Although menstrual cups have a long history and numerous benefits, many women of reproductive age remain unaware. This study assessed the knowledge, attitude and use regarding menstrual cups and its associated factors among females of reproductive age in Siddharthanagar Municipality, Lumbini Province, Nepal.

Cross-sectional study

Siddharthanagar municipality, Rupandehi was taken as the study setting.

A total of 250 women of reproductive age group (15–49 years) residing in Siddharthanagar Municipality.

Knowledge, attitude and use of menstrual cups were assessed by a pretested structured tool. The knowledge scores for each question were given as one mark for a correct response, and the overall scores were categorised using a modified Bloom’s cut-off as follows: good knowledge≥60% and poor knowledge80%), neutral (60%–80%) and unfavourable (2 test and multivariable logistic regression analysis were performed to determine factors associated with knowledge, attitude and use at the 5% level of significance.

This study found that the majority (88.04%) had poor knowledge about the menstrual cup, with 31.2% of participants expressing a favourable attitude. Only 10.6% of participants had used a menstrual cup. The odds of adequate knowledge among the participants with bachelor and higher level of education was 3.470 times (adjusted OR (aOR)=3.470, 95% CI 1.08 to 11.10) as compared with participants with secondary or lower level of education, adjusting for other explanatory variables. The odds of having adequate knowledge among participants who were employed was 1.66 times (aOR=1.66, 95% CI 1.24 to 5.83) compared with those who were unemployed, which was 2.487 times (aOR=2.487, 95% CI 1.24 to 7.95) in case of favourable attitude. Similarly, the odds of using a menstrual cup among the participants with an adequate level of knowledge was 7.960 times (aOR=7.960, 95% CI 2.70 to 23.40) as compared with participants who had an inadequate level of knowledge, adjusting for other explanatory variables.

Our study revealed that, despite their advantages, participants have limited knowledge and usage of menstrual cups. This highlights the need for advocacy and education about menstrual cups to enable informed choices, enhance women’s quality of life and protect the environment by reducing waste from disposable menstrual products.

To assess factors associated with the adoption of the WHO Package of Essential Non-Communicable Diseases (PEN) Protocol 1 at primary healthcare (PHC) facilities in Nepal after healthcare workers received training.

Cross-sectional study.

PHC facilities across various provinces in Nepal.

A total of 180 healthcare workers trained in PEN, recruited from a random selection of 105 basic healthcare facilities.

The adoption of PEN Protocol 1 components: blood pressure measurement, blood glucose screening, 10-year cardiovascular disease (CVD) risk assessment using WHO/International Society of Hypertension risk charts and body mass index (BMI) assessment. Factors associated with protocol adoption were assessed using generalised estimating equations for ORs.

Among participants, 100% reported measuring blood pressure, while 56% measured blood sugar, 28% assessed CVD risk and 27% assessed BMI. The adoption of the CVD risk prediction chart was positively associated with the availability of amlodipine (adjusted OR (aOR) 3.00; 95% CI 1.09 to 8.27). The adoption of BMI assessment was positively associated with access to a stadiometer (aOR 3.23; 95% CI 1.26 to 8.30) and a glucometer (aOR 3.07; 95% CI 1.12 to 8.40), and negatively associated with lack of motivation/inertia of previous practice (aOR 0.60; 95% CI 0.42 to 0.87) and environmental factors such as lack of time and resources (aOR 0.57; 95% CI 0.37 to 0.89). Blood glucose level measurements were positively associated with being at a PHC centre (aOR 7.34; 95% CI 2.79 to 19.3) and the availability of metformin (OR 2.40; 95% CI 1.08 to 5.29).

Adoption of PEN Protocol 1 varied by component and was influenced by resource availability, provider motivation and system barriers. Addressing these factors is key to optimising implementation in low-resource settings.