMPs are used internationally and are an effective, safe, cheaper, and environmentally friendly option for menstrual product provision by programmes. Good quality studies in this field are needed.Anna Maria van EijkNaduni JayasingheGarazi ZulaikaLinda MasonMuthusamy SivakamiHolger W UngerPenelope A Phillips-HowardPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257610 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Anna Maria van Eijk Naduni Jayasinghe Garazi Zulaika Linda Mason Muthusamy Sivakami Holger W Unger Penelope A Phillips-Howard Exploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally.
description	<h4>Background</h4>Girls and women need effective, safe, and affordable menstrual products. Single-use menstrual pads and tampons are regularly provided by agencies among resource-poor populations. Reusable menstrual pads (RMPs: fabric layers sewn together by an enterprise for manufacture of menstrual products) may be an effective alternative.<h4>Methods</h4>For this review (PROSPERO CRD42020179545) we searched databases (inception to November 1, 2020) for quantitative and qualitative studies that reported on leakage, acceptability, or safety of RMPs. Findings were summarised or combined using forest plots (random-effects meta-analysis). Potential costs and environmental savings associated with RMPs were estimated.<h4>Results</h4>A total of 44 studies were eligible (~14,800 participants). Most were conducted in low- and middle-income countries (LMIC, 78%), and 20% in refugee settings. The overall quality of studies was low. RMP uptake in cohort studies ranged from 22-100% (12 studies). One Ugandan trial among schoolgirls found leakage with RMPs was lower (44.4%, n = 72) compared to cloths (78%, n = 111, p<0.001). Self-reported skin-irritation was 23.8% after 3 months among RMP-users in a Ugandan cohort in a refugee setting (n = 267), compared to 72.8% at baseline with disposable pad use. There were no objective reports on infection. Challenges with washing and changing RMP were reported in LMIC studies, due to lack of water, privacy, soap, buckets, and sanitation/drying facilities. Among 69 brands, the average price for an RMP was $8.95 (standard deviation [sd] $5.08; LMIC $2.06, n = 10, high-income countries [HIC] $10.11), with a mean estimated lifetime of 4.3 years (sd 2.3; LMIC 2.9, n = 11; HIC 4.9 years, n = 23). In 5-year cost-estimates, in LMICs, 4-25 RMPs per period would be cheaper (170-417 US$) than 9-25 single-use pads, with waste-savings of ~600-1600 single-use pads. In HICs, 4-25 RMPs would be cheaper (33-245 US$) compared to 20 single-use tampons per period, with waste-savings of ~1300 tampons.<h4>Conclusion</h4>RMPs are used internationally and are an effective, safe, cheaper, and environmentally friendly option for menstrual product provision by programmes. Good quality studies in this field are needed.
format	article
author	Anna Maria van Eijk Naduni Jayasinghe Garazi Zulaika Linda Mason Muthusamy Sivakami Holger W Unger Penelope A Phillips-Howard
author_facet	Anna Maria van Eijk Naduni Jayasinghe Garazi Zulaika Linda Mason Muthusamy Sivakami Holger W Unger Penelope A Phillips-Howard
author_sort	Anna Maria van Eijk
title	Exploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally.
title_short	Exploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally.
title_full	Exploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally.
title_fullStr	Exploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally.
title_full_unstemmed	Exploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally.
title_sort	exploring menstrual products: a systematic review and meta-analysis of reusable menstrual pads for public health internationally.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/6c2261c5e4b146f7b5dab58359007171
work_keys_str_mv	AT annamariavaneijk exploringmenstrualproductsasystematicreviewandmetaanalysisofreusablemenstrualpadsforpublichealthinternationally AT nadunijayasinghe exploringmenstrualproductsasystematicreviewandmetaanalysisofreusablemenstrualpadsforpublichealthinternationally AT garazizulaika exploringmenstrualproductsasystematicreviewandmetaanalysisofreusablemenstrualpadsforpublichealthinternationally AT lindamason exploringmenstrualproductsasystematicreviewandmetaanalysisofreusablemenstrualpadsforpublichealthinternationally AT muthusamysivakami exploringmenstrualproductsasystematicreviewandmetaanalysisofreusablemenstrualpadsforpublichealthinternationally AT holgerwunger exploringmenstrualproductsasystematicreviewandmetaanalysisofreusablemenstrualpadsforpublichealthinternationally AT penelopeaphillipshoward exploringmenstrualproductsasystematicreviewandmetaanalysisofreusablemenstrualpadsforpublichealthinternationally
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Exploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally.

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