{"id":"https://openalex.org/W7220835337","doi":"https://doi.org/10.3389/frph.2026.1931799","title":"Using qualitative data to build causal pathways on perceived associations between poor menstrual health and hygiene and harms among schoolgirls in western Kenya","display_name":"Using qualitative data to build causal pathways on perceived associations between poor menstrual health and hygiene and harms among schoolgirls in western Kenya","publication_year":2026,"publication_date":"2026-10-07","ids":{"openalex":"https://openalex.org/W7220835337","doi":"https://doi.org/10.3389/frph.2026.1931799","pmid":"https://pubmed.ncbi.nlm.nih.gov/42909003","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13683675"},"language":"en","primary_location":{"id":"doi:10.3389/frph.2026.1931799","doi":"https://doi.org/10.3389/frph.2026.1931799","is_oa":true,"landing_page_url":"https://doi.org/10.3389/frph.2026.1931799","pdf_url":"https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2026.1931799/pdf","source":{"id":"https://openalex.org/S4210207188","display_name":"Frontiers in Reproductive Health","issn_l":"2673-3153","issn":["2673-3153"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Reproductive Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2026.1931799/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5120095429","display_name":"Ellie Ansell","orcid":"https://orcid.org/0009-0008-4423-602X","observed_orcids":["https://orcid.org/0009-0008-4423-602X"]},"institutions":[{"id":"https://openalex.org/I194839184","display_name":"Liverpool School of Tropical Medicine","ror":"https://ror.org/03svjbs84","country_code":"GB","type":"funder","lineage":["https://openalex.org/I194839184"]},{"id":"https://openalex.org/I79619799","display_name":"University of Birmingham","ror":"https://ror.org/03angcq70","country_code":"GB","type":"education","lineage":["https://openalex.org/I79619799"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Ellie Ansell","raw_affiliation_strings":["Department Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham","Department of Clinical Sciences, Liverpool School of Tropical Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham","institution_ids":["https://openalex.org/I79619799"]},{"raw_affiliation_string":"Department of Clinical Sciences, Liverpool School of Tropical Medicine","institution_ids":["https://openalex.org/I194839184"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5157869029","display_name":"Israa Saleh","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I194839184","display_name":"Liverpool School of Tropical Medicine","ror":"https://ror.org/03svjbs84","country_code":"GB","type":"funder","lineage":["https://openalex.org/I194839184"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Israa Saleh","raw_affiliation_strings":["Department of Clinical Sciences, Liverpool School of Tropical Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Clinical Sciences, Liverpool School of Tropical Medicine","institution_ids":["https://openalex.org/I194839184"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5045984282","display_name":"Garazi Zulaika","orcid":"https://orcid.org/0000-0003-1452-6225","observed_orcids":["https://orcid.org/0000-0003-1452-6225"]},"institutions":[{"id":"https://openalex.org/I194839184","display_name":"Liverpool School of Tropical Medicine","ror":"https://ror.org/03svjbs84","country_code":"GB","type":"funder","lineage":["https://openalex.org/I194839184"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Garazi Zulaika","raw_affiliation_strings":["Department of Clinical Sciences, Liverpool School of Tropical Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Clinical Sciences, Liverpool School of Tropical Medicine","institution_ids":["https://openalex.org/I194839184"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031007152","display_name":"David Obor","orcid":"https://orcid.org/0000-0002-2852-6368","observed_orcids":["https://orcid.org/0000-0002-2852-6368"]},"institutions":[{"id":"https://openalex.org/I79619799","display_name":"University of Birmingham","ror":"https://ror.org/03angcq70","country_code":"GB","type":"education","lineage":["https://openalex.org/I79619799"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"David Obor","raw_affiliation_strings":["Department Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham","Safe Water and AIDS Project"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham","institution_ids":["https://openalex.org/I79619799"]},{"raw_affiliation_string":"Safe Water and AIDS Project","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5085832275","display_name":"Anna Maria van Eijk","orcid":"https://orcid.org/0000-0003-1635-1289","observed_orcids":["https://orcid.org/0000-0003-1635-1289"]},"institutions":[{"id":"https://openalex.org/I194839184","display_name":"Liverpool School of Tropical Medicine","ror":"https://ror.org/03svjbs84","country_code":"GB","type":"funder","lineage":["https://openalex.org/I194839184"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Anna Maria van Eijk","raw_affiliation_strings":["Department of Clinical Sciences, Liverpool School of Tropical Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Clinical Sciences, Liverpool School of Tropical Medicine","institution_ids":["https://openalex.org/I194839184"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5052933652","display_name":"Kelvin Oruko","orcid":"https://orcid.org/0000-0001-7281-4036","observed_orcids":["https://orcid.org/0000-0001-7281-4036"]},"institutions":[{"id":"https://openalex.org/I116082035","display_name":"Kenya Medical Training College","ror":"https://ror.org/02ccxj712","country_code":"KE","type":"education","lineage":["https://openalex.org/I116082035"]},{"id":"https://openalex.org/I20581793","display_name":"University of Kent","ror":"https://ror.org/00xkeyj56","country_code":"GB","type":"education","lineage":["https://openalex.org/I20581793"]}],"countries":["GB","KE"],"is_corresponding":false,"raw_author_name":"Kelvin Oruko","raw_affiliation_strings":["Centre for Health Services Studies, University of Kent","Kenya Medical Training College"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Centre for Health Services Studies, University of Kent","institution_ids":["https://openalex.org/I20581793"]},{"raw_affiliation_string":"Kenya Medical Training College","institution_ids":["https://openalex.org/I116082035"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5064500926","display_name":"Sandra Y. Oketch","orcid":"https://orcid.org/0000-0002-7328-0301","observed_orcids":["https://orcid.org/0000-0002-7328-0301"]},"institutions":[{"id":"https://openalex.org/I2841861","display_name":"Kenya Medical Research Institute","ror":"https://ror.org/04r1cxt79","country_code":"KE","type":"facility","lineage":["https://openalex.org/I2841861"]}],"countries":["KE"],"is_corresponding":false,"raw_author_name":"Sandra Oketch","raw_affiliation_strings":["Centre for Global Health Research, Kenya Medical Research Institute"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Centre for Global Health Research, Kenya Medical Research Institute","institution_ids":["https://openalex.org/I2841861"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5025400594","display_name":"Penelope A. Phillips\u2010Howard","orcid":"https://orcid.org/0000-0003-1018-116X","observed_orcids":["https://orcid.org/0000-0003-1018-116X"]},"institutions":[{"id":"https://openalex.org/I194839184","display_name":"Liverpool School of Tropical Medicine","ror":"https://ror.org/03svjbs84","country_code":"GB","type":"funder","lineage":["https://openalex.org/I194839184"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Penelope A. Phillips-Howard","raw_affiliation_strings":["Department of Clinical Sciences, Liverpool School of Tropical Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Clinical Sciences, Liverpool School of Tropical Medicine","institution_ids":["https://openalex.org/I194839184"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5134930993","display_name":"Linda Mason","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I194839184","display_name":"Liverpool School of Tropical Medicine","ror":"https://ror.org/03svjbs84","country_code":"GB","type":"funder","lineage":["https://openalex.org/I194839184"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Linda Mason","raw_affiliation_strings":["Department of Clinical Sciences, Liverpool School of Tropical Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Clinical Sciences, Liverpool School of Tropical Medicine","institution_ids":["https://openalex.org/I194839184"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5134930993"],"corresponding_institution_ids":["https://openalex.org/I194839184"],"apc_list":{"value":2550,"currency":"CHF","value_usd":3077},"apc_paid":{"value":2550,"currency":"CHF","value_usd":3077},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.76549536,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"8","issue":null,"first_page":"1931799","last_page":"1931799"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12054","display_name":"Menstrual Health and Disorders","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12054","display_name":"Menstrual Health and Disorders","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10327","display_name":"Adolescent Sexual and Reproductive Health","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10960","display_name":"Hypothalamic control of reproductive hormones","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2743","display_name":"Reproductive Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/menstrual-health-and-hygiene","display_name":"menstrual health and hygiene","score":0.9940000176429749},{"id":"https://openalex.org/keywords/female-students","display_name":"female students","score":0.9710000157356262},{"id":"https://openalex.org/keywords/poverty","display_name":"poverty","score":0.5809999704360962},{"id":"https://openalex.org/keywords/menstrual-products","display_name":"menstrual products","score":0.5339999794960022},{"id":"https://openalex.org/keywords/school-absenteeism","display_name":"school absenteeism","score":0.8209999799728394},{"id":"https://openalex.org/keywords/psychosocial-distress","display_name":"psychosocial distress","score":0.8069999814033508},{"id":"https://openalex.org/keywords/transactional-sex","display_name":"transactional sex","score":0.8930000066757202},{"id":"https://openalex.org/keywords/teenage-pregnancy","display_name":"adolescent pregnancy","score":0.9850000143051147},{"id":"https://openalex.org/keywords/reproductive-tract-infections","display_name":"reproductive tract infections","score":0.9129999876022339},{"id":"https://openalex.org/keywords/educational-outcomes","display_name":"educational outcomes","score":0.6190000176429749},{"id":"https://openalex.org/keywords/western-kenya","display_name":"Western Kenya","score":0.40700000524520874}],"concepts":[{"id":"https://openalex.org/C150966472","wikidata":"https://www.wikidata.org/wiki/Q3410145","display_name":"Psychosocial","level":2,"score":0.6729999780654907},{"id":"https://openalex.org/C189326681","wikidata":"https://www.wikidata.org/wiki/Q10294","display_name":"Poverty","level":2,"score":0.6168000102043152},{"id":"https://openalex.org/C56995899","wikidata":"https://www.wikidata.org/wiki/Q1126687","display_name":"Focus group","level":2,"score":0.613099992275238},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5723999738693237},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.4982999861240387},{"id":"https://openalex.org/C139265228","wikidata":"https://www.wikidata.org/wiki/Q5283089","display_name":"Distress","level":2,"score":0.477400004863739},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.4496999979019165},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.4016999900341034},{"id":"https://openalex.org/C2780665704","wikidata":"https://www.wikidata.org/wiki/Q959298","display_name":"Intervention (counseling)","level":2,"score":0.39340001344680786},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.38909998536109924},{"id":"https://openalex.org/C2780137041","wikidata":"https://www.wikidata.org/wiki/Q7833728","display_name":"Transactional sex","level":4,"score":0.3736000061035156},{"id":"https://openalex.org/C121752807","wikidata":"https://www.wikidata.org/wiki/Q1981388","display_name":"Reproductive health","level":3,"score":0.3702999949455261},{"id":"https://openalex.org/C547646559","wikidata":"https://www.wikidata.org/wiki/Q162297","display_name":"Hygiene","level":2,"score":0.3517000079154968},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.3357999920845032},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.2935999929904938},{"id":"https://openalex.org/C147077947","wikidata":"https://www.wikidata.org/wiki/Q1515895","display_name":"Socioeconomic status","level":3,"score":0.290800005197525},{"id":"https://openalex.org/C2779771394","wikidata":"https://www.wikidata.org/wiki/Q12171","display_name":"Menstruation","level":2,"score":0.2892000079154968},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.28450000286102295},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.2827000021934509},{"id":"https://openalex.org/C87156501","wikidata":"https://www.wikidata.org/wiki/Q7268708","display_name":"Qualitative property","level":2,"score":0.2800000011920929},{"id":"https://openalex.org/C14262774","wikidata":"https://www.wikidata.org/wiki/Q4880695","display_name":"Behavior change","level":2,"score":0.26030001044273376},{"id":"https://openalex.org/C2776210078","wikidata":"https://www.wikidata.org/wiki/Q351870","display_name":"Reproductive medicine","level":3,"score":0.2540999948978424},{"id":"https://openalex.org/C46578552","wikidata":"https://www.wikidata.org/wiki/Q2725393","display_name":"Global health","level":3,"score":0.25290000438690186}],"mesh":[],"locations_count":5,"locations":[{"id":"doi:10.3389/frph.2026.1931799","doi":"https://doi.org/10.3389/frph.2026.1931799","is_oa":true,"landing_page_url":"https://doi.org/10.3389/frph.2026.1931799","pdf_url":"https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2026.1931799/pdf","source":{"id":"https://openalex.org/S4210207188","display_name":"Frontiers in Reproductive Health","issn_l":"2673-3153","issn":["2673-3153"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Reproductive Health","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13683675","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13683675/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13683675/pdf/frph-08-1931799.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Front Reprod Health","raw_type":"Text"},{"id":"pmid:42909003","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42909003","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in reproductive health","raw_type":"Journal Article"},{"id":"pmh:oai:kar.kent.ac.uk:116763","doi":null,"is_oa":true,"landing_page_url":"https://doi.org/10.3389/frph.2026.1931799>)","pdf_url":"https://kar.kent.ac.uk/116763/1/frph-8-1931799.pdf","source":{"id":"https://openalex.org/S4377196264","display_name":"Kent Academic Repository (University of Kent)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I20581793","host_organization_name":"University of Kent","host_organization_lineage":["https://openalex.org/I20581793"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":null,"raw_type":"Article"},{"id":"pmh:oai:doaj.org/article:298deabd83224a32be2e861c95e90cc6","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/298deabd83224a32be2e861c95e90cc6","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Reproductive Health, Vol 8 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/frph.2026.1931799","doi":"https://doi.org/10.3389/frph.2026.1931799","is_oa":true,"landing_page_url":"https://doi.org/10.3389/frph.2026.1931799","pdf_url":"https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2026.1931799/pdf","source":{"id":"https://openalex.org/S4210207188","display_name":"Frontiers in Reproductive Health","issn_l":"2673-3153","issn":["2673-3153"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Reproductive Health","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.98580002784729,"display_name":"Good health and well-being"},{"id":"https://metadata.un.org/sdg/10","score":0.7578999996185303,"display_name":"Reduced inequalities"},{"id":"https://metadata.un.org/sdg/1","score":0.666700005531311,"display_name":"No poverty"},{"id":"https://metadata.un.org/sdg/5","score":0.6025999784469604,"display_name":"Gender equality"}],"study_designs":[],"awards":[{"id":"https://openalex.org/G3203192429","display_name":"Menstrual solutions in adolescent schoolgirls in western Kenya: an acceptability, feasibility and safety study","funder_award_id":"G1100677/1","funder_id":"https://openalex.org/F4320334626","funder_display_name":"Medical Research Council"}],"funders":[{"id":"https://openalex.org/F4320311904","display_name":"Wellcome Trust","ror":"https://ror.org/029chgv08"},{"id":"https://openalex.org/F4320321637","display_name":"Department for International Development","ror":"https://ror.org/05rf29967"},{"id":"https://openalex.org/F4320334626","display_name":"Medical Research Council","ror":"https://ror.org/03x94j517"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7220835337.pdf","grobid_xml":"https://content.openalex.org/works/W7220835337.grobid-xml"},"referenced_works_count":49,"referenced_works":["https://openalex.org/W2046740816","https://openalex.org/W2066959016","https://openalex.org/W2079892063","https://openalex.org/W2092680858","https://openalex.org/W2104971230","https://openalex.org/W2112927998","https://openalex.org/W2152411858","https://openalex.org/W2286197293","https://openalex.org/W2292933427","https://openalex.org/W2556685222","https://openalex.org/W2565221974","https://openalex.org/W2588908018","https://openalex.org/W2734368707","https://openalex.org/W2781519879","https://openalex.org/W2890643375","https://openalex.org/W2905151409","https://openalex.org/W2911931621","https://openalex.org/W2946739594","https://openalex.org/W2955511150","https://openalex.org/W2996617870","https://openalex.org/W3023304184","https://openalex.org/W3105299322","https://openalex.org/W3173645721","https://openalex.org/W3196014129","https://openalex.org/W3209107648","https://openalex.org/W3216784913","https://openalex.org/W4200058602","https://openalex.org/W4210326405","https://openalex.org/W4221053078","https://openalex.org/W4285494868","https://openalex.org/W4286203333","https://openalex.org/W4301374107","https://openalex.org/W4378903454","https://openalex.org/W4385237352","https://openalex.org/W4385260446","https://openalex.org/W4386889529","https://openalex.org/W4387481106","https://openalex.org/W4389057647","https://openalex.org/W4389130310","https://openalex.org/W4396775763","https://openalex.org/W4399602035","https://openalex.org/W4401748709","https://openalex.org/W4402005050","https://openalex.org/W4404162437","https://openalex.org/W4407181989","https://openalex.org/W4408512322","https://openalex.org/W4410392593","https://openalex.org/W7154366432","https://openalex.org/W7167699362"],"related_works":["https://openalex.org/W7048739192","https://openalex.org/W2771095280","https://openalex.org/W4410546728","https://openalex.org/W7202286006","https://openalex.org/W7139843755","https://openalex.org/W7165774176","https://openalex.org/W7162016669","https://openalex.org/W4396540585","https://openalex.org/W3093800823","https://openalex.org/W4377087915"],"abstract_inverted_index":{"Background:":[0],"Poor":[1,159],"menstrual":[2,74,131,133,193,195,211],"health":[3,11,24,77],"and":[4,16,25,62,76,78,89,122,151,197,213,243,268],"hygiene":[5],"(MHH)":[6],"is":[7,284],"a":[8,37,92,253,285],"global":[9],"public":[10],"concern,":[12],"particularly":[13],"in":[14,22,41,234,281,295],"low-":[15],"middle-income":[17],"countries.":[18],"It":[19],"can":[20],"result":[21],"adverse":[23],"educational":[26,79,142,189,207],"impacts.":[27],"Narratives":[28],"from":[29,96,180],"baseline":[30],"focus":[31],"group":[32],"discussions":[33],"(FGDs)":[34],"conducted":[35],"during":[36],"pilot":[38],"intervention":[39],"study":[40],"rural":[42],"western":[43],"Kenya":[44],"were":[45,65,87,162,249],"explored":[46],"to":[47,68,114,171,187,205,246,251],"reveal":[48],"perceived":[49,70,84,164,239,261,278,292],"associations.":[50],"Methods:":[51],"Transcripts":[52],"of":[53,94,119,126,225,304],"19":[54],"FGDs":[55],"involving":[56],"87":[57],"post-menarche":[58],"schoolgirls,":[59],"47":[60],"parents,":[61],"46":[63],"teachers":[64],"analysed":[66],"thematically":[67],"identify":[69],"causal":[71,100,256],"links":[72],"between":[73],"issues":[75],"outcomes.":[80,174],"Quotes":[81],"illustrating":[82],"these":[83],"cause-and-effect":[85],"relationships":[86],"logged":[88],"synthesised":[90],"into":[91],"series":[93],"pathways,":[95],"which":[97],"an":[98,247],"overarching":[99],"pathway":[101,183,201,217],"model":[102],"was":[103,263],"produced.":[104],"Results:":[105],"Poverty":[106],"underpinned":[107],"poor":[108,141,188,206,244,300],"MHH,":[109,301],"characterised":[110],"by":[111],"the":[112,117,123,223,277,296],"inability":[113],"afford":[115],"products,":[116,121],"use":[118,125,224],"inadequate":[120,192,210,226,231],"prolonged":[124],"products.":[127],"Key":[128],"outcomes":[129,143,161,190,208],"included":[130],"issues,":[132],"accidents":[134],"(e.g.,":[135,139,144,153],"leaking),":[136],"psychosocial":[137,198],"distress":[138],"humiliation),":[140],"school":[145,264,269],"absence),":[146],"transactional":[147,235],"sex,":[148],"adolescent":[149],"pregnancy,":[150],"infections":[152,221],"localised":[154],"or":[155,167],"reproductive":[156],"tract":[157],"infections).":[158],"MHH":[160,245],"often":[163],"as":[165,299],"\"nodes\"":[166],"drivers":[168],"that":[169],"led":[170,186,204],"further":[172],"distal":[173],"Four":[175,238],"pathways":[176,240],"emerged,":[177],"all":[178],"stemming":[179],"poverty.":[181],"In":[182,200,216,228],"1,":[184],"poverty":[185,203,219,242],"via":[191,209],"materials,":[194],"accidents,":[196],"stress.":[199],"2,":[202],"materials":[212,232],"physical":[214],"discomfort.":[215],"3,":[218],"caused":[220],"through":[222],"materials.":[227],"Pathway":[229],"4,":[230],"resulted":[233],"sex.":[236],"Conclusion:":[237],"linking":[241],"endpoint":[248],"used":[250],"develop":[252],"single":[254],"overall":[255],"pathway.":[257],"The":[258],"most":[259],"frequently":[260],"outcome":[262],"absence,":[265],"with":[266],"pregnancy":[267],"dropout":[270],"noted":[271],"much":[272],"less":[273],"frequently.":[274],"As":[275],"poverty,":[276],"underlying":[279],"cause":[280],"this":[282],"pathway,":[283,297],"complex":[286],"target,":[287],"focusing":[288],"interventions":[289],"on":[290],"proximal":[291],"key":[293],"nodes":[294],"such":[298],"would":[302],"be":[303],"value.":[305]},"counts_by_year":[],"updated_date":"2026-10-30T12:39:25.321706","created_date":"2026-10-08T00:00:00"}