Thesis:

Assessing effectiveness of menstrual health management initiatives on primary health care delivery projects in Sololo sub-county, Marsabit county, Kenya

Menstrual Health Management (MHM) is strategically driving gender equality, social inclusion, and sustainable development, especially in underserved regions like Sololo Sub-County and Marsabit County, Kenya. Despite increasing global attention, MHM remains underprioritized in local planning and project design, leading to health risks, educational setbacks, and limited economic participation for girls and women. This study assessed the effectiveness and planning adequacy of existing MHM interventions, with a focus on access to menstrual products, sanitation infrastructure, waste management systems, and menstrual health education. The objective was to determine their influence on the effectiveness and reach of primary healthcare delivery programs. A mixed-method research design was adopted, sampling 377 participants from a target population of 21,354 women and girls aged 15–45. Data was collected using structured questionnaires, and analysis was carried out using IBM SPSS software. Key project-related metrics were evaluated through correlation, regression, and ANOVA to understand the relational and predictive impact of MHM components on health project outcomes. Findings revealed critical demographic and socio-economic patterns: 26.3% of respondents were aged 20– 24, with 57.5% identifying as low-income and 26.8% unemployed, underscoring the importance of targeted planning and resource allocation. Access to menstrual products was inconsistent: 34.4% always accessed products, while 23.7% and 13.4% accessed them occasionally or not at all, respectively. Affordability was a major challenge, rated as a barrier by 38.3% of respondents. Sanitation infrastructure was moderately available, with 72.7% reporting access to clean, private facilities, yet maintenance was uneven. Only 39.0% reported daily cleaning, and 13.0% noted no cleaning at all. The study demonstrated a strong positive relationship (R = 0.786) between MHM components and project success in primary healthcare delivery. Education programs emerged as the most impactful intervention (Beta = 0.368), followed by product access (Beta = 0.341), sanitation (Beta = 0.295), and waste disposal systems (Beta = 0.249). The regression model accounted for 61.8% of the variability in project outcomes, emphasizing the importance of integrated, well-planned MHM initiatives. This study highlights the need for improved planning, funding prioritization, and community-based implementation of MHM components. Strengthening these systems through participatory planning, policy support, and effective monitoring and evaluation frameworks will enhance primary healthcare outcomes and promote gender-responsive development planning in Sololo Sub-County and similar marginalized areas.