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BackgroundResearch on menstrual health is required to understand the needs of girls, women, and others who menstruate; and to strengthen programmes with evidence-based interventions to improve health, wellbeing, and productivity. The identification of research priorities is an important process to help researchers, policymakers, programmers, and funding agencies decide where to invest their efforts and resources.MethodsA modified version of the Child Health and Nutrition Research Initiative (CHNRI) approach was utilized to reach consensus on a set of research priority questions. Multisector stakeholders with expertise in policy, programming, financial support, and/or research relating to menstrual health were identified through networks and the literature. Individuals were invited to submit priority questions through survey monkey online on i) understanding the problem; ii) designing and implementing interventions; iii) integrating and scaling up interventions. Responses were consolidated and individuals were then invited to rank these questions based on i) novelty; ii) potential for intervention; and iii) importance/impact. Research priority scores were calculated from these responses and analyzed to evaluate associations with social and occupational characteristics of participating respondents.ResultsEighty-two participants, of whom 89% were female and 39.0% from low- and middle-income countries (LMIC), proposed a total of 1135 research questions: 45.9% on understanding the problem, 39.7% on designing and implementing interventions, 12.7% on integrating and scale-up, plus 1.5% on other aspects. Questions were consolidated into a final list of 91 unique research questions. Sixty-six participants, of whom 80.3% were women and 39.4% from LMIC, ranked these questions. Top ten-ranked research priority questions comprised four questions on ‘understanding the problem’, four on ‘designing and implementing interventions’, one on ‘integrating and scaling up’, and one on ‘measurement and research’. Academics gave higher prioritization to ‘designing and implementing interventions,’ and lower prioritization to questions on ‘understanding the problem,’ ‘integrating and scaling up,’ and ‘measurement and research.ConclusionsUse of CHNRI generated unique research priority questions from expertise internationally. The top-ranking research priorities can be utilized by policymakers, programmers, researchers, and funders to guide future research in menstrual health.

To determine the prevalence of malaria and anaemia among urban and peri-urban women attending their first antenatal clinic (ANC) in an area of perennial malaria transmission.Between November 2003 and May 2004 we screened first ANC attenders for malaria and anaemia in a large urban hospital in Kisumu (western Kenya) and interviewed them to obtain demographic and medical information.Among the 685 study participants, prevalence of malaria parasitaemia was 18.0%, prevalence of any anaemia (haemoglobin11 g/dl) was 69.1% and prevalence of moderate anaemia was (haemoglobin8 g/dl) 11.8%. Sixteen women were hospitalized during pregnancy, eight because of malaria. In multivariate analysis, young age, living in a house with mud walls, a visit to rural area, peri-urban residence, second trimester of pregnancy and Luo ethnicity were significant risk factors for malaria parasitaemia. Malaria was an important risk factor for any and moderate anaemia; use of an insecticide-treated net (ITN) was a protective factor for any anaemia. Married women with a higher level of education, better-quality housing and full-time employment were more likely to use an ITN.Malaria and anaemia are established problems by the time of the first ANC visit. Mechanisms to deliver ITNs to women of child-bearing age before they become pregnant need to be explored. Early ANC visits are warranted in order for women to benefit from policies aimed at reducing the burden of malaria and anaemia.

To evaluate the effect of routine antenatal haematinic supplementation programmes and intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP) in Kenya.Anaemia [haemoglobin (Hb)11 g/dl), severe anaemia (Hb8 g/dl) and placental malaria were compared among women with known HIV status who delivered at a provincial hospital after study enrolment in the third trimester during three consecutive periods: period 1, no routine intervention (reference); period 2, routine haematinic supplementation (60 mg elementary iron three times/day, folic acid 5 mg once daily) and period 3, haematinics and IPT with SP.Among 3108 participants, prevalence of placental malaria, anaemia and severe anaemia postpartum was 16.7%, 53.6% and 12.7%, respectively. Compared with period 1, women in period 2 were less anaemic [adjusted odds ratio (AOR), 95% confidence interval anaemia: 0.56, 0.47-0.67; severe anaemia 0.37, 0.28-0.49] and shared a similar prevalence of placental malaria (AOR 1.07, 0.86-1.32). Women in period 3 were also less anaemic (AOR anaemia: 0.43, 0.35-0.53 and severe anaemia: 0.43, 0.31-0.59), and had less placental malaria (AOR 0.56, 0.42-0.73). The effect of intervention did not differ significantly by HIV status.The haematinic supplementation programme was associated with significant reductions in anaemia in HIV-seropositive and HIV-seronegative women. The subsequent introduction of IPT was associated with halving of malaria, but no additional haematological benefit over haematinics.