Building a sustainable model to promote menstrual, sexual and reproductive health (MSRH) amongst secondary school girls in Tanzania
Medical Research Council
Mwanza Intervention Trials Unit
The project addresses a critical evidence gap in how to comprehensively address menstrual, sexual, and reproductive health (MSRH) challenges of adolescent girls in Tanzania. Poor MSRH is associated with subsequent psychosocial (high levels of shame, depression, anxiety) and physical (pain, increased risk of reproductive and urinary tract infections) ill health, and poor school outcomes (including poor performance, participation, and completion). Our Theory of Change builds on a model which was developed after a qualitative metasynthesis of 76 studies and over 6,000 women and girls. The model shows how the social and cultural context underpin social support, behavioural expectations, knowledge, and the physical and economic environment that affect elements of girls' menstrual experience, including practices and perceptions, confidence to participate, and menstrual-anxiety, all ultimately impacting on girls' mental and physical health and education. The project will be conducted in four phases. An initial inception phase (Phase 1) will be followed by a formative phase (Phase 2) to iteratively refine an existing MSRH intervention and collaboratively design strategies to embed the intervention into government structures thereby promoting scaleability. In Phase 3 we will pilot and evaluate the refined intervention and implementation strategies using a before-after mixed methods design to assess (a) feasibility (including cost per student, school and district), sustainability, and acceptability and (b) effect on MSRH practice and perceptions and the overall school climate. In the final phase (Phase 4) we will collaboratively synthesise the research findings. Our phased project approach will enable us to develop a scaleable MSRH intervention that fits within Tanzanian government structures to improve MSRH practices and perceptions and the school climate to ensure the psychosocial wellbeing and optimal school participation and performance of secondary school girls.
3.2 Interventions to alter physical and biological environmental risks / Research Grant