Protocol for the Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study in Khulna, Bangladesh: A Prospective cohort to quantify the influence of menstrual health on adolescent girls’ health and education outcomes.
Peter Azzopardi,
Sabina Faiz Rashid,
Helen Anne Weiss,
Md Tanvir Hasan,
Julie Hennegan,
G J Melendez-Torres,
Adrita Kaiser,
Kyu Kyu Than,
Nick Scott,
Sonia Grover,
Abdul Jabbar,
Mahfuj-ur Rahman,
Thin Mar Win,
Tasfiyah Jalil,
Elissa Kennedy,
Erin Hunter,
Sabina Akter,
Afreen Zaman,
Laura Dunstan,
Alexandra Head,
Chad L Hughes,
Mahadi Hasan
Affiliations
Peter Azzopardi
National Centre for Indigenous Genomics, Australian National University, Canberra, Australian Capital Territory, Australia
Sabina Faiz Rashid
BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
Helen Anne Weiss
MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
Md Tanvir Hasan
BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
Julie Hennegan
Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
G J Melendez-Torres
Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
Adrita Kaiser
BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
Kyu Kyu Than
Myanmar Country Program, Burnet Institute, Yangon, Myanmar
Nick Scott
Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
Sonia Grover
Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
Abdul Jabbar
BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
Mahfuj-ur Rahman
WaterAid Bangladesh, Dhaka, Bangladesh
Thin Mar Win
Myanmar Country Program, Burnet Institute, Yangon, Myanmar
Tasfiyah Jalil
BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
Elissa Kennedy
Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
Erin Hunter
Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
Sabina Akter
BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
Afreen Zaman
BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
Laura Dunstan
Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
Alexandra Head
Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
Chad L Hughes
Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
Background Menstrual health is essential for gender equity and the well-being of women and girls. Qualitative research has described the burden of poor menstrual health on health and education; however, these impacts have not been quantified, curtailing investment. The Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study aims to describe menstrual health and its trajectories across adolescence, and quantify the relationships between menstrual health and girls’ health and education in Khulna, Bangladesh.Methods and analysis AMEHC is a prospective longitudinal cohort of 2016 adolescent girls recruited at the commencement of class 6 (secondary school, mean age=12) across 101 schools selected through a proportional random sampling approach. Each year, the cohort will be asked to complete a survey capturing (1) girls’ menstrual health and experiences, (2) support for menstrual health, and (3) health and education outcomes. Survey questions were refined through qualitative research, cognitive interviews and pilot survey in the year preceding the cohort. Girls’ guardians will be surveyed at baseline and wave 2 to capture their perspectives and household demographics. Annual assessments will capture schools’ water, sanitation and hygiene, and support for menstruation and collect data on participants’ education, including school attendance and performance (in maths, literacy). Cohort enrolment and baseline survey commenced in February 2023. Follow-up waves are scheduled for 2024, 2025 and 2026, with plans for extension. A nested subcohort will follow 406 post-menarche girls at 2-month intervals throughout 2023 (May, August, October) to describe changes across menstrual periods. This protocol outlines a priori hypotheses regarding the impacts of menstrual health to be tested through the cohort.Ethics and dissemination AMEHC has ethical approval from the Alfred Hospital Ethics Committee (369/22) and BRAC James P Grant School of Public Health Institutional Review Board (IRB-06 July 22-024). Study materials and outputs will be available open access through peer-reviewed publication and study web pages.
