Penelope A Phillips-Howard

Penelope A Phillips-Howard
Liverpool School of Tropical Medicine · Department of Clinical Sciences

PhD

About

209
Publications
86,443
Reads
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9,425
Citations
Citations since 2016
85 Research Items
4189 Citations
20162017201820192020202120220200400600
20162017201820192020202120220200400600
20162017201820192020202120220200400600
20162017201820192020202120220200400600
Additional affiliations
August 2019 - present
Liverpool School of Tropical Medicine
Position
  • Professor
August 2018 - July 2019
Liverpool School of Tropical Medicine
Position
  • Professor (Full)
March 2012 - July 2018
Liverpool School of Tropical Medicine
Position
  • Professor (Associate)
Education
June 1985 - October 1988
London School of Hygiene and Tropical Medicine
Field of study
  • Community Health/Epidemiology
September 1974 - December 1978
September 1974 - July 1978
London South Bank University
Field of study
  • Biological and social sciences (Nursing)

Publications

Publications (209)
Article
Full-text available
Background: Adolescent pregnancy increases the risk of adverse health outcomes, social stigma, loss of education and employment, and early marriage. Research characterising at risk girls will inform targeting of effective interventions.Methods: Risk characteristics for adolescent pregnancy were evaluated in schoolgirls aged 14-16 years as a seconda...
Article
Full-text available
The vaginal microbiome (VMB) impacts numerous health outcomes, but evaluation among adolescents is limited. We characterized the VMB via 16S rRNA gene amplicon sequencing, and its association with Bacterial vaginosis (BV) and sexually transmitted infections (STIs; chlamydia, gonorrhea, trichomoniasis) among 436 schoolgirls in Kenya, median age 16.9...
Article
Full-text available
Background Adolescence is a sensitive time for girls’ sexual and reproductive health (SRH), as biological changes occur concurrently with heightening pressures for sexual activity. In western Kenya, adolescent girls are vulnerable to acquiring sexually transmitted infections (STIs), such as HIV and herpes simplex virus type 2 (HSV-2), and to becomi...
Article
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Background Through a multisectoral approach, the DREAMS Partnership aimed to reduce HIV incidence among adolescent girls and young women (AGYW) by 40% over 2 years in high-burden districts across sub-Saharan Africa. DREAMS promotes a combination package of evidence-based interventions to reduce individual, family, partner, and community-based drive...
Article
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Introduction Secondary school closures aimed at limiting the number of infections and deaths due to COVID-19 may have amplified the negative sexual and reproductive health (SRH) and schooling outcomes of vulnerable adolescent girls. This study aimed to measure pandemic-related effects on adolescent pregnancy and school dropout among school-going gi...
Article
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Introduction Despite many institutions gaining access to improved water sanitation and hygiene (WASH) services, childcare centres in informal settlements have low access and poor condition of WASH services. It is imperative to understand how existing actors and social networks operate in the WASH sector in childcare centres in Nairobi’s informal se...
Article
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In sub-Saharan Africa, girls suffer from high rates of morbidity and mortality, enduring high exposure to sexual and reproductive health harms. Staying in school helps protect girls from such harms. Focus group discussions were conducted in a rural, impoverished area of Kenya with adolescent girls participating in a 4-arm cluster randomised control...
Preprint
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Background Accountability strategies are expected to enhance access to water, sanitation and hygiene (WASH) service delivery in low-and middle-income countries (LMIC). Conventional formal social accountability mechanisms (SAMs) for WASH service delivery have been inadequate to meet the needs of residents in informal settlements in LMICs. This has p...
Article
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Although urban areas are diverse and urban inequities are well documented, surveys commonly differentiate intimate partner violence (IPV) rates only by urban versus rural residence. This study compared rates of current IPV victimization among women and men by urban residence (informal and formal settlements). Data from the 2014 Kenya Demographic an...
Article
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Objective: To analyze the relative value of providing menstrual cups and sanitary pads to primary schoolgirls. Design: Cost-effectiveness and cost-benefit analyses of three-arm single-site open cluster randomized controlled pilot study providing menstrual cups or sanitary pads for 1 year. Participants: Girls 14-16 years of age enrolled across...
Article
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Background Menstrual health (MH) is a recognised global public health challenge. Poor MH may lead to absence from school and work, and adverse health outcomes. However, reviews suggest a lack of rigorous evidence for the effectiveness of MH interventions on health and education outcomes. The objective of this paper is to describe the methods used i...
Article
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Background The menstrual needs of girls and women are important to health, education, and well-being. Unmet need and harm from poor menstrual health in low-and- middle-income countries have been documented, but with little empirical research undertaken in high income countries. Continuing austerity in the UK suggests menstruators are likely more vu...
Article
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Social accountability for water, sanitation and hygiene (WASH) services is a critical component to realising child rights to WASH services by the urban poor, more so in childcare centres. Despite the existence of discrete social accountability mechanisms (SAMs) in informal settlements, informal SAMs rarely form part of strategic approaches to addre...
Article
Full-text available
Introduction Several studies have shown that residents of urban informal settlements/slums are usually excluded and marginalised from formal social systems and structures of power leading to disproportionally worse health outcomes compared to other urban dwellers. To promote health equity for slum dwellers, requires an understanding of how their li...
Conference Paper
Introduction Out-of-school adolescent girls are vulnerable to harms related to menstrual, and sexual and reproductive health (SRH), including HIV infection, unplanned pregnancy, and poor menstrual hygiene. Targeted interventions can reduce their risks. The aim of this study is to identify what interventions have been evaluated among out-of-school g...
Article
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Objectives: We sought evidence of DREAMS' impact on uptake of services and sexual risk among adolescent-girls-and-young-women (AGYW). Design: Cohorts of AGYW aged 13-22 years were randomly selected in 2017-2018 and followed-up to 2019; 1081 in Nairobi, Kenya;1171 in Gem, western Kenya;and 2184 in uMkhanyakude, South Africa. Methods: Outcomes w...
Article
Objectives. To identify key effects of the pandemic and its economic consequences on menstrual product insecurity with implications for public health practice and policy. Methods. Study participants (n = 1496) were a subset of individuals enrolled in a national (US) prospective cohort study. Three survey waves were included (March‒October 2020). Me...
Article
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Background: We sought to determine the effectiveness of common cleaning procedures in eliminating S. aureus from silicone menstrual cups. Methods: In this in vitro study, we tested four cleaning techniques: (1) cold water; (2) cold water and liquid soap; (3) cold water followed by steeping the cup in boiled water for 5 min in a ceramic mug cover...
Article
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In recognition of the opportunity created by the increasing attention to menstrual health at global, regional, and national levels, the World Health Organization’s Department of Sexual and Reproductive Health and Research and the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction...
Article
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Background Girls and women need effective, safe, and affordable menstrual products. Single-use menstrual pads and tampons are regularly provided by agencies among resource-poor populations. Reusable menstrual pads (RMPs: fabric layers sewn together by an enterprise for manufacture of menstrual products) may be an effective alternative.Methods For t...
Article
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Introduction People living in slums face several challenges to access healthcare. Scarce and low-quality public health facilities are common problems in these communities. Costs and prevalence of catastrophic health expenditures (CHE) have also been reported as high in studies conducted in slums in developing countries and those suffering from chro...
Article
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There is increasing global attention to the importance of menstrual health and hygiene (MHH) for the lives of those who menstruate and gender equality. Yet, the global development community, which focuses on issues ranging from gender to climate change to health, is overdue to draw attention to how addressing MHH may enable progress in attaining th...
Preprint
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Does access to sanitary products improve schoolgirls' well-being? We conduct the first cluster randomized controlled feasibility study to provide different sanitary technologies (sanitary pads or menstrual cup or usual practice) to 644 primary schoolgirls in western Kenya, across 30 schools with 10 schools per treatment arm. Inclusion restrictions...
Article
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Progress has been made in recent years to bring attention to the challenges faced by school-aged girls around managing menstruation in educational settings that lack adequate physical environments and social support in low- and middle-income countries. To enable more synergistic and sustained progress on addressing menstruation-related needs while...
Article
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Establishing the cause of death (CoD) is critical to better understanding health and prioritizing health investments, however the use of full post-mortem examination is rare in most low and middle-income counties for multiple reasons. The use of minimally invasive autopsy (MIA) approaches, such as needle biopsies, presents an alternate means to ass...
Article
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Objectives: To determine the age-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China. Design and setting: Retrospective, multicentre cohort study performed at 24 hospitals in Jiangsu, China. Participants: 625 patients with COVID-19 enrolled between 10 January and 15 March 2020. Resu...
Preprint
Full-text available
Objective: To analyze the relative value of providing menstrual cups and sanitary pads to schoolgirls in rural Kenya. Methods: From a healthcare payer or government program perspective, program costs were calculated for two interventions (provision of menstrual cups or sanitary pads) to girls (14-16 years old) in Kenya for one year. Cost-effective...
Preprint
Full-text available
Objectives To determine the age-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China. Design and setting This is a retrospective, multi-center cohort study performed at twenty-four hospitals in Jiangsu, China. Participants From January 10 to March 15, 2020, 625 patients with COVID-19 were...
Article
Evidence suggests an overlap between intimate partner violence (IPV) experience and perpetration. However, few studies in sub-Saharan Africa have investigated experience and perpetration of IPV among women and men within the same community. This study reports prevalence of past year IPV experience and perpetration among women and men living in an i...
Article
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Safeguarding is rapidly rising up the international development agenda, yet literature on safeguarding in related research is limited. This paper shares processes and practice relating to safeguarding within an international research consortium (the ARISE hub, known as ARISE). ARISE aims to enhance accountability and improve the health and well-bei...
Article
Effective future control of female genital schistosomiasis (FGS) requires an integrated and multisectoral approach, bringing together HIV, sexual and reproductive health, and reproductive rights sectors. In this article, an underappreciated but important connection between FGS and menstrual hygiene initiatives in Africa is highlighted.
Article
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There exists growing global attention focused on tackling the menstrual management related challenges facing adolescent girls and women in low- and middle-income countries (LMIC). This includes a surge of growth in new and locally produced menstrual products, often accompanied by innovative distribution approaches aimed at enhancing accessibility,...
Article
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Background: Adolescent girls in sub-Saharan Africa are disproportionally vulnerable to sexual and reproductive health (SRH) harms. In western Kenya, where unprotected transactional sex is common, young females face higher rates of school dropout, often due to pregnancy, and sexually transmitted infections (STIs), including HIV. Staying in school h...
Article
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BACKGROUND: Ivermectin is being considered for mass drug administration for malaria, due to its ability to kill mosquitoes feeding on recently treated individuals. In a recent trial, 3-day courses of 300 and 600 mcg/kg/day were shown to kill Anopheles mosquitoes for at least 28 days post-treatment when fed patients' venous blood using membrane fee...
Article
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Objective The objective of this analysis was to examine trends in malaria parasite prevalence and related socioeconomic inequalities in malaria indicators from 2006 to 2013 during a period of intensification of malaria control interventions in Siaya County, western Kenya. Methods Data were analysed from eight independent annual cross-sectional sur...
Article
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Background: Girls in low and middle-income countries (LMIC) lack access to hygienic and affordable menstrual products. We explore Kenyan schoolgirls’ use and views of the cup compared to girls provided with disposable sanitary pads for a feasibility study.Methods: Schoolgirls aged 14-16 years, received a menstrual cup in 10 schools or 16 pads/month...
Article
Full-text available
Background: Girls and women need effective, safe, and affordable menstrual products. Single-use products are regularly selected by agencies for resource-poor settings; the menstrual cup is a less known alternative. We reviewed international studies on menstrual cup leakage, acceptability, and safety and explored menstrual cup availability to infor...
Preprint
Full-text available
Due to data limitations it is unclear if biological processes hinder girls in developing countries from participating in school to a greater extent than boys. We collect 32,000 unannounced random spot-checks for 6,000 students in Kenya to assess this claim. Although absenteeism is common, pubescent girls miss more schooldays because of school trans...
Article
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High‐dose ivermectin, co‐administered for 3 days with dihydroartemisinin‐piperaquine (DP), killed mosquitoes feeding on individuals for at least 28 days posttreatment in a recent trial (IVERMAL), whereas 7 days was predicted pretrial. The current study assessed the relationship between ivermectin blood concentrations and the observed mosquitocidal...
Article
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Background HIV, syphilis, malaria and anaemia are leading preventable causes of adverse pregnancy outcomes in sub-Saharan Africa yet testing coverage for conditions other than HIV is low. Availing point-of-care tests (POCTs) at rural antenatal health facilities (dispensaries) has the potential to improve access and timely treatment. Fundamental to...
Article
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Background: Lack of menstrual knowledge, poor access to sanitary products and a non-facilitating school environment can make it difficult for girls to attend school. In India, interventions have been developed to reduce the burden of menstruation for school girls by government and non-governmental organizations (NGOs). We sought to identify challe...
Article
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Background: A menstrual cup can be a good solution for menstrual hygiene management in economically challenged settings. As part of a pilot study we assessed uptake and maintenance of cup use among young school girls in Kenya. Methods: A total of 192 girls between 14 to 16 years were enrolled in 10 schools in Nyanza Province, Western Kenya; thes...
Article
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Many females lack access to water, privacy and basic sanitation—felt acutely when menstruating. Water, sanitation and hygiene (WASH) conditions in schools, such as access to latrines, water, and soap, are essential for the comfort, equity, and dignity of menstruating girls. Our study was nested within a cluster randomized controlled pilot feasibili...
Article
Full-text available
Background: HIV risk remains unacceptably high among adolescent girls and young women (AGYW) in southern and eastern Africa, reflecting structural and social inequities that drive new infections. In 2015, PEPFAR (the United States President's Emergency Plan for AIDS Relief) with private-sector partners launched the DREAMS Partnership, an ambitious...