An Exploratory Systematic Review and Meta-analysis on Period Poverty

BackgroundPeriod poverty is a global health and social issue that needs to be addressed. The primary aim of this study was to provide a comprehensive understanding on period poverty, including outcomes associated menstruation. MethodsAll observational and randomised clinical trials reporting menstruation challenges, menstrual poverty and menstrual products were included. Our search strategy included multiple electronic databases of PubMed, Web of Science, ScienceDirect, ProQuest and EMBASE. Studies published in a peer review journal in English between the 30th of April 1980 and the 30th of April 2022 were included. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias (RoB) of the systematic included studies. Pooled odds ratios (ORs) together with 95% confidence intervals (CIs) are reported overall and for sub-groups. ResultsA total of 80 studies were systematically selected, where 38 were included in the meta-analysis. Of the 38 studies, 28 focused on children and young girls (i.e., 10-24 years old) and 10 included participants with a wider age range of 15-49 years. The prevalence of using disposable sanitary pads was 45% (95% CI = [0.35,0.58]). The prevalence of menstrual education pre-menarche was 68% (95% CI = [0.56, 0.82]). The prevalence of good MHM was 39% (95% CI = [0.25, 0.61]). Women in rural area (OR = 0.30, 95% CI = [0.13, 0.69]) were 0.70 times less likely to have good MHM practices than those living in urban area. DiscussionThere was a lack of evidence, especially from low- and middle-income countries. Further research to better understand the scope and prevalence of period poverty should be considered. This will enable the development of improved policies to increase access to menstrual products and medical support where necessary. FundingNot Applicable RegistrationA systematic methodology was developed and published (CRD42022339536).