Welcome to the INSPIRES study website

Investigating a reusable Sanitary Pad Intervention in a Rural Educational Setting

The INSPIRES study was a partial preference, parallel group, cluster randomised controlled pilot study conducted in Kenyan schools in Summer 2011. The study was funded and run by the Irise charity.

Who are Irise?

Irise is a charity run by students and graduates from the University of Sheffield. The charity was set up following concerns and stories of African women and girls. Evaluations in Kenya found that many women and girls have problems affording sanitary towels and suffer from unhygienic conditions and humiliation as a result.

Irise is supported by the School of Health and Related Research (ScHARR) and other individuals.

Why did the study take place?

Problems adequately managing menstruation have been identified in women and girls from sub-Saharan Africa and South Asia and are thought to hinder educational development through increased school absenteeism. Women from these poor areas can seldom afford to buy manufactured menstruation products, resulting in decreased school attendance, humiliation, and the inability to carry out some daily activities.

Despite growing concern about problems with menstruation for women and girls in Kenya, there was still very little known about the scale of the issue. A potential solution, the Mwezi sanitary towel, had been developed but was still underused and not well tested.

The aims of the study were:

  • to assess the scale of the impact of menstruation on school attendance in Nyaza province, Kenya
  • to evaluate the acceptability and short-term impact of teaching Kenyan schoolgirls how to make a reuseable sanitary product
  • to assess the feasibility of conducting a full-scale cluster randomised controlled trial in this setting.

What did the study involve?

The INSPIRES trial was a partial preference, parallel group, cluster randomised controlled pilot trial taking place in 10 schools. Five of these schools were randomised to the intervention arm and five were randomised to the control arm. Thirty girls from each school took part in the trial; those in the intervention arm were taught to make Mwezi sanitary pads, while those in the control arm were not. In total 302 girls participated in the trial.

Schools were followed up 1 month after the first visit, and questionnaires were completed at both baseline and follow-up for both arms.

The primary endpoint was the number of days of school missed in the last 4 weeks. Secondary endpoints included the proportion of days missed in the last 4 weeks, and quality of life measures. As the study was a pilot study it also served to obtain an estimate of the intra-cluster correlation for the endpoints in this region.

What were the main results?

The study found that girls that were taught to make Mwezi sanitary towels missed an average of 1.48 fewer days of school per month than girls that were not taught to make them (p=0.077).

For more detailed results please see the INSPIRES executive summary or the full report in the Links section on the right of this page.

INSPIRES Team


Name Location Email Role
Emily F Wilson School of Medicine and Biomedical Sciences, University of Sheffield irise.int@gmail.com Chief Investigator
Josephine M K Reeve School of Medicine and Biomedical Sciences, University of Sheffield irise.int@gmail.com Principal Investigator
Alice H Pitt School of Medicine and Biomedical Sciences, University of Sheffield irise.int@gmail.com Principal Investigator
Benjamin G O Sully School of Health and Related Research, University of Sheffield b.g.sully@sheffield.ac.uk Statistician
Dr Steven A Julious School of Health and Related Research, University of Sheffield s.a.julious@sheffield.ac.uk Senior Statistician
Victoria Ramsden School of Medicine and Biomedical Sciences, University of Sheffield irise.int@gmail.com Research Assistant
Nicola Fitzgerald School of Medicine and Biomedical Sciences, University of Sheffield irise.int@gmail.com Research Assistant
Kirsten Thompson School of Medicine and Biomedical Sciences, University of Sheffield irise.int@gmail.com Research Assistant
Kate Hargreaves School of Medicine and Biomedical Sciences, University of Sheffield irise.int@gmail.com Research Assistant
Sophie Dickinson School of Medicine and Biomedical Sciences, University of Sheffield irise.int@gmail.com Research Assistant
Louise Tyson School of Medicine and Biomedical Sciences, University of Sheffield irise.int@gmail.com Research Assistant