Experiences Of Adolescent Girls Research Articles

Navigating Education in the Context of COVID-19 Lockdowns and School Closures: Challenges and Resilience Among Adolescent Girls and Young Women in South Africa

Gender related vulnerabilities and inequalities place female learners at high risk of school disengagement due to COVID-19 disruptions. Understanding the impacts of school closures and educational disruptions on female learners in South Africa is critical to inform appropriate, gender-sensitive policies, and programs, to mitigate further exacerbation of educational inequalities. We examined the effects that COVID-19 and lockdowns have had on the educational experiences of adolescent girls and young women (AGYW) aged 15–24, in six districts of South Africa characterized by high rates of HIV, teenage pregnancy and socio-economic hardship. Following a concurrent triangulation mixed-methods approach, we conducted a cross-sectional survey with 515 AGYW, and qualitative interviews with 50 AGYW. More than half of survey participants enrolled in education had been unable to continue with their studies. Factors associated with educational disruption included low socio-economic status, lack of cell phone access and household food insecurity. Qualitative narratives included challenges with online learning and studying at home in resource restricted settings, and insufficient support from schools and teachers. However, despite multiple barriers to continuing education, some AGYW demonstrated educational resilience, enabled by psychosocial and structural support, and resource access. Our findings lend support to an emerging evidence base showing that the closure of schools and tertiary institutions, combined with challenging home environments, and a lack of access to appropriate technology, has disproportionately impacted the most vulnerable AGYW, exacerbating pre-existing educational inequalities within the South African education system. Addressing structural barriers to educational equity, particularly in the pandemic context, including access of technology and the internet, is urgent.

Sexual and Reproductive Health Service Provision to Adolescents in Edmonton: A Qualitative Descriptive Study of Adolescents’ and Service Providers’ Experiences

The goal of adolescent sexual reproductive health (SRH) services is to provide information, education and healthcare to promote safe health practices and protect adolescents from negative health outcomes; however, access to timely, effective, and affordable SRH services by adolescents in Edmonton, Canada remains relatively unknown. Our study sought to understand the perspectives and experiences of adolescent girls and service providers in relation to availability, accessibility, and quality of SRH services available in Edmonton. The study objectives were to explore SRH services adolescents seek, uncover barriers in accessing SRH services and identify areas to improve accessibility. Qualitative description design was employed to conduct this study. Five service providers specializing in SRH, and eight females (ages 17–20 years) that access SRH services were recruited from the Alberta Health Services Birth Control Centre (BCC). Semi-structured interviews took place via Zoom. Thematic analysis was conducted using NVIVO software. Findings consisted of four primary themes: (1) views and current SRH practices; (2) barriers to accessibility; (3) the effects of COVID-19 on accessibility; (4) identified gaps in SRH care. The findings from our study support the development of knowledge translation strategies and make recommendations to improve the present quality of SRH services in Edmonton.

Peer support for adolescent girls living with scoliosis: finding a digital community

Introduction : Scoliosis in a condition where a curve develops in the spine. Adolescent girls affected by scoliosis are significantly more likely to require treatment such as bracing or surgery than their male counterparts. Curvy Girls is a peer support group for adolescent girls with scoliosis that allows them to engage with each other in a safe environment. Objectives : This study endeavours to explore the experiences of adolescent girls living with scoliosis who are Curvy Girls members and understand how this peer support group has affected their experience. Approach : Sixteen participants were recruited through a senior board member of Curvy Girls. Data was gathered through semi-structured interviews with open-ended questions, transcribed verbatim, and analyzed using an applied philosophical hermeneutic approach, a practice of uncovering insights from transformational conversation. Findings : We found that the participants’ sense of belonging to Curvy Girls did not depend on their level of involvement with the group. Whether they were leaders in their in-person local group, or simply following the organization on social media, seeing themselves represented allowed the participants to feel like they belonged to the group. Future Directions : These findings may help clinicians, healthcare professionals, and peer support organisations deepen their understanding of the perspectives of this specific population. This transformed understanding could lead to the instauration of care and services that are better adapted to this population’s needs, resulting in lessening the burden of the condition on the individual and their support system.

Experiences of Menstruation with Factors Influencing Menstrual Hygiene Practices Among Adolescent Girls Attending Outpatient Department of Secondary Care Hospital Setting

Background: Menstruation is a physiological process as it brings changes in a young woman’s life. In this process, menarche is the most important phase in menstruation. It is the onset of first menstruation in girls. In today’s time also, menstruation is confused by different perceptions, myths, and misconceptions, which later affect their menstrual hygiene practices. Materials and Methods: The mixed method approach is adopted for the study. A qualitative approach using an in-depth interview was adopted for exploring the experiences of adolescent girls, and a quantitative approach was used for assessing factors influencing menstrual hygiene practices. Results: Adolescent girls had various experiences regarding their menarche. Seventy-four percent of girls had average menstrual hygiene practices. Several influencing factors were found and after applying binary logistic analysis four risk factors were found, which are caste, problems faced by girls during menses, frequency of changing pads, and method of disposal. Conclusion: The present study shows that girls had various experiences at the time of their menarche. They are having average menstrual hygiene practices, and there are various factors found which influence menstrual hygiene practices. Though there are several modules to maintain menstrual hygiene, still many adolescent girls lack resources such as a supply of clean water, availability of toilets, and use of sanitary pads.

Knowledge and experiences of abortion among adolescent girls in Asia: a scoping review from 2010 to 2020

It has been estimated that 5.6 million abortions occur each year among adolescent girls aged 15 - 19 years, of which 3.9 million are unsafe. The situation in Asia is particularly complicated compared to other regions due to the distinction in socio-cultural characteristics. This study aimed to describe abortion knowledge and experiences of adolescent girls in Asian countries in the period 2010 - 2020. Among 22 included publications, 41% of the studies were conducted in South-East Asia. The percentage of girls lacked knowledge and had improper perceptions of abortion could be as high as 95.7%. Common reasons for abortion were health conditions and socio-economic pressures, such as poverty and the need to maintain social self-sufficiency. Medical and surgical abortion was common, and while many girls went to hospitals and legitimate health providers, some did it themselves or went to clandestine abortion. Physical complications included menstrual disorders, pain, fever, vaginal bleeding or even septic shock, while feeling guilty and stressed was flagged as emotional consequences. To improve the situation of teenage abortion in Asia, adolescents should be provided with adequate knowledge on abortion laws and care, parents should be more open to this issue and governments should consider permitting legal abortion among adolescents.

Living with Internet Addiction: Experience of Adolescent Girls during Learning from Home in COVID-19 Pandemic


 Aims: In recent years, the internet has been seen as a positive tool that simplify various activities of human life. However, internet use is also seen as negatively impacting the lives of adolescents, especially during the Covid 19 pandemic. This study aimed to explore the life experiences of adolescent girls who became addicted to the internet while learning from home during the Covid 19 pandemic.
 
 
 Methods: This was a qualitative phenomenology study was conducted in West Java Province, Indonesia. Total sample was 13 adolescent girls which obtained by purposive sampling technique. The inclusion criteria for this study were high school students from high schools; experienced moderate internet addition as evidenced by the result of the Internet Addiction Test (IAT); and able to communicate in Indonesian. Exclusion criteria was participants with communication problem and psychiatric disorders such as depression and schizophrenia. Data were collected through in-depth interviews and analysis was performed using the Collaizzi approach.
 
 
 Results: Five themes were identified in this study: constant use of the internet due to boredom, bad mood, and curiosity; health issues due to internet use; easily influenced by internet contents; tend to forget learning materials and lazy to learn; and parental supervision.
 
 Conclusion: Adolescent girls with internet addiction have a complex life as they are easily influenced by what they see on the internet. In addition, these girls also experience various health problems. The results of this study can provide information to the public and health workers about the importance of monitoring the use of the internet among adolescents. Controlling the use of the internet is still necessary for internet use and is good and in accordance with the needs and based on the development of adolescents.

Kicking goals: Exploring the experiences of girls who play Australian Rules football.

Increasing physical activity of adolescent girls is a key priority for health promotion, as their physical activity levels are generally lower than boys. This study aims to understand the experiences of adolescent girls who play Australian Football League Women's (AFLW) football and to explore girls' pathways to playing football. Understanding how AFLW and gender norms/stereotypes influence girls' experiences and self-perceptions was a key focus. A qualitative description design and purposive sampling were used. Six adolescent girls aged 11-17 that play football in urban Victoria, Australia participated. Short interview survey questions covering demographic and football pathway information were administered prior to online one-on-one interviews. Interviews lasted 30-45minutes. Questions were framed broadly, open-ended and non-directive (some using image prompts). Data were analysed using thematic analysis. The results cover four themes: (a) Self-perception-participants presented with positive self-perceptions, (b) Social support-a supportive team and exposure to women playing football, and family support/involvement, were encouraging factors in pathways to playing football, (c) AFLW role models-were positive influences on participants' experience and self-perceptions and (d) Influence of gender norms/stereotypes-participant self-perceptions displayed conforming and non-conforming features of gender norms/stereotypes. Participants reported exposure to sexist commentary about girls in sport through social media and peers but instead of being discouraged, most used it as motivation or empowerment, while others were dismissive. Findings suggest increased media coverage of AFLW players may be beneficial. Education programs/initiatives which i) involve AFLW role models and ii) encourage family friendly club environments and team bonding spaces are recommended. SO WHAT?: Findings indicate that adolescent girls can thrive in their football experience, which could increase feelings of empowerment and foster positive self-perceptions, contributing to overall health. Further research in this area is recommended to expand on and strengthen our study findings.

Adolescents' experiences of menarche and menstruation in disadvantaged schools in South Africa: a qualitative exploration

PurposeThis study explores how menstruation is perceived, experienced and navigated by school-going adolescent girls living in low-to-middle income settings in South Africa. Existing research from developing countries suggest that the onset of menstruation has implications for school attendance and academic performance. There is evidence that menstrual cycle–related symptoms (primarily physical) lead to difficulties in, or interference with, and disengagement from school, social relations, and physical activities (van Iersel et al., 2016; Steiner et al., 2011; Kiesner and Pastore, 2010; Taras, 2005). The onset of menstruation can be shame-inducing and has been associated with anxiety and confusion. Few studies have been conducted on menstruation in countries with a history of sectarian violence and characterised by substantial socio-economic disparities and high levels of gender-based violence. Understanding the experiences of girls in these contexts is important in generating contextually-grounded knowledge and appropriate interventions.Design/methodology/approachA qualitative, exploratory, descriptive and contextual research design was used to collect data from 48 adolescent girls aged 13–16 year-old. A total of six focus group discussions (FGDs) were conducted using a semi-structured questionnaire among a purposive sampling method. Data collected were transcribed verbatim and thematically analysed. Written parental consent was obtained for participants under 18 years old.FindingsThe findings illustrated complex psychological experiences in response to menarche and menstruation. Experiences of shame in relation to menstruation were aggravated by unsupportive responses from school teachers. Challenges such as scarcity of sanitary products were experienced as creating a barrier for girls' school attendance.Research limitations/implicationsExisting research from developing countries suggests that the onset of menstruation has implications for school attendance and academic performance. The research data includes the views of adolescent learners and their negative reactions and positive experiences towards menstruation within the school environment.Practical implicationsGiven the comparative paucity of research emerging from developing countries in sub-Saharan Africa, this paper addresses an important gap in the literature by providing contextually-nuanced information about the menstrual experiences of adolescent girls. The study can further provide information for efforts made by the Department of Education and Department of Health regarding the impact of menstruation on adolescent girls' school attendance.Social implicationsThis study provides important insights regarding the experiences of South African school girls in relation to menstruation. Although dominant feelings of shame, confusion and disgust may surround menstruation, the study also highlighted potential positive experiences associated with menstruation. Teachers and school administrators need to be oriented towards the needs of adolescent girls if issues regarding poor school attendance are to be addressed.Originality/valueTo reduce absenteeism in schools and ensure learners are provided with improved allocation of sanitary products in schools, there is a need for the advocacy regarding sexuality education and resources to promote the psychological health of adolescent girls.

Sexual and reproductive health experiences of adolescent girls and women in marginalised communities in Bangladesh

Participatory research was conducted with adolescent girls and women in three isolated rural communities of Bangladesh to assess their perspectives and the role of social and gender norms on the construction of knowledge regarding menstruation, pregnancy and abortion. Norms of privacy and silence, local beliefs and a culture of shame held that the human body is ‘natural’ and does not require formal sexual and reproductive health care. Instead, participants sought out traditional healers and used herbal plants as natural remedies. Participants reported being restricted in performing religious activities, cooking and food consumption during menstruation. Because sanitary protection was expensive, women used old cloths to soak up menstrual blood and used them repeatedly without washing with soap or drying in the open air, due to shame and the fear of evil spirits. The local incidence of child marriage was high, which also limited women’s agency and voice. Contraceptive use was irregular and inappropriate; none of participants or their husbands used contraceptives, resulting in unwanted pregnancy often followed by unsafe abortion. Programmes and interventions are needed that engage with women’s experiences within the sociocultural context of studied communities.

Physical Activity Experiences of Adolescent Girls Living in a Rural Community

This study explored the daily life physical activity (PA) experiences of 11 adolescent girls living in a rural community in the Northwest of the United States. This qualitative study employed visual methods to explore adolescent girls’ PA experiences in their daily lives. Specifically, this study used visual diaries and photo-elicitation interviews to capture girls’ PA experiences. Data from this study revealed two distinct PA patterns among the 11 participants: casual movers and sporty girls. Casual movers have a much less structured approach to PA. They engage in a wide variety of PA types—mostly individual forms of PA and PA geared towards recreation. They describe fun, enjoyment, and task mastery as their main motivations to be physically active. Casual movers often engage in PA with family members and are compelled to be active outdoors and in their homes or neighborhoods. In contrast, all five sporty girls belong to competitive sports teams and have a more structured PA routine. They seek performance improvement and have high perceptions of physical competence. Sporty girls value being active with their teammates and receive strong support from their families in the form of encouragement, role modeling, and financial/structural assistance. Sporty girls feel confident being active in their schools’ fields, courts, and gymnasiums, but also appreciate the outdoors environment. Findings from this study support the need for schools to increase access to PA opportunities that are not focused on skill or fitness performance, thus appealing to casual movers’ approach to physical movement.

A Qualitative Study Exploring Menstruation Experiences and Practices among Adolescent Girls Living in the Nakivale Refugee Settlement, Uganda

(1) Background: Girls in low- and lower-middle income countries face challenges in menstrual health management (MHM), which impact their health and schooling. This might be exacerbated by refugee conditions. This study aimed at describing menstruation practices and experiences of adolescent girls in Nakivale refugee settlement in Southwestern Uganda. (2) Methods: We conducted a qualitative study from March to May 2018 and we intentionally selected participants to broadly represent different age groups and countries of origin. We conducted 28 semistructured interviews and two focus group discussions. Data were transcribed and translated into English. Analysis included data familiarization, manual coding, generation and refining of themes. (3) Results: Main findings included: (a) challenging social context with negative experiences during migration, family separation and scarcity of resources for livelihood within the settlement; (b) unfavorable menstruation experiences, including unpreparedness for menarche and lack of knowledge, limitations in activity and leisure, pain, school absenteeism and psychosocial effects; (c) menstrual practices, including use of unsuitable alternatives for MHM and poor health-seeking behavior. (4) Conclusions: A multipronged approach to MHM management is crucial, including comprehensive sexual education, enhancement of parent–adolescent communication, health sector partnership and support from NGOs to meet the tailored needs of adolescent girls.

‘That’s given me a bit more hope’ – adolescent girls’ experiences of Forest School

ABSTRACT Forest School is an outdoor learning program aimed at improving wellbeing and resilience. Few studies discuss Forest School experiences from the viewpoint of adolescent girls, particularly those with mental health risk factors. The study’s aim was to explore the experiences of adolescent girls involved in a Forest School program in Scotland. An interpretive approach, using qualitative interviews captured the experiences of eight girls, who were considered at risk for mental health problems, participating in a Forest School program in rural Scotland. Data were analysed using thematic analysis, which facilitated understanding the complexity of meaning participants attached to their experiences. Four main themes were identified from interviews; mental wellbeing and resilience, community and social interaction, learning, and perception of Forest School. Most participants felt the program positively affected their mood, confidence, social skills and relationships, which went beyond the Forest School setting.

"My Body Hates Me": A Qualitative Analysis of the Experience of Functional Nausea in Adolescent Girls and Their Mothers.

Nausea is a somatic sensation typically associated with the need to vomit in order to remove a toxin from the body. When nausea occurs in the absence of a specific structural cause or toxin, it is classified as a functional gastrointestinal disorder (FGID). Functional nausea was newly recognized in 2016 as a FGID in children and little is known about its prevalence, course or patient experiences. Nausea co-occurring with functional abdominal pain in childhood has been associated with long-term risk for anxiety and ongoing somatic symptoms into young adulthood. However, few studies have focused uniquely on the experience and impact of nausea on youth. The present study aimed to qualitatively understand the experiences of adolescent girls with functional nausea and their parents. Five mother–daughter dyads were recruited from a specialized pediatric gastroenterology clinic focused on nausea and completed semi-structured interviews. Interviews were transcribed and coded using interpretive phenomenological analysis (IPA). Four main themes emerged: nausea interference, body frustration, misunderstanding of symptoms, and maternal helplessness and guilt. These themes were similar to prior studies on the experiences of youth with chronic pain but also indicated unique challenges due to nausea, such as significant food restriction and subsequent weight loss.

‘Can you move your fat ass off the baseline?’ Exploring the sport experiences of adolescent girls with body image concerns

ABSTRACT Body-related self-conscious emotions such as shame, guilt, envy, and embarrassment are highly prevalent in sport contexts and are associated with poor sport experiences and lower participation among adolescent girls. However, little is known about how body self-consciousness impacts quality sport among adolescent girls. The current study aimed to explore the sport experiences of girls with high body self-consciousness. Eleven adolescent girls (M age = 14.5 years) with an average of six years of experience in sport were purposefully sampled and participated in semi-structured interviews. Using a thematic analysis, six themes were identified: (i) navigating the culture of ‘body talk’, (ii) managing appearance- and fitness-related social comparisons, (iii) tension between appearance and sport competence evaluations, (iv) evaluation and competition in the sport culture, (v) compensatory behaviours (i.e. exercise) and restrictive eating to manage body self-consciousness, and (vi) duality of the body within and outside of sport. Collectively, the findings highlight the need to improve social practices in sport among girls in an effort to enhance adolescent girls’ sport experiences.

Studi Fenomenologi: Pengalaman Remaja Perempuan Menjalankan Peran Sebagai Ibu

Carrying out the role of a mother is not easy, especially for a teenage girl. Pregnant, giving birth and caring for a baby has its challenges for adolescent girls. The purpose of this study is to explore deeply the experiences of adolescent girls in carrying out their roles as mothers. This research is qualitative research with a phenomenological approach. Data collection was carried out by using in-depth interviews with seven informants. Data analysis was performed using the Moustakas content analysis thematic approach. This study produced three broad themes. The first theme is that young women do not give exclusive breastfeeding to their babies. The second theme is that adolescent girls cannot do basic baby care. The third theme is teenage girls not knowing the process of pregnancy. The young age and growth and development are not optimal making adolescent girls have difficulty in carrying out the role of motherhood. Lack of knowledge and experience causes adolescent girls are not optimal in providing the best for their children. Nurses especially maternity nurses can provide health education to adolescent girls in caring for newborns. Nurses can also educate adolescent girls to prepare themselves before deciding to become a mother.Keywords: Teenage mother; Maternity nurse; Newborn baby; Exclusive breastfeeding

Testing Positive and Disclosing in Pregnancy: A Phenomenological Study of the Experiences of Adolescents and Young Women in Maseru, Lesotho.

The routine antenatal screening through the prevention of mother to child transmission of HIV (PMTCT) services results in pregnancy being often the point at which an HIV diagnosis is made. Disclosure to partners presents particular complexities during pregnancy. However, research on the pattern and experiences of disclosure in pregnancy is limited in Lesotho, despite the high prevalence of HIV among pregnant women. The aim of this study was to explore and describe the disclosure experiences of adolescent girls and young women (AGYW) after receiving a positive HIV test result during pregnancy. Methods. Descriptive phenomenology using semistructured in-depth interview was used to collect data from AGYM sampled purposively from PMTCT sites located in urban areas of Maseru, Lesotho. Data analysis was inductive and followed the thematic approach. Findings. There were 15 AGYW involved in this study with the mean age of 20 years. Fourteen reported being pregnant with their first child and perceived HIV testing in antenatal care as compulsory. Ten AGYM disclosed their HIV status in the immediate posttesting period to protect their partners from HIV infection. The narratives revealed that the AGYM hoped that after disclosing, the partner would be tested for HIV. Furthermore, the AGYM disclosed because they wanted freedom to take their medication. Their experience of disclosure was relief, as they did not have to hide their HIV status. The AGYM reported being supported to adhere to medication and clinic attendance by their partners who also provided emotional support to them to deal with being HIV positive and pregnant. Conclusion. The AGYM recounted an overall positive experience of disclosure to their partners who agreed to test for HIV and adopted safe sex practices. This has positive implications for the PMTCT programme and the involvement of men in reproductive health. Therefore, there is need to integrate disclosure and partner testing interventions in the cascade of services in PMTCT programmes.

Prevalence and associated psychosocial and health factors of chronic pain in adolescents: Differences by sex and age.

Chronic pain is a common issue in adolescents. Prevalence of pain and associated factors present differently in sex and age subgroups; however, the interaction of sex and age combined has not been thoroughly assessed. This study aimed to identify psychosocial and health factors associated with chronic pain in younger and older adolescent girls and boys. Students from five schools in grades 5-10 self-completed a pain survey. Participants were 2,280 adolescents (52% girls) aged 10-18years (M=12.95, SD=1.84). Data were analysed using multivariate logistic regression models. Chronic pain was present in 33% of participants. The risk of chronic pain increased by 29% in girls, compared to 16% in boys, per year of age (p=.039). Overall, depression (OR=2.05, p<.001), anxiety (OR=1.51, p<.001), lower school satisfaction (OR=1.41, p=.034) and sleep issues (OR=2.34, p<.001) were associated with chronic pain. Stratified analyses identified unique significant associations between chronic pain and psychosocial factors. In boys aged 10-13years, higher socioeconomic status (OR=1.76, p=.024) and poorer school performance (OR=1.60, p=.027) were uniquely important; in girls aged 10-13years, lower school satisfaction (OR=2.92, p=.003) was associated with pain, and in older girls aged 14-18years, anxiety (OR=1.74, p=.009) was significantly associated with pain. When these differences were assessed statistically, only lower school satisfaction had significant differences between subgroups (p=.049). Many psychosocial and health factors are similarly important, with few differences, for chronic pain in girls and boys at different stages of adolescence. We report evidence that negative psychosocial and health factors are related to a higher prevalence of chronic pain in adolescents. Furthermore, the relationships between anxiety, socioeconomic status, lower school satisfaction and lower school performance with pain may vary between adolescents of differing sexes and ages. Understanding how possible risk factors for chronic pain contribute differently to the pain experience of adolescent girls and boys is an important step towards lowering the prevalence of this common health condition.

Psychological Experiences of Adolescent Girls with Polycystic Ovary Syndrome: A Qualitative Study.

Background:Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders in the women of reproductive age. In addition to multiple physical problems, this syndrome has many psychological manifestations. Thus, the present research was conducted aimed at investigating the psychological experiences of the adolescent girls with PCOS.Materials and Methods:This research was conducted using the qualitative content analysis method. A total of 18 adolescent girls with PCOS and 15 healthcare providers were selected by the purposive sampling method. The data were collected through in-depth interviews, focus group discussions, and field notes, which were analyzed using the conventional content analysis method.Results:After analyzing, three main categories and seven subcategories were extracted. First, the psychological experiences related to the disease symptoms had three subcategories: “psychological experiences related to hirsutism, alopecia, and acne,” “psychological experiences related to obesity,” and “psychological experiences related to menstrual disorders.” Second, the psychological experiences related to disease complications had two subcategories: “psychological experiences related to infertility” and “psychological experiences related to disease progression.” Third, the psychological experiences related to treatment of the disease had two subcategories: “psychological experiences related to prolongation of the treatment and uncertain fate of the disease” and “psychological experiences related to the complications of the medical treatment.”Conclusions:Results of the study showed that adolescent girls with PCOS were exposed to multiple concerns endangering their psychological health. Therefore, it is recommended to provide adequate and appropriate information about the disease and its consequences, as well as psychosocial supports and regular assessment of psychological state by the team of healthcare providers in the adolescent girls with PCOS.

Unmet Needs and Experiences of Adolescent Girls with Heavy Menstrual Bleeding and Dysmenorrhea: A Qualitative Study.

To identify and examine the key areas of need and explore the experiences of adolescent girls with heavy menstrual bleeding and/or dysmenorrhea. Qualitative interview study using semi-structured interviews. Gynaecology outpatient clinic at The Royal Children's Hospital, Melbourne, Australia. Adolescent girls (12-18years; mean age, 14.8±1.5years) presenting with heavy menstrual bleeding and/or dysmenorrhea at the clinic (N=30). In-depth semi-structured interviews were conducted between May and August 2018. Interview data were thematically analyzed using a grounded theory approach. Themes covered experiences and unmet needs of adolescent girls with heavy menstrual bleeding and/or dysmenorrhea. A total of 12 themes were identified, and covered the impact of symptoms, experiences, and/or unmet needs of these adolescents. Key themes highlighting experiences and unmet needs related to (1) coordination of healthcare, (2) day-to-day coping, (3) school, and (4) information surrounding menstrual issues. From these themes, 7 unmet needs emerged and were organized under 3 key areas of need: (1) treatment, management, and care, (2) improvements in the school environment, and (3) menstrual health as a gendered issue. Menstrual concerns can have a profound physical and psychosocial impact on adolescents. Effective school-based menstrual education programs may be key in reducing stigma, fear, and shame surrounding menstruation, in teaching positive management strategies and in encouraging adolescents to seek help for their menstrual concerns.

'It’s like a burden on the head': Redefining adequate menstrual hygiene management throughout women’s varied life stages in Odisha, India

There has been growing recognition of menstrual hygiene management (MHM) as a significant public health issue. However, research has predominately focused on the experiences of adolescent girls in school settings. The purpose of this research is to examine detailed accounts of menstruation for women in rural Odisha, India at various life stages with a view toward improving international monitoring of MHM. Focus group discussions and in-depth interviews were conducted to understand women’s experiences of menstruation across four life stages (unmarried women, recently married women, married women, and older women). Thematic analysis was used to identify menstruation-related challenges and needs. We found women voiced needs that aligned with those captured by the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) definition for MHM: access to clean materials, privacy for changing materials, soap and water for bathing, and disposal facilities for materials. However, we also found women require materials that are not only clean but comfortable and reliable; soap and water for more than bathing; privacy for the full spectrum of menstruation-related practices, not just when changing; and disposal facilities that are private and safe, not just accessible. Additionally, we identified needs that extend beyond the existing definition: pain management, social support, and an enabling sociocultural environment. Overall, women representing all life stages discussed menstruation challenges, including bathing, pain, and washing, drying, and storing cloth materials. Cloth management challenges were most acute for unmarried and recently married women, who were concerned that practices could reveal their menstrual status and harm their reputations, thus informing their preference for disposable materials, if attainable. We propose a revised definition of adequate MHM for this population that more comprehensively captures their needs. This definition may also prove useful for other populations, future research, creating measures of assessment, and guiding interventions and program priorities.