Youth insights on menstrual health and hygiene in Burkina Faso; a comparison of written versus spoken qualitative text.

Understanding girls' lived experiences with menstruation is essential yet can be challenging given the taboo nature of the topic. While diaries have not previously been employed as a data collection method among girls in this setting, the use of diaries could generate unique insights due to their private, reflective, and participant-led nature. Our study aimed to explore the menstrual health and hygiene experiences of schoolgirls in Burkina Faso, comparing diaries and in-person interviews, and to capture girls' thoughts on the process and value (or lack thereof) of diary writing. This study involved 30 girls aged 10-19 years to understand their experiences of menstruation. Data were analyzed using inductive and deductive approaches within a systematic thematic analysis framework, supported by NVivo 12 pro. Common social meanings attached to menarche include "becoming a woman" and "staying away from boys". Bullying, stigma, and inadequate water, sanitation, and hygiene facilities were identified as major challenges in schools. For some, the diary provided a safe space to express their thoughts and share their menstruation stories. However, challenges with diary writing included its additional workload, limitations linked to language proficiency and writing ability, and perceptions of the diaries as being repetitive in terms of questions. Diaries and IDIs generated similar menstruation-related themes, indicating that they are equally effective in capturing experiences on this topic among this respondent group in this setting. Our study reinforces the need to support schoolgirls in achieving menstrual health and wellbeing. Efforts should prioritize promoting education across communities to mitigate the impact of cultural and religious restrictions. In contexts where participants have limited writing and language proficiency, future studies may consider alternative methods that nevertheless facilitate privacy and are respondent-driven, such as audio diaries. Further research could benefit from adopting either method of data collection to fit the contextual needs of participants.