MPNS FAQ

No, you do not need permission to use any version of the MPNS. The measure is freely available under a creative-commons by attribution license for non-commercial purposes, as long as you cite the original source in your reporting.  

If you are using the measure, we would love to know and welcome your feedback!  Get in touch. 

It is important to cite the measure you use in your work.  

There are different citations, depending on which version of the measure you use. Use the table below to cite the measure in your work.  

MPNS-36

Hennegan, J., Nansubuga, A., Smith, C., Redshaw, M., Akullo, A., & Schwab, K.J. (2020). Measuring menstrual hygiene experience: Development and validation of the Menstrual Practice Needs Scale (MPNS36) in Soroti, Uganda. BMJ Open, 10, e034. https://doi.org/10.1136/bmjopen-2019-034461  

MPNS-36 (adult) Note: the scale was reduced to 28 items for adults.

Hennegan, J., Bukenya, J. N., Kibira, S. P., Nakamya, P., Makumbi, F. E., Exum, N. G., & Schwab, K. J. (2022). Revalidation and adaptation of the Menstrual Practice Needs Scale (MPNS) in a cross-sectional survey to measure the menstrual experiences of adult women working in Mukono District, Uganda. BMJ open, 12(7), e057662. https://doi.org/10.1136/bmjopen-2021-057662

MPNS-SF and R

Hennegan, J., Hasan, M.T., Jalil, T., Hunter, E.C., Head, A., Jabbar, A., Mohosin, A.B., Zoha, N.S., Alam, M.K., Dunstan, L., Akter, S., Zaman, A., Smith, C., Bagala, L., & Azzopardi, P.S. 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. medRxiv. https://doi.org/10.1101/2024.01.22.24301625 

It may also be helpful to cite the original measure development manuscript for context, particularly if you have made adaptations, or offer discussion of the measured construct (menstrual practice needs) as part of your report. 

Hennegan, J., Nansubuga, A., Smith, C., Redshaw, M., Akullo, A., & Schwab, K.J. (2020). Measuring menstrual hygiene experience: Development and validation of the Menstrual Practice Needs Scale (MPNS36) in Soroti, Uganda. BMJ Open, 10, e034.

If you are using a translation, you will need to add citation to the re-validation in the new language (if available).

Removing individual items is not recommended.  

The MPNS has three versions available, including a short (SF) and rapid (R) form. These have all been validated and offer a varying number of items (lengths) to accommodate the needs of your research project.  

  • MPNS-36 – includes 36 items. 28 applicable to all respondents and 8 applicable to respondents who reuse menstrual products.  

  • The MPNS-36 is comprised of 6 sub-scales. Users may choose to select individual sub-scales for measurement.  

  • MPNS-Short form (SF) - includes 18 items. 14 applicable to all respondents and 4 applicable to respondents who reuse menstrual products and;  

  • MPNS-Rapid (R) - includes 9 items. 7 applicable to all respondents and 2 applicable to respondents who reuse menstrual products.  

If items are removed, researchers should justify their decision and recognize that the measure may no longer be valid. 

We note that individual items may be used as discrete indicators, such as those recommended in the shortlist of indicators for monitoring menstrual health and hygiene among adolescents. 

Training research team members is critical for the effective and consistent delivery of any survey tool, including the MPNS. Whether the survey is to be self-completed by respondents, or delivered by an interviewer, research teams should have an understanding of the key features and terminology used in the scale and how to support respondents where needed. 

Our training page has all the information and resources needed to support effective training.  

The MPNS has been developed to capture respondents’ menstrual needs during the last menstrual period. In principle, items are applicable over a larger time window. For example, the recall period could be amended to the last three menstrual periods. Note that other time-frames have not been tested.

The measure has been developed and validated using a 4-point response scale. 

We recommend using: 

“never”, “sometimes”, “often”, “always” 

OR  

“never”, “less than half the time”, “more than half the time”, “always”  

When using the measure in different contexts, alternative response options, sensitive to translation, may be needed.  

We do not recommend changing the number of response options unless you are equipped to undertake a revalidation, or in extreme cases where a 4-point response option cannot be adapted to for context. Responses on a shorter (e.g., 3-point) response are unlikely to be comparable. 

Where respondents are unfamiliar with this type of response, we recommend using a short pre-survey activity to help familiarize them with the response options. For example, the interviewer may use off-topic examples (“During the last week, I had rice with dinner…”) to discuss with participants and help to calibrate responses. 

The MPNS-36 was developed and tested in English and Ateso, with re-validation among adults in Luganda, and with adolescents in Bengali. When translating the measure for use in different populations, it is likely that some terms may need to be adapted. In particular, “menstrual materials” may need to be modified to terms that best reflect this meaning in the population.

Please see the Downloads page or  User Guide for more information on translation. 

We currently recommend scoring the scale using a mean (average) score. Using this scoring method, respondents with some missing items can still be given a score (which will reflect the average of the items answered). 

The User Guide has more detailed information on managing missing data, and scoring the scale. 

Following the scoring guide, higher scores represent a more positive experience. A score of 3 would indicate that the participant has no unmet menstrual practice needs. This could be reversed, as needed, for analysis. 

Use of the MPNS in different contexts has suggested groupings that are likely to be useful. We suggest creating categories using the total score. At this time, we suggest the below categories for presenting (ordinal) groupings of need using MPNS, MPNS-SF and MPNS-R total scores. 

Score range 

Grouping 

3* 

Menstrual practice needs met 

2.50-2.99 (or 3)   

Few unmet needs   

2.00-2.49   

Some unmet needs 

1.50-1.99   

Many unmet needs   

0.00-1.49   

Severe unmet needs   

*This category may not be useful in all populations. It is more likely to be applicable for adult women than adolescents. If <5% of your population has a score of 3, we recommend a top category of scores 2.5-3 (‘few unmet needs’). 

Note that we currently do not have sufficient normative data for the MPNS. Respondent appraisals of their menstrual needs may vary by context. More research is needed to determine whether average (mean) scores can be compared across settings and if there are threshold scores that reliably predict better outcomes. 

You can compare scores within your population. Looking at the responses to individual items (for example, the proportion of the population that reports their menstrual materials were “always” comfortable) will also provide insights into the menstrual experiences of your population. 

We aim to update this website with information on new translations as they become available. See the Downloads page for current versions and their citations. 

We may not be alerted to all translations of the measure. The best way to see if the scale has been validated in your context is to search for studies testing the measure, for example using GoogleScholar or an academic database such as PsycINFO 

If you have translated the MPNS-36, SF or R and are willing to make your translation freely available, please contact us. Sharing your translation will support others to undertake menstrual health research.  

Great! You do not need permission to use the MPNS-36, SF or R, or to test the reliability and validity of the measure in a new setting. 

We are eager to hear feedback on the usefulness of the measure so we can continue to improve the scale. If you have feedback on the measure, or if you would like to collaborate with the developers on re-validation, you can get in touch via the contact page.  

 Yes, you can get in touch via the contact page. 

MPQ FAQ

No, you do not need permission to use any version of the MPQ. The measure is freely available under a creative-commons by attribution license for non-commercial purposes, as long as you cite the original source in your reporting.  

If you are using the measure, we would love to know and welcome your feedback! Get in touch.

It is important to cite the measure you use in your work. 

The measure should be cited as:

Hennegan, J., Nansubuga, A., Akullo, A., Smith, C., & Schwab, K.J., (2020). The Menstrual Practices Questionnaire (MPQ): Development, elaboration, and implications for future research. Global Health Action, 13(1), 1829402.   https://doi.org/10.1080/16549716.2020.1829402

Users should see this publication for more information about each of the questions, and guidance for using the MPQ in your work.

No. Unlike the MPNS, the MPQ is designed to provide a comprehensive pool of questions about menstrual practices. Users can select questions that fit with their research questions and needs. We have provided more information on the rationale behind each question, and guidance for selection on the Using the MPQ page.

The MPQ asks respondents about practices during their last menstrual period. Part of the purpose of the MPQ is to consolidate questions used across studies and contexts, this includes the recall period.

The MPQ questions could be updated to capture alternative time periods (e.g., over the last three menstrual periods). Users should be aware that if they select an alternative recall period, that the information collected will not be comparable to that in other studies, and in national monitoring surveys which ask about the last menstrual period. 

More research is needed on the influence of the recall period on the reliability of self-reported menstrual practices. 

Yes.

The MPQ provides a basic set of questions that can be used to capture menstrual practices. When using the questionnaire in different settings and languages it is likely that some terms will need to be adapted, or that different phrasing will be more intuitive.

For example: “menstrual materials” may need to be modified to a term appropriate for your population. When the survey is administered with an interviewer, or electronically, wording can also be updated for each respondent (e.g., “menstrual materials” could be replaced with the materials that the respondent reported using).

However, please note that when the meaning of the question is changed, responses may no longer be comparable to those in other studies.

Users should adhere to best research practices when reporting survey non-response and missing data. The proportion of respondents that are missing should be transparently reported. Large proportions of missing data may indicate a question did not perform well in your population. There is no aggregated or total score associated with the MPQ so missing data can be reported for each item. 

Questions included in the MPQ may be used to investigate the relationships between menstrual practices and reproductive tract infections or genital irritation. However, we do not believe the MPQ on its own offers a measure of menstrual hygiene.

The questions could be used to make inferences about menstrual hygiene in users populations. To do so users would need to outline their definition of menstrual hygiene, justify how this definition was operationalised in relation to the MPQ questions, and provide justification for which practices were considered ‘hygienic.’ Please see the Using the MPQ page for more discussion of this topic.

We aim to update this website with information on new translations as they become available. See the Download page for current versions and their citations. We may not be alerted to all translations of the tool.  

If you have translated the MPQ questions and are willing to make your translation freely available, please send us a note via the contact page.

 Yes, you can get in touch via the contact page.