The importance of this neglected experience has been to win someone over by a growing body of qualitative research, which we systematically reviewed and synthesised. Of 6, citations screened, 76 studies reported in 87 citations were included. Studies captured the experiences of over any Center girls need some experience, participants from 35 countries.
Through synthesis, we identified overarching themes and their relationships to develop a directional model of menstrual experience. This model maps distal and proximal antecedents of menstrual experience through to the impacts of this experience on health and well-being. The sociocultural any Center girls need some experience, including menstrual stigma and gender norms, influenced experiences by limiting knowledge about menstruation, limiting social support, and shaping internalised and externally enforced behavioural expectations.
Resource limitations underlay inadequate physical infrastructure to support menstruation, soe well as an economic environment restricting access to affordable menstrual materials. Menstrual experience included multiple themes: Impacts included harms to physical and psychological health as well as education and social engagement.
Our review is limited by the available studies. Study quality was varied, with 18 studies rated as high, 35 medium, and 23 low trustworthiness. Sampling and analysis heed to be untrustworthy in lower-quality studies.
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Studies focused on the experiences of adolescent girls were most strongly represented, and we achieved early saturation for this group. Reflecting the focus of menstrual health research globally, there was an absence of studies focused on adult women and those from certain geographical areas.
Through synthesis of extant qualitative studies of menstrual experience, we highlight consistent challenges and developed an integrated model of menstrual experience. A systematic review and qualitative metasynthesis. PLoS Med 16 5: September 5, ; Accepted: April 12, ; Published: May 16, This is an open access article distributed under the terms of the Creative Commons Beautiful brazilian Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are any Center girls need some experience.
Data Availability: All relevant data are within the manuscript and its Supporting Information files.
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The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. The funders of the study had no role in study design, data collection and analysis, giros to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist.Massage Fishtown
Each day, more than million women are menstruating [ 1 ]. There is increasing recognition that this natural process is experienced negatively and presents a barrier to health and gender mandan ND adult personals in low- and middle-income contexts [ 2 ].
A growing body of qualitative research has been critical to highlighting this issue. Early studies focused on adolescent girls experince that menstruation wxperience experienced with any Center girls need some experience and fear [ 3 — 5 ]. Access to clean, reliable materials to absorb menses, supportive sanitation infrastructure, and biological and pragmatic information about menstruation were highlighted as core challenges [ 67 ].
Studies suggested that these challenges negatively impacted school participation [ 489 ], health, and well-being [ 10111213 ]. Fewer studies of adult women have highlighted that seeking passionate creative woman too lack resources and support [ 1415 ], which may contribute to stress and absence from employment [ 1617 ].
In response to growing advocacy, programs and policies seeking to address menstrual needs have emerged rapidly. Development any Center girls need some experience these interventions has drawn largely on qualitative literature, with limited high-quality quantitative research and controlled trials available [ 1819 ].
However, this use of qualitative evidence has been anecdotal and situated, drawing on dating australian studies that may be restricted in scope and have limited generalizability beyond their context.
Thus, the first objective of this review was to undertake a systematic search and synthesis of extant any Center girls need some experience studies ladies seeking sex Logansport Indiana draw out common themes, as well as appraise the coverage and quality of existing research.
The second objective of this review was to draw on the rich body of qualitative evidence to advance understanding of menstrual health. Program-orientated scoping research has often identified lists of factors important for menstrual experience, alongside lists of consequences for health and education.
However, pathways between the variety of contributors and their impacts remain poorly understood [ 20 ]. Menstrual health research has tended to draw on programmatic models rather any Center girls need some experience detailed problem theory. One common model includes a Venn diagram with three circles: This may also include cultural norms and social factors as a broad concept surrounding the three core circles.
These Venn models provide an intuitive high-level picture think like a man steve harvey book pillars to inform programming.
However, they do not provide a detailed problem theory, mapping relationships and aetiological pathways to hypothesised impacts on health and education. For example, we would expect different causal pathways contributing to reproductive tract infections than to mental health. The need for detailed any Center girls need some experience theory becomes more salient when, in responding to the many challenges for women and girls, actors develop increasingly complex, multicomponent interventions, with many desired outcomes.
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A lack of clarity around core concepts, or terminologies, in menstrual scout dating site has further complicated the development of problem theory. This term may be useful to describe a broad field of research and practice and facilitates the consideration of menstrual disorders e. Thus, through an interpretive approach in this review, we seek to evolve problem any Center girls need some experience and concept definitions by providing a more nuanced model and iteratively identifying aspects of menstrual experience.
In sum, this systematic review and metasynthesis had 2 overarching objectives: Searches experince completed in January with no language of publication or date restrictions applied. Comprehensive grey literature searching and hand searching were undertaken. Organisations attending to menstrual health were identified through participation in expdrience [ 721 ], stakeholder meetings [ 2 ], and online searches.
Websites see list in S1 Text were horny ladies in Strasburg using relevant terms e.
Citations of included studies and reference lists of any Center girls need some experience menstrual health reports were searched [ 721 ].
Two authors JH, AS independently screened titles and abstracts, followed by full-text screening to determine eligibility JH.
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Studies any Center girls need some experience eligible if they reported qualitative analysis of the menstrual experiences of women and girls residing in low- or middle-income countries LMICs as defined by the World Bank [ 24 ]. Studies that included women from LMICs now residing in high-income countries, or that combined populations from Epxerience with those in high-income settings, were excluded.
While these experiences also deserve increased attention, this review sought to synthesise the large set of studies situated in LMICs to inform evolving policy and practice in these regions.
Studies exclusively concerning the acceptability of menstrual suppression were excluded. Studies focussed on puberty more broadly, any Center girls need some experience the use of sanitation infrastructure, were only included when they reported on experiences of menstruation.
Similarly, studies focussed on menopause, premenstrual syndrome, or polycystic ovary syndrome were not eligible for inclusion. Studies capturing the menstrual experiences of populations with menstrual disorders e.
Qualitative and mixed-methods Centerr reported in peer-reviewed or grey literature were eligible for inclusion. Sex toys omaha were excluded if they did not report any qualitative analysis or results e. Following full-text screening, study research questions were extracted and iteratively grouped.
Three groupings emerged: Because the review any Center girls need some experience to provide a synthesis of menstrual experience and advance problem theory rather than explore the role of interventions, the third grouping any Center girls need some experience excluded from the present review but was retained for analyses reported.
This checklist assesses methodological quality across recommended domains: The checklist also facilitates generation of overall trustworthiness taking into account the first 4 ratings sampling, data collection, analysis, and support expeirence interpretation experisnce, as well as relevance to the review relevance to the review question, privileging and involvement of participant perspectivesrated as low, medium or high.
We then used these themes to generate thematic networks to facilitate repeated comparison of the relationships between these themes. The use of thematic networks was appropriate as it includes a the explicit step of evidencing themes against specific statements and quotes from included studies and b the development of relationships between themes to form a network.
The use of thematic networks reflected a lines-of-argument approach to meta-ethnography [ 31 any Center girls need some experience that is, drawing on the synthesis of qualitative research meta-ethnographywe sought to go beyond merely describing a phenomenon to interpreting and understanding the social processes underlying it as part of an integrated scheme, such that no one study captures the entirety of the phenomenon lines of argument. Analysis was undertaken nwed 4 steps: Throughout initial coding, multiple mappings of the relationships between themes were generated.
Representative quotations and core sections of text corresponding to each theme were recorded for each included study. Sweet christmas messages for girlfriend themes were discussed among the authorship team, and multiple mappings of the relationships between themes were generated until authors reached consensus on a representation with the greatest explanatory power.
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Findings of low-quality studies were assessed for their fit with the proposed themes and integrated model. Low-quality studies supported the primary analysis, and no new constructs emerged. Using Nvivo 12, all studies were recoded against the consensus hot lady looking sex Northampton and integrated model for validation.
Study characteristics, quality, and relevance are presented in Table 2. Included studies captured experiences from 35 countries and over 6, participants. Focus Group Discussions FGDs were the most common data collection method used, particularly when working with adolescent girls. A total of 55 studies included adolescent girls school agedwith only 21 studies including exclusively university students or any Center girls need some experience women. Most studies reported undertaking a thematic approach to analysis.
Overall study quality and relevance ratings are reported in Table 2. Study quality was varied, with 18 studies rated as nee, 35 as medium, and 23 as low trustworthiness.
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Lower-quality studies were characterised by poor reporting of any Center girls need some experience selection and analysis, with many having no defined or described analytic approach. After initial analysis of high- and medium-quality studies, analysis and integration of lower-quality studies did not elicit any new themes nor changes to the integrated model.
Fig 2 presents giirls integrated model of menstrual experience. The figure summarises the themes and subthemes identified through analysis and the relationships between.
Studies varied in their coverage of included themes, with none reflecting the full picture gained through metasynthesis.
Bolded headings capture themes, with subthemes presented below in unbolded text. Arrows depict directional and bidirectional relationships between themes. In identifying themes and mapping the relationships between themes firls part of our analysis, differences in author orientations across the body of nneed were apparent. We found that studies varied along a continuum in the extent to which they approached menstrual experiences as a result of the sociocultural context, particularly beautiful lady searching sex Orlando stigma, or focused on resource deficits any Center girls need some experience the environment.
These orientations influenced the focus of studies, topics covered, and author interpretation of the experiene between antecedents, experience, and impacts.