The Menstrual Practice Needs Scale Short Form (MPNS-SF) and Rapid (MPNS-R): Development in Khulna, Bangladesh, and validation in cross-sectional surveys from Bangladesh and Uganda

Abstract

Objectives. Develop and validate short and rapid forms of the 36-item Menstrual Practice Needs Scale (MPNS-36). Design. Item reduction prioritised content validity and was informed by cognitive interviews with schoolgirls in Bangladesh, performance of scale items in past research, and stakeholder feedback. The original MPNS-36 was revalidated, and short and rapid forms tested in a cross-sectional survey. This was followed by further tests of dimensionality, internal consistency, and validity in multiple cross-sectional surveys. Setting and participants. Short form (MPNS-SF) and rapid form (MPNS-R) measures were developed in a survey of 313 menstruating girls (mean age=13.51) in Khulna, Bangladesh. They were further tested in the baseline survey of the Adolescent Menstrual Experiences and Health Cohort, in Khulna, Bangladesh (891 menstruating girls, mean age=12.40); and the dataset from the MPNS-36 development in Soroti, Uganda (538 menstruating girls, mean age=14.49). Results. The 18-item short form reflects the six original subscales, with the four core subscales demonstrating good fit in all three samples (Khulna pilot: RMSEA=0.064 90%CI 0.043-0.084, CFI=.94, TLI=.92. Cohort baseline: RMSEA=0.050 90%CI 0.039-0.062, CFI=.96, TLI=.95. Uganda: RMSEA=0.039 90%CI 0.028-0.050, CFI=.95, TLI=.94). The 9-item rapid form captures diverse needs. A two-factor structure was the most appropriate but fell short of adequate fit (Khulna pilot: RMSEA=0.092 90%CI 0.000-0.158, CFI=.93, TLI=.89). Hypothesised associations between the MPNS scores and other constructs were comparable between the MPNS-36 and MPNS-SF in all populations, and replicated, with attenuation, in the MPNS-R. Internal consistency remained acceptable. Conclusions. The MPNS-SF offers a reliable and valid measure of adolescent girls' menstrual hygiene experience while reducing participant burden, to support implementation and improve measurement in menstrual health research. The MPNS-R provides a brief measure with poorer structural validity, suited to including menstrual health within broader water, sanitation and hygiene or sexual and reproductive health research.