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<p>Adolescent girls in sub-Saharan Africa must transition through puberty in the context
of heightened risk for reproductive tract infections and mental illness. At the same
time, girls experience menstrual stigma and a lack of resources to manage menstruation.
Although menstruation and other puberty-specific stressors may negatively impact girls’
well-being, little is known about the relationships between puberty-specific stressors,
coping, mental health, and reproductive health among girls in sub-Saharan Africa.
The present dissertation seeks to fill this gap by investigating the types of puberty-specific
stressors experienced by adolescent girls and young women in Tanzania, how girls cope
with stressors, and the associations between stress and coping and mental health and
reproductive health. A qualitative interview study and cross-sectional survey study
were conducted to explore stress, coping, and health among adolescent girls in Tanzania.
Both studies showed that girls experienced significant and disruptive puberty-specific
stressors, with sexual pressure and menstrual pain constituting two of the most common
stressors. Stressors were associated with depression, anxiety, and reproductive tract
infections. Active coping and avoidant coping showed inconsistent relationships with
stressors and mental health. Overall, psychosocial interventions are needed to reduce
the negative impact of puberty-specific stressors on mental health and reproductive
health among adolescent girls in Tanzania.</p>
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