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García-Egea A, López-Jiménez T, Jacques-Aviñó C, Morero Beltrán AM, Pi Sánchez A, Martínez-Bueno C, Carrilero-Carrió N, Berenguera A, Medina-Perucha L. [Menstrual experiences and acceptability of a menstrual equity intervention among adolescents in Catalonia (Spain)]. GACETA SANITARIA 2024; 38:102415. [PMID: 39047371 DOI: 10.1016/j.gaceta.2024.102415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To explore menstrual knowledge, menstrual management, the use of menstrual products, the prevalence of menstrual poverty and to assess the acceptability of a menstrual equity intervention among students in the fourth grade of compulsory secondary education in Catalonia (Spain). METHOD Post-intervention mixed-methods study (cross-sectional study and qualitative study with focus groups) with a critical and gender perspective. It was conducted between July 2022 and March 2023. Descriptive and bivariate statistical analyses stratified by gender were carried out. Qualitative data were analysed using thematic analysis. RESULTS Women and people who menstruate rated the intervention favourably, while some men were reluctant. The intervention promoted the use of some reusable menstrual products, although some barriers to use menstrual cups were identified. Participants reported institutional barriers to menstrual management in the school setting and 19.4% stopped attending school during menstruation in the 6 months prior to the study. Between 10.9-16.4% reported menstrual poverty in the 6 months prior to the study, and 29,0% took actions to reduce the environmental impact of menstrual products. CONCLUSIONS This study highlights the need for co-designing menstrual interventions that consider gender dynamics and sexist attitudes with students, as well as targeting it to teachers. The provision of reusable menstrual products can be helpful in promoting their use, although accompaniment should be provided. In parallel, it is crucial to strengthen menstrual education, as well as to reduce menstrual poverty and school absenteeism during menstruation.
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Affiliation(s)
- Andrea García-Egea
- Fundació Institut Universitari per a la Recerca a l'Atenció Primária de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Universitat Autónoma de Barcelona, Bellaterra (Cerdanyola del Vallès, Barcelona), España
| | - Tomàs López-Jiménez
- Fundació Institut Universitari per a la Recerca a l'Atenció Primária de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Universitat Autónoma de Barcelona, Bellaterra (Cerdanyola del Vallès, Barcelona), España
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la Recerca a l'Atenció Primária de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Universitat Autónoma de Barcelona, Bellaterra (Cerdanyola del Vallès, Barcelona), España; Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), España
| | - Anna María Morero Beltrán
- Departament d'Igualtat i Feminismes, Generalitat de Catalunya, Barcelona, España; Departament de Sociologia, Universitat de Barcelona, Barcelona, España
| | - Aina Pi Sánchez
- Servei d'Atenció a la Salut Sexual i Reproductiva (ASSIR), Direcció Assistencial d'Atenció Primària, Institut Català de la Salut, Barcelona, España
| | - Cristina Martínez-Bueno
- Grup de Recerca de l'Atenció a la Salut Sexual i Reproductiva (GRASSIR), Barcelona, España; Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, España; Grup de Recerca en Atenció Primària i Comunitària en Barcelona (APICBA), Hospital del Mar Research Institute, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España
| | - Neus Carrilero-Carrió
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), España; Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, España; Grup de Recerca en Atenció Primària i Comunitària en Barcelona (APICBA), Hospital del Mar Research Institute, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España
| | - Anna Berenguera
- Fundació Institut Universitari per a la Recerca a l'Atenció Primária de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Universitat Autónoma de Barcelona, Bellaterra (Cerdanyola del Vallès, Barcelona), España; Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), España; Departament d'Infermeria, Universitat de Girona, Girona, España
| | - Laura Medina-Perucha
- Fundació Institut Universitari per a la Recerca a l'Atenció Primária de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Universitat Autónoma de Barcelona, Bellaterra (Cerdanyola del Vallès, Barcelona), España; Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), España.
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Medina-Perucha L, Jacques-Aviñó C. [Menstrual health, equity and justice: collective knowledge and menstrual policymaking in Spain]. GACETA SANITARIA 2024; 38:S0213-9111(24)00003-7. [PMID: 38350394 DOI: 10.1016/j.gaceta.2024.102356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/06/2023] [Accepted: 11/22/2023] [Indexed: 02/15/2024]
Affiliation(s)
- Laura Medina-Perucha
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès (Barcelona), España; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), España.
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès (Barcelona), España; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), España
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García-Egea A, Holst AS, Jacques-Aviñó C, Martínez-Bueno C, Berenguera A, Vicente-Hernández MM, Valls-Llobet C, Pinzón-Sanabria D, Pujolar-Díaz G, Medina-Perucha L. Perspectives on menstrual policymaking and community-based actions in Catalonia (Spain): a qualitative study. Reprod Health 2024; 21:1. [PMID: 38178256 PMCID: PMC10768382 DOI: 10.1186/s12978-023-01730-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Menstrual research and policymaking have become imperative worldwide. It is necessary that these are informed by women and people who menstruate (PWM) alongside expert professionals and activists. METHODS The main aim of this study was to identify and propose policies and community-based actions to address menstrual inequity and promote menstrual health in Catalonia (Spain). This study consisted of two qualitative studies: (a) 34 individual photoelicitation interviews with women and PWM, (b) a World Café study with 22 professionals and activists. Sampling for both studies was purposive and selective. Recruitment was conducted through healthcare centres, social media, key contacts, and snowball sampling techniques. Data were collected in December 2020-September 2022, and analysed using Framework Analysis. RESULTS Participants considered the implementation of menstrual policies that address the taboo and stigma of menstruation to be crucial. They stressed the need for menstrual education, which should be integrated into formal education curricula. Participants, and especially women and PWM, highlighted the need to improve the access and quality of healthcare services, so that the menstrual cycle and menstruation are seen as health indicators. Health professionals should encourage agentic informed decisions, hence why both participant groups considered menstrual health education amongst health professionals to be pivotal. Taking action to improve the access and affordability of menstrual products was also imperative for participants, especially for socioeconomically vulnerable populations. Participants agreed on guaranteeing fully equipped menstrual management facilities, and and professionals discussed gender-neutral and sex-segregated bathrooms. Workplace menstrual policies to accommodate and ensure menstrual self-care were also suggested. CONCLUSIONS Our study highlights the need for multi-dimensional menstrual policies. These should include actions to address menstrual taboo and stigma, to promote menstrual education that goes beyond the hegemonic biomedical prism, to improve the access and quality of menstrual health services, along with policies ensuring adequate menstrual management facilities in public spaces and the access to menstrual products. Policymaking should also focus on how to ensure menstrual management and care in workplaces. Menstrual policies and community-based actions should be framed within intersectionality, to consider how societal structures of power and oppression influence menstrual experiences.
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Affiliation(s)
- Andrea García-Egea
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Anna Sofie Holst
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - Cristina Martínez-Bueno
- Servei d'Atenció a la Salut Sexual i Reproductiva (ASSIR), Direcció Assistencial d'Atenció Primària, Institut Català de la Salut, Barcelona, Spain
- Sexual and Reproductive Health Care Research Group (GRASSIR), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Anna Berenguera
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Departament d'Infermeria, Universitat de Girona, Girona, Spain
| | | | | | | | - Georgina Pujolar-Díaz
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Laura Medina-Perucha
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain.
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