Frequently Asked Questions

Do I need permission to use the MPNS-36?

No, you do not need permission to use the MPNS-36. The measure is freely available under a creative-commons by attribution license for non-commercial purposes. 
We would love to know where the measure is being used and hear your feedback. Please drop us a note via the contact page to help us keep up to date on where the measure is being used.

How do I cite (reference) the measure?

The measure should be cited as:
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 (MPNS-36) in Soroti, Uganda. BMJ Open, 10, e034461.
Researchers should see this publication for further information about the measure.

Do I need to use all of the items in the scale?

The measure has been developed to include 36 items and is comprised of 6 sub-scales. At this time no alternative versions have been validated. In the future a short-form version of the measure may be available.
Users may choose to select individual sub-scales for measurement. Removing individual items is not recommended. Researchers should justify their decision to remove items and recognise that the measure may no longer be valid.

Can I change the time-frame on the MPNS?

The MPNS has been developed to capture respondents’ menstrual needs during the last menstrual period. In principle, items should be 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.

Can I change the response options for the MPNS?

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

We recommend using:

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


“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 responding, we recommend using a short activity to help familiarise 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 responding.

Can I change the item wording?

The current scale was developed and tested in English and Ateso. 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 measure User Guide for more information.

When translating the tool we recommend maintaining the meaning of the original item, while adapting terms and phrasing as appropriate. Note that changing the meaning of individual items means that you are no longer using the same measure. Scale structure and validation may no longer apply.

What should I do if respondents miss some items?

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).

If a respondent is missing responses to 3 or more items, we suggest excluding the respondent or using multiple imputation methods. Respondents using only reusable items that were not disposed of during the last period may be missing on these items. Scores should be generated for all relevant items and these should not be considered as ‘missing’. 

What is a good score on the MPNS?

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.

There are currently no levels or thresholds that indicate a ‘good’ or ‘bad’ score. As the scale is used more and more, we will be able to understand if any such categories exist and how these could be applied.

Respondent appraisals of their menstrual needs may vary by context. More research is needed to determine whether scores can be compared across settings, and if there are scores (levels) that reliably predict better outcomes. At this time, 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.

Has the scale been validated in [my context/language]?

We aim to update this website with information on new translations as they become available. See the View and Download 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 and are willing to make your translation freely available, please send us a note via the contact page.

I would like to study the reliability and the validity of the MPNS in my context.

Great! You do not need permission to use the MPNS-36, 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. 

I have more questions about the measure, can I contact the developers?

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