Abstract

This article draws on grounded theory and ethnographic fieldwork approaches and applies a political ecology of adolescent health (PEAH) framework to examine how school-going adolescent girls and their communities perceive sexual and reproductive health education (SRHE) and menstrual hygiene management (MHM) in the region. Three young girls were purposefully selected from each of 10 government-run mixed primary schools in Juba, South Sudan, as peer research evaluators (PREs) and key informants ( N = 30). Each PRE interviewed and reported on three of their peers about how they talk about and manage menstruation. The findings show that political, socioeconomic, and cultural factors do influence adolescent girls’ and their communities’ perceptions about puberty and menstruation. In general, MHM was culturally constructed, but the results show a disproportionate emphasis on social norms rather than on SRHE, which could have long-lasting health implications for adolescent girls. There is a need for all stakeholders in education to come together to better grasp and address the obstacles young girls face in their communities and school environments. There is also a need to develop relevant training materials to assist care providers and adolescent girls to openly talk about and address sexual and reproductive health issues.

Highlights

  • Menstruation is a biological phenomenon that happens every month to healthy reproductive age females

  • The findings presented below demonstrate the complex ways school-going adolescent girls and their communities perceive sexual and reproductive health education (SRHE) and menstrual hygiene management (MHM) within the political ecology of adolescent health (PEAH) analytical framework in South Sudan

  • The results fall under five major themes: knowledge about puberty and menstruation; perceptions about menstruation; MHM; challenges of menstrual management; and coping mechanisms among adolescent girls

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Summary

Introduction

Menstruation is a biological phenomenon that happens every month to healthy reproductive age females. Researchers have gained interest in studying menstrual hygiene management (MHM) and sexual and reproductive health education (SRHE) among young girls in low- and middle-income countries (LMIC) (Bharadwaj & Patkar, 2004; Sommer, Hirsh, et al, 2015). This is partly because poor MHM negatively affects young girls’ school enrollment and retention compared with their counterparts (Biddlecom et al, 2009).

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