Wood, Shannon N.Milkovich, RachelThiongo, MaryByrne, Meagan E.Devoto, BiancaWamue-Ngare, GraceDecker, Michele R.Gichangi, Peter2023-08-072023-08-072022Wood, S. N., Milkovich, R., Thiongo, M., Byrne, M. E., Devoto, B., Wamue-Ngare, G., ... & Gichangi, P. (2022). Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya. EClinicalMedicine, 49.https://doi.org/10.1016/j. eclinm.2022.101482http://ir-library.ku.ac.ke/handle/123456789/26604article(AGYW). Among AGYW in Nairobi, Kenya, this prospective mixed-methods study characterised menstrual health product-access challenges at two time points during the COVID-19 pandemic; assessed trajectories over the pandemic; and examined factors associated with product-access trajectories. Methods Data were collected from an AGYW cohort in August−October 2020 and March−June 2021 (n=591). The prevalence of menstrual health product-access challenges was calculated per timepoint, with trajectories characterizing product-access challenges over time. Logistic regression models examined associations with any product-access challenge throughout the pandemic; multinomial and logistic regressions further assessed factors associated with trajectories. Qualitative data contextualize results. Findings In 2020, 52¢0% of AGYW experienced a menstrual health product-access challenge; approximately six months later, this proportion dropped to 30¢3%. Product-access challenges during the pandemic were heightened for AGYW with secondary or lower education (aOR=2¢40; p<0¢001), living with parents (aOR=1¢86; p=0¢05), not the prime earner (aOR=2¢27; p=0¢05); and unable to meet their basic needs (aOR=2¢25; p<0¢001). Between timepoints, 38¢0% experienced no product-access challenge and 31¢7% resolved, however, 10¢2% acquired a challenge and 20¢1% experienced sustained challenges. Acquired product-access challenges, compared to no challenges, were concentrated among those living with parents (aOR=3¢21; p=0¢05); multinomial models further elucidated nuances. Qualitative data indicate deprioritization of menstrual health within household budgets as a contributor. Interpretation Menstrual health product-access challenges are prevalent among AGYW during the pandemic; barriers were primarily financial. Results may reflect endemic product-access gaps amplified by COVID-specific constraints. Ensuring access to menstrual products is essential to ensure AGYW’s health needs.enMenstrual healthCOVID-19Adolescent girls and young womenKenyaArticle