Professor Penelope Phillips-Howard

Public health epidemiologist: Adolescent health, sexual and reproductive health, social equity, behaviour change, morbidity and mortality surveillance, non-communicable diseases, malaria.

Menstrual Health Management: Research on the effect of unmet menstrual needs on girls’ and women’s health, social equity, education and life-chances; quantifying the impact of interventions on improving girls’ and women’s equity in terms of their improved health, schooling and employment.  PPH is involved with global advocacy and support of policy and implementation and provides support to research and programmes internationally.

Capacity development: Working in partnership with colleagues and organizations in low middle-income countries to improve sexual and reproductive health, with a focus on menstrual health and hygiene, including local HIV/STI notifiable disease surveillance and evaluating young peoples’ sexual risk behaviours associated with alcohol use and wellbeing.

Career Summary

Professor Phillips-Howard joined LSTM in 2012 as a public health epidemiologist with 30 years’ experience; and has over 130 publications, with 20 specially on Menstrual Health.  She started her career as a Bachelor of Science Degree nurse, at Westminster Hospital London, linked with South Bank University. After qualifying she specialized in Tropical Diseases at the Hospital for Tropical Diseases, London. She gained experience with Save the Children, providing care for Vietnamese refugees settling in Britain, followed by midwifery training at the John Radcliffe Hospital, Oxford.

Whilst living in the Amazon in Bolivia, she retained her interest in tropical medicine and returned to the UK, where she conducted research on imported malaria at the London School of Hygiene and Tropical Medicine, where she attained her PhD. She briefly worked as a British Airways Research Fellow on travel medicine at the Hospital for Tropical Diseases, London but then gained employment with World Health Organization, Geneva, as a technical officer in the Malaria Control Programme.

In 1995 Professor Phillips-Howard and her family relocated to western Kenya where she coordinated a multi-disciplinary trial investigating the impact of insecticide treated bednets (ITN) on malaria morbidity and mortality, which informed global policy for provision of ITNs free of charge for under 5’s and pregnant women. She collaborated widely with other researchers involved with infectious disease and public health studies.

After six years in Kenya, Professor Phillips-Howard took a career break to look after her family resettling in UK. When returning to academia, she took a post at Liverpool John Moores University, where she developed an interest in research on young adolescent health, including local HIV/STI notifiable disease surveillance and evaluating young peoples’ sexual risk behaviours associated with alcohol use and wellbeing. Her focus returned to Kenya, examining the public health challenges of changing mortality patterns in rural populations.  She started and continues to this day, collaborating with KEMRI/CDC Research and Public Health Collaboration.

She is the PI on a number of projects including an ongoing Joint Global Health Trial (JGHT) award evaluating menstrual cups or cash to reduce girls’ sexual and reproductive health harms and education equity, conducted in ~4000 girls in 96 schools in western Kenya. This follows from a previous JGHT award, as PI exploring the acceptability, use and impact of menstrual cups and sanitary pads on girls’ sexual and reproductive health and schooling. Findings supported Kenyan strategy, policy, and guidelines to include menstrual cups. She was PI of a UNICEF India study examining menstrual needs of schoolgirls across India, contributing to national policy and guidelines. A nested NIH study, with co-partner leads from University of Illinois is evaluating the role of menstrual cups in protecting the vaginal microbiome, and implications for STI/HIV and maternal health. PPH is also the LSTM PI on DREAMS impact evaluation in Kenyan girls and young women. She is LSTM investigator on GCRF multi-country hub on intractable challenges (urban equity) and is an MHM technical advisor to Grand Challenges Canada Innovators.

Professor Phillips-Howard’s interest in menstrual health has expanded to period poverty including in impoverished in high income countries, to menstrual needs of women in the workplace, and to other types of bleeding that remain hidden due to shame across societies.

Current Grants

Principal investigator: Menstrual cups or cash transfer to reduce sexual and reproductive harm and school dropout in adolescent schoolgirls in western Kenya MRC/DfID/Wellcome Trust Global Health Trials.

Co-investigator: Menstrual cup maturation of the adolescent vaginal microbiome and STI/HIV risk. National Institute of Health (PI Mehta, S: University of Illinois at Chicago).

Co-investigator: Strengthening East and Southern African capacity for menstrual hygiene management (MHM) research Academy of Medical Sciences Global Challenges Research Fund Networking Grant Scheme (PI Ferrand R, Biomedical Training Institute, Zimbabwe, LSHTM).

Principal investigator: Mentor MHM innovators transition to scale of menstrual product and education innovations Grand Challenges Canada

Co-Principal Investigator:Impact Evaluation of PEPFAR’s DREAMS Initiative, Siaya County, western Kenya. London School of Hygiene and Tropical Medicine (co-PI Dr Daniel Kwaro, KEMRI).

Co-Principal Investigator: Technical Advisor on the Theory of Change, and Monitoring and Evaluation of Menstrual Hygiene Management for GCC Innovators. Grand Challenges Canada (co-PI, Prof Marni Sommers, Columbia University).

Principal Investigator: The effectiveness of Mooncups to reduce school absenteeism and sexual and reproductive harms in Kenyan schoolgirls.  MRC/DfID/Wellcome Trust Global Trials

Principal Investigator: Review of Menstrual Hygiene Management in Schools in India. UNICEF India.

Current Students - PhD                                                                 

Garazi Zulaika                                                   
Vincent Were
Beate Ringwald

Committees and Technical Panels

LSTM Research Committee - Member

MEGAMBO - Chair Trial Steering Committee, Gambia (PI-Belen Torondel, LSHTM)

MENISCUS - Scientific Advisory Group, Uganda (PI – Helen Weiss, LSHTM)

MHM in TEN - Expert Panel

Adviser WHO Expert Panel on MHM

The Cup – Board Member

Athena Swan – Contribute and present at events

UK-RC grants - Reviewer

East African Menstrual Health Management

Grand Coalition on Menstrual Health Management

UNFPA African Coalition for Menstrual Health Management

Collaborating partners nationally and internationally

Centers for Disease Control and Prevention (CDC), Kenya, India, Atlanta; 2011 - current; collaborate on research studies on MHM among schoolgirls, and sexual and reproductive health in Kenya and India.

Emory University, Atlanta, USA; 2014 - current; collaborate on global advocacy and guideline papers around MHM.

Golden Girls, Kisumu, Kenya; 2017 – current; collaborate on NGO research studies on MHM (schoolgirls, boarding schools).

Kenya Medical Research Institute (KEMRI), Kenya; 2011 - current; collaborate on research studies on MHM among schoolgirls, and sexual and reproductive health in Kenya.

London School of Hygiene and Tropical Medicine (LSHTM), UK; 2016 - current; collaborate on global advocacy and guideline papers around MHM; member of their steering committee to guide MHM research in Uganda; collaborate on common research issues for MHM, development of east African MHM research network; co-investigator on London School grant for DREAMS initiative.

North-Western University, Chicago, USA; 2016 - current; collaborate on the development of new research studies on fidelity (high quality) MHM implementation among schoolgirls in Kenya.

Safe Water and AIDS Project (SWAP), Kisumu, Kenya; 2011 - current; collaborate on research studies on MHM among schoolgirls, and sexual and reproductive health in Kenya 

Tata Institute of Social Sciences, Mumbai, India; 2014 - current; collaborate on research studies on MHM among schoolgirls, and development of new grants in India; potential collaboration on developing research on menstrual cup use for girls and women in India.

UNICEF, India and New York; 2014 - current; collaborate on research studies on MHM among schoolgirls in India, and inferences for policies and guidelines; member of UNICEF and Columbia lead MHM in Ten advisory panel.

University of Bangor, UK; 2011 - current; collaborate on the completion of research study on MHM among schoolgirls in Kenya.

University of Columbia, New York, USA; 2014 - current; collaborate on global advocacy and guideline papers around MHM; development of collaborative studies; co-PI on Grand Challenges Canada technical advisor grant on theory of change and monitoring and evaluation; member of Columbia University / UNICEF New York led MHM in Ten panel.

University of Illinois at Chicago, USA; 2017 - current; collaborate on the development of new research studies on sexual and reproductive health associated with menstrual cups among girls and women in Kenya.

University of Liverpool, UK; 2017 - current; collaborate on formative studies and development of research studies on MHM in Indian slums.

University of Oxford, UK; 2017 - collaborate on ethical ramifications of research studies among girls and communities on sensitive topics (i.e. sexual, MHM, reproductive).

University of Sheffield, UK; 2017 – current; collaborate on common research issues for MHM, development of east African MHM research network.

WaterAid, London, UK; 2014 - current; collaborate on global advocacy and guideline papers around MHM.

Selected publications

  • Research Publications in Menstrual Health Management

    vanEijk, Anna , Zulaika, Garazi, Lechner, Madeline, Mason, Linda, Sivakami, Muthusamy, Nyothach, Elizabeth, Unger, Holger, Laserson, Kayla and Phillips-Howard, Penelope  (2019) 'Menstrual cup use, leakage, acceptability, safety, and availability: a systematic review and meta-analysis'. Lancet, Vol 4, Issue 8, e376-e393.

    Benshaul-Tolonen A, Zulaika G, Nyothach E, Oduor C, Alexander K, Mason L, Laserson KF, Phillips-Howard PA (2019). Pupil absenteeism, measurement, and menstruation. -  Evidence from Kenya,  CDEP-CGEC Working Paper No 74. Center for Development Economics and Policy.

    Sivakami M, van Eijk AM, Thakur H, Kakade N, Patil C, Shinde S, Surani N, Bauman A, Zulaika G, Yusuf Kabir Y, Dobhal A, Singh P, Mason L, Alexander K, Thakkar MB, Kayla F Laserson KF, Phillips-Howard PA (2019). Effect of menstruation on girls and their schooling, and facilitators of menstrual hygiene management in schools: surveys in government schools in three states in India 2015, J Global Health,  9(1):010408.

    van Eijk AM, Laserson KF, Nyothach E, Oruko K, Omoto J, Mason L, Alexander K, Oduor C, Mohammed A, Eleveld A, Ngere I, Obor D, Vulule J. Phillips-Howard PA (2018). Use of menstrual cups among schoolgirls: longitudinal observations nested in a randomised controlled feasibility study in rural western Kenya, Reproductive Health, 15:139.

    Juma J, Nyothach E, Laserson KF, Oduor C, Arita L, Ouma C, Oruko K, Omoto J, Mason L, Alexander K, Fields B, Onyango C, Phillips-Howard PA.(2017) Examining the safety of the menstrual cup provided to rural primary school girls in Western Kenya, BMJ Open, 0:e015429.

    Phillips-Howard PA, Caruso B, Torondel B, Zulaika G, Sahin M, Sommer M. (2016). Menstrual hygiene management among adolescent schoolgirls in low- and middle-income countries: research priorities. Glob Health Action. Dec 8; 9:33032.

    Phillips-Howard PA, Nyothach E, ter Kuile FO, Omoto J, Wang D, Zeh C, Onyango C, MasonL, Alexander K, Odhiambo FO, Eleveld A, Mohammed A, Tudor-Edwards R, van Eijk AM, Vulule J, Faragher B, Laserson KF. (2016). Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: A cluster randomised controlled feasibility study in rural western Kenya, BMJ Open; 6(11):e013229.

    van Eijk AM, Sivakami M, Thakkar MB, Bauman A, Laserson KF, Coats S, Phillips-Howard PA. (2016) Menstrual hygiene management among adolescent girls in India: a systematic review and Meta-Analysis. BMJ Open; 6:e010290.

    Sommer M, Caruso B, Sahin M, Calderon T, Cavill S, Mahon T, Phillips-Howard PA. (2016) A time for global action: addressing girls’ menstrual hygiene management needs in schools. PLoS MED: 13(2) e1001962.

    Kerubo E, Laserson KF, Otecko N, Odhiambo C, Mason L, Nyothach E, Oruko K, Bauman A, Vulule J, Zeh C, Phillips-Howard PA. (2016). Prevalence of reproductive tract infections and the predictive value of girls’ symptom-based reporting: findings from a cross sectional survey in rural western Kenya. BMJ-Sex Transm Infect, 92(4):251-6.

    Phillips-Howard PA, Olilo G, Burmen B, Otieno F, Odongo F, Oduor C, Nyothach E, Amek N, Zielinski-Gutierrez E, Odhiambo F, Zeh C, Kwaro D, Mills L, Laserson KF. (2015) Menstrual needs and associations with sexual and reproductive risks in rural Kenyan females: a cross-sectional behavioural survey linked with HIV prevalence. J Womens Health, 24 (10), 1-11.