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This study describes women’s menstrual health needs at work in Uganda and explores the associations between unmet needs and women’s work and wellbeing. We undertook a cross-sectional survey of women working in marketplaces, public primary schools, and health care facilities in Mukono district, central Uganda. Survey questions were designed to capture women’s experiences of managing menstrual bleeding, pain, social support, and the social environment. A total 435 women working in markets, 45 teachers and 45 health care facility workers participated. Of these, 15% missed work due to their last period, and 41% would prefer not to work during menstruation. Unmet menstrual health needs were associated with consequences for women’s work and psychological wellbeing. Experiencing menstrual pain (aPR 3.65 95%CI 1.48–9.00), along with the use of improvised menstrual materials (aPR 1.41 95%CI 1.08–1.83), not feeling comfortable to discuss menstruation at work (aPR 1.54 95%CI 1.01–2.34) and the expectation that women should stay home when menstruating (aPR 2.44 95%CI 1.30–4.60) were associated with absenteeism due to menstruation. In contrast, not having menstrual management needs met (aPR 1.45 95%CI 1.17–1.79) and the attitude that menstruating women are dirty (aPR 1.94 95%CI 1.50–2.51), along with pain (aPR 1.59 95%CI 1.12–2.24) and norms around absenteeism were associated with wanting to miss work. After adjustment for age and poverty, unmet menstrual management needs (b = -5.97, 95%CI -8.89, -2.97), pain (b = -3.89, 95%CI -7.71, -0.08) and poor social support (b = -5.40, 95%CI -9.22, -1.57) were associated with lower wellbeing measured using the WHO-5. Attitudes that menstruation should be kept secret (b = 4.48, 95%CI 0.79, 8.17) and is dirty (b = 4.59, 95%CI 0.79, 8.40) were associated with higher wellbeing. Findings suggest that supporting care for menstrual pain, addressing secrecy surrounding menstruation and the perception of menstruation as dirty, and improving access to materials and facilities for managing menstrual bleeding are avenues for programs and policies to support working women.

Hepatitis B Virus (HBV) infection remains a significant global public health challenge especially in low-and-middle income countries. Although there are significant global and national efforts to control Hepatitis B, equitable distribution and access to prevention services such as testing and vaccination remains a challenge. Efforts to increase access are hindered by inadequate evidence on the availability and distribution of HBV services. This cross-sectional study aimed at generating evidence of the distribution of HBV prevention services in Wakiso District, Uganda. A total of 55 healthcare facilities (HCFs) including 4 hospitals, and 51 primary care facilities were surveyed. Data were collected using an electronic structured questionnaire and analysed using STATA 14.0. A chi-square test was performed to establish the relationship between HCF characteristics and the availability of hepatitis B services. ArcGIS (version 10.1) was used to generate maps to illustrate the distribution of hepatitis B prevention services. We found out that the hepatitis B vaccine was available in only 27.3% (15) of the HCF, and 60% (33) had testing services. Receipt of the hepatitis B vaccine doses in the last 12 months was associated with the level (p = ≤0.001) and location (p = 0.030) of HCF. Availability of the hepatitis B vaccine at the time of the survey was associated with the level (p = 0.002) and location (p = 0.010) of HCF. The availability of hepatitis B testing services was associated with the level (p = 0.031), ownership (p≤0.001) and location (p = 0.010) of HCF. HCFs offering vaccination and testing services were mostly in urban areas, and close to Kampala, Uganda's capital. Based on this study, hepatitis B prevention services were sub-optimal across all HCF levels, locations, and ownership. There is a need to extend hepatitis B prevention services to rural, public and private-not-for-profit HCFs.

This study describes women's menstrual health needs at work in Uganda and explores the associations between unmet needs and women's work and wellbeing. We undertook a cross-sectional survey of women working in marketplaces, public primary schools, and health care facilities in Mukono district, central Uganda. Survey questions were designed to capture women's experiences of managing menstrual bleeding, pain, social support, and the social environment. A total 435 women working in markets, 45 teachers and 45 health care facility workers participated. Of these, 15% missed work due to their last period, and 41% would prefer not to work during menstruation. Unmet menstrual health needs were associated with consequences for women's work and psychological wellbeing. Experiencing menstrual pain (aPR 3.65 95%CI 1.48-9.00), along with the use of improvised menstrual materials (aPR 1.41 95%CI 1.08-1.83), not feeling comfortable to discuss menstruation at work (aPR 1.54 95%CI 1.01-2.34) and the expectation that women should stay home when menstruating (aPR 2.44 95%CI 1.30-4.60) were associated with absenteeism due to menstruation. In contrast, not having menstrual management needs met (aPR 1.45 95%CI 1.17-1.79) and the attitude that menstruating women are dirty (aPR 1.94 95%CI 1.50-2.51), along with pain (aPR 1.59 95%CI 1.12-2.24) and norms around absenteeism were associated with wanting to miss work. After adjustment for age and poverty, unmet menstrual management needs (b = -5.97, 95%CI -8.89, -2.97), pain (b = -3.89, 95%CI -7.71, -0.08) and poor social support (b = -5.40, 95%CI -9.22, -1.57) were associated with lower wellbeing measured using the WHO-5. Attitudes that menstruation should be kept secret (b = 4.48, 95%CI 0.79, 8.17) and is dirty (b = 4.59, 95%CI 0.79, 8.40) were associated with higher wellbeing. Findings suggest that supporting care for menstrual pain, addressing secrecy surrounding menstruation and the perception of menstruation as dirty, and improving access to materials and facilities for managing menstrual bleeding are avenues for programs and policies to support working women.