Prevalence of unmet menstrual hygiene management needs among women employees in shopping arcades in Kampala Central Division

Abstract

Introduction: Menstruation in a workplace remains underestimated in explorations of occupational health and entire public health literature despite presenting a burden at work. For working women, menstrual challenges have critical implications for their health, well-being, and economic outcomes. In Uganda, it has caused some women to miss work and lose income. Furthermore, research in Kampala arcades has indicated poor sanitation facilities mainly due to high demand of available public toilets further suggesting that women employees in arcades are potentially more at risk of not meeting their MHM needs. Objective: This study sought to establish the prevalence and factors associated with unmet MHM needs of women employees in arcades in Kampala central division. Methods: This was a cross sectional study that involved systematic sampling of shops in selected arcades and one participant was randomly selected per shop. Structured questionnaires were loaded on kobo collect data collection tool and were interviewer administered. Observation checklists were used to assess the status of WASH facilities. The outcome variable was unmet MHM needs; women with unmet MHM needs were coded 1 and 0 for those that had met MHM. Analysis was done using modified poison regression to attain factors associated with unmet MHM needs. Variables with a p-value < 0.05 and those known to be important from literature were considered in the final model. Results: A total of 416 women employees in arcades participated in the study. Of these, 42.5% (177/416) had unmet MHM needs. Majority of the women used disposable sanitary pads 87.7% (365/416). Of which 73.7% (269/365) changed their materials from the toilet and 69.9% (255/365) disposed them into the latrines at home. Majority of the toilet facilities 90% (157/174) in arcades met the basic WASH standards for MHM. Having medium [APR: 5.52, 95% CI: 1.56, 6.49] and high lived poverty [APR: 4.83, 95% CI: 1.12, 5.84], and making three or more calls [APR: 3.28, 95% CI: 1.01, 4.62] to the sanitation facilities were associated with having more unmet MHM needs. However, having positive attitudes such as: Agreeing that women should purchase food from a menstruating woman [APR: 0.04, 95% CI: 0.003, 0.09], Disagreeing with a belief that “women should avoid working during menstruation” [APR: 0.17, 95% CI: 0.16, 0.92], and peer support [APR: 0.44, 95% CI: 0.21, 0.92] were associated with reduced unmet MHM needs at multivariable level. Conclusion: Overall prevalence of unmet MHM needs was 42.5%. Female employees depended upon workplace social networks to facilitate MHM. Strategies to improve MHM may be more effective if they enhance positive attitudes towards MHM among older menstruating females and those financially constrained. Intervention might also be effective if focused on peer support.