{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:01:20Z","timestamp":1790874080908,"version":"4.1.0"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T00:00:00Z","timestamp":1728259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>This study investigates the prevalence of the use of reusable menstrual materials in LMICs, examines differences in prevalence between countries and areas, and identifies individual and country-level factors associated with their use.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Data from Multiple Indicator Cluster surveys conducted between 2017 and 2020 in LMICs were used. Prevalence estimates and 95% CIs were calculated for overall, rural, and urban areas. Multivariable logistic regression was used to identify individual and country-level factors associated with the use of reusable menstrual materials.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The study included 42 surveys from LMICs, with 1653850 weighted women and girls aged 15\u201349 years. The overall prevalence of the use of reusable menstrual materials was 12.1% (95% CI 12.1\u201312.2), with significant variation between and within countries, ranging from 0.5% (0.3\u20130.8) in Serbia to 97.2% (96.5\u201397.9) in Sao Tome and Principe. The prevalence was higher in rural areas (23.9% [23.8\u201324.0]) than in urban areas (6.2% [6.2\u20136.2]), with significant differences between most countries. Use of reusable menstrual materials was associated with lower education levels, being married, low economic status, living in Asia and Africa, living in countries with lower GDP, living in rural areas, and limited availability of private places to wash menstrual materials. The prevalence of the use of reusable menstrual materials had an inverse linear relationship with the country\u2019s GDP.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The study found that the use of reusable menstrual materials is more prevalent among women and girls in rural areas, those with lower education levels, lower economic status, and those living in countries with lower GDP. Given these disparities, policies and initiatives targeted at improving menstrual health in LMICs should focus on socioeconomically disadvantaged groups to ensure they have access to safe and appropriate menstrual materials.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0310451","type":"journal-article","created":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T17:31:42Z","timestamp":1728322302000},"page":"e0310451","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cross-national variation in the prevalence and correlates of current use of reusable menstrual materials: Analysis of 42 cross-sectional surveys in low-income, lower-middle-income, and upper-middle-income countries"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8454-6128","authenticated-orcid":true,"given":"Nitai","family":"Roy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. 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Eveleth","year":"2020","journal-title":"New York Times Wirecutter"},{"key":"pone.0310451.ref035","author":"IFRC","year":"2016","journal-title":"Menstrual hygiene management (MHM) in emergencies: consolidated report 2016."},{"key":"pone.0310451.ref036","doi-asserted-by":"crossref","DOI":"10.1186\/s41018-018-0034-7","article-title":"Pilot testing and evaluation of a toolkit for menstrual hygiene management in emergencies in three refugee camps in Northwest Tanzania","volume":"3","author":"M Sommer","year":"2018","journal-title":"Journal of International Humanitarian Action"},{"key":"pone.0310451.ref037","doi-asserted-by":"crossref","first-page":"2562","DOI":"10.3390\/ijerph15112562","article-title":"Menstrual Hygiene Management and Waste Disposal in Low and Middle Income Countries\u2014A Review of the Literature.","volume":"15","author":"M Elledge","year":"2018","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"pone.0310451.ref038","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.3390\/w10091193","article-title":"Making the Case for a Female-Friendly Toilet.","volume":"10","author":"M Schmitt","year":"2018","journal-title":"Water"},{"key":"pone.0310451.ref039","author":"M. 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