Stress, Coping, Mental Health, and Reproductive Health among Adolescent Girls Transitioning through Puberty in Tanzania

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.