'Making of a strong woman': a constructivist grounded theory of the experiences of young women around menarche in Papua New Guinea

Maulingin‑Gumbaketi, Elizabeth, Larkins, Sarah, Gunnarsson, Ronny, Rembeck, Gun, Whittaker, Maxine, and Redman-MacLaren, Michelle (2021) 'Making of a strong woman': a constructivist grounded theory of the experiences of young women around menarche in Papua New Guinea. BMC Women's Health, 21. 144.

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Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Item ID: 69415
Item Type: Article (Research - C1)
ISSN: 1472-6874
Keywords: Menarche, Menstrual health and hygiene, Reproductive health, Papua New Guinea
Copyright Information: © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Date Deposited: 22 Sep 2021 03:13
FoR Codes: 45 INDIGENOUS STUDIES > 4516 Pacific Peoples health and wellbeing > 451607 Pacific Peoples health promotion @ 50%
45 INDIGENOUS STUDIES > 4516 Pacific Peoples health and wellbeing > 451603 Pacific Peoples cultural determinants of health @ 50%
SEO Codes: 21 INDIGENOUS > 2111 Pacific Peoples health > 211101 Pacific Peoples determinants of health @ 50%
20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200509 Women's and maternal health @ 50%
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