College of Medicine and Dentistry, James Cook University, Townsville, Australia.
Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
BMC Womens Health. 2021 Apr 8;21(1):144. doi: 10.1186/s12905-021-01229-0.
Menarche, the first menstruation, is a significant developmental milestone for females. In Papua New Guinea (PNG), menarche is an important socio-cultural event marking transition from girlhood to womanhood. PNG is a culturally and linguistically diverse nation, with wide-ranging socio-cultural beliefs and practices around menarche. This study explored post-menarcheal women's understanding about body changes and menarche, preparation for menarche, and related cultural beliefs and practices at menarche.
A constructivist grounded theory study was conducted with 98 female participants who originated from four PNG provinces: Eastern Highlands Province; East Sepik Province; Milne Bay Province; and National Capital District. The participants were purposively and theoretically sampled, with 10 focus group discussions and six individual interviews conducted using a semi-structured interview guide for data collection. Focus group discussions and interviews were voice recorded and transcribed. Data were inductively analyzed using initial, intermediate and advanced coding, memos and constant comparative methods to develop a theoretical model that explains women's experiences at menarche. Interview participants also identified actions required to improve future experiences of girls at menarche in PNG.
A grounded theory comprising the core category of 'Making of a Strong Woman' and four interconnecting categories ('Having Baby Sense'; 'Beginning of Learning'; 'Intensifying Learning'; and 'Achieving Womanhood') was constructed. 'Urban' and 'Rural' represented both geographical and socio-cultural intervening conditions that influence the experiences of girls at menarche. Experiences of young women at menarche were rooted in socio-cultural beliefs and practices. Women reported being physically and emotionally distressed and unprepared at onset of menarche. Mothers were considered important support, however, their ability to adequately prepare their daughters is limited by shame and secrecy. Despite these limitations, cultural practices at menarche provided an opportunity for intensive preparation of girls for womanhood.
Limited pre-menarcheal awareness of the meaning of body changes and menarche of girls was linked to culture of shame and secrecy about open discussion on sexuality. However, traditional cultural practices provide an opportunity for collective support and focused learning for girls. Findings from this study have implications for broader sexual and reproductive health education programs in addressing menstrual health and hygiene in PNG, and the Pacific.
初潮是女性的一个重要发育里程碑。在巴布亚新几内亚（PNG），初潮是一个重要的社会文化事件，标志着从少女到成年的过渡。PNG 是一个文化和语言多样化的国家，在初潮方面存在广泛的社会文化信仰和习俗。本研究探讨了初潮后女性对身体变化和初潮的理解、初潮准备以及相关的文化信仰和习俗。
采用建构主义扎根理论研究方法，对来自 PNG 四个省的 98 名女性参与者进行研究：东高地省；东塞皮克省；米尔恩湾省；和国家首都区。参与者是根据目的和理论进行抽样的，使用半结构化访谈指南进行了 10 次焦点小组讨论和 6 次个人访谈，以收集数据。对焦点小组讨论和访谈进行了录音和转录。使用初始、中间和高级编码、备忘录和恒比方法对数据进行归纳分析，以建立一个理论模型，解释女性在初潮时的经历。访谈参与者还确定了在 PNG 改善女孩未来初潮体验所需的行动。
构建了一个由核心类别“塑造坚强女性”和四个相互关联的类别（“有生育意识”；“学习的开始”；“强化学习”；和“成为女性”）组成的扎根理论。“城市”和“农村”代表了影响女孩初潮经历的地理和社会文化干预条件。年轻女性在初潮时的经历根植于社会文化信仰和习俗。女性报告说，在初潮开始时，她们在身体和情感上感到痛苦和准备不足。母亲被认为是重要的支持，但她们准备女儿的能力受到羞耻和秘密的限制。尽管存在这些限制，但初潮的文化习俗为女孩成为女性提供了一个强化准备的机会。
女孩对身体变化和初潮意义的认识有限，这与对性问题公开讨论的羞耻和秘密文化有关。然而，传统的文化习俗为女孩提供了集体支持和集中学习的机会。本研究的结果对在 PNG 和太平洋地区更广泛的性和生殖健康教育项目中解决月经健康和卫生问题具有启示意义。
