"It Gives You a Feeling of Pride when You Touch Her": The Role of Masculinity in Sexual Harassment of Adolescent Schoolgirls in Tanzania.

Sexual harassment or the unwanted offensive behaviours that women and girls experience is a pervasive global challenge. Yet, there is limited evidence on the lived experiences of sexual harassment from school-based settings in sub-Saharan Africa. We explore students' perceived experiences, perpetration, and drivers of sexual harassment in schools in Mwanza, Tanzania. This study employed a qualitative research design involving 30 in-depth interviews and seven focus group discussions with 30 male and 40 female secondary school pupils aged 13-19 years. Data was analysed using a thematic approach. The findings show that experiences of sexual harassment among schoolgirls were widespread. Common forms of harassment were verbal and non-verbal gestures of a sexual nature. The desire to prove one's masculinity and peer pressure were key drivers of perpetration among schoolboys. Teachers took advantage of their positions of authority to sexually harass female pupils and employed corporal punishment to those who resisted their advances. Sexual harassment had multiple negative outcomes, including schoolgirls dropping out of school and mental health issues, such as anxiety, stress and poor academic performance. Girls rarely reported sexual harassment for fear of further victimisation and stigma from others. Sexual harassment of girls is common in secondary schools in Mwanza and is mainly driven by peer pressure and the desire to prove one's masculinity. Given its harmful effects, there is a need to implement clear policies to protect girls, support confidential disclosure and reporting and to address toxic masculinity norms among young men.

"Menstruation is a Fearful Thing": A Qualitative Exploration of Menstrual Experiences and Sources of Information About Menstruation Among Adolescent Schoolgirls.

Background: Although menstruation is a biological phenomenon, it is still subjected to secrecy, shame, and negativity. Schoolgirls lack access to appropriate sources of information about menstruation. Little is known about the content of the information provided to schoolgirls concerning menstruation in northern Ethiopia. This study explored schoolgirls' experiences and the content of information they receive concerning menstrual hygiene management in Tigray. Methods: A qualitative design was implemented. Focus group discussions and in-depth interviews were conducted using the local language among 79 schoolgirls who had experienced menarche. Data were audio-recorded, transcribed, translated, and imported into ATLAS.ti-7.5.18 computer software for analysis. Data were coded and analyzed using a thematic analysis. Results: Five themes have emerged from the analysis: 1) there is an indistinct and haphazard source of menstrual information; 2) menstruation is perceived as "a natural gift"; 3) menstruation is also considered fearful and embarrassing; 4) negative community perceptions of menstruation lead to menstrual restrictions, and 5) lack of privacy for dealing with menstrual issues as well as the scarcity of menstrual hygiene management materials is an on going problem. Schoolgirls have indistinct and haphazard sources of information concerning menstrual hygiene management, obtaining it from teachers, mothers, sisters, and friends, but the information they receive is shrouded in secrecy and often is factually incorrect. Menstruation is commonly linked to notions of sexuality, shame, and the approach of marriageability. Conclusion: The information that schoolgirls in rural Tigray receive about menstrual hygiene management is inaccurate, insufficient, and encumbered with social taboos. Thus, schoolgirls do not have an adequate understanding of the physiology of menstruation and do not receive adequate emotional support at menarche, leaving them with feelings of embarrassment and anxiety. There should be efforts to implement programs that change community perceptions about menstruation.

Perceptions of human papillomavirus vaccination of adolescent schoolgirls in western Uganda and their implications for acceptability of HPV vaccination: a qualitative study.

BACKGROUND: Human papillomavirus (HPV) vaccination has been perceived in diverse ways some of which encourage its uptake while others could potentially deter its acceptability. This study explored community member's perceptions about HPV vaccination in Ibanda district and the implications of the perceptions for acceptability of HPV vaccination. The study was conducted following initial vaccination of adolescent schoolgirls in the district between 2008 and 2011. METHODS: This qualitative study employed focus group discussions (FGDs) and key informant interviews (KIIs). FGDs were conducted with schoolgirls and parents/guardians and KIIs were conducted with school teachers, health workers and community leaders. Transcripts from the FGDs and KIIs were coded and analyzed thematically using ATLAS.ti (v. 6). RESULTS: The HPV vaccination was understood to safely prevent cervical cancer, which was perceived to be a severe incurable disease. Vaccinations were perceived as protection against diseases like measles and polio that were known to kill children. These were major motivations for girls' and parents' acceptance of HPV vaccination. Parents' increased awareness that HPV is sexually transmitted encouraged their support for vaccination of their adolescent daughters against HPV. There were reports however of some initial fears and misconceptions about HPV vaccination especially during its introduction. These initially discouraged some parents and girls but over the years with no major side effects reported, girls reported that they were willing to recommend the vaccination to others and parents also reported their willingness to get their daughters vaccinated without fear. Health workers and teachers interviewed however explained that, some concerns stilled lingered in the communities. CONCLUSIONS: The perceived benefits and safety of HPV vaccination enhanced girls' and parents' acceptability of HPV vaccination. The initial rumors, fears and concerns about HPV vaccination that reportedly discouraged some girls and parents, seemed to have waned with time giving way to more favourable perceptions regarding HPV vaccination although the study still found that a few concerns still lingered on and these have implications for HPV vaccination acceptability.

Psychological reactions of adolescent schoolgirls to human papillomavirus vaccination in western Uganda: A comparative cross-sectional study.

Schoolgirls in two Ugandan districts were recently vaccinated against human papillomavirus that causes most cervical cancer. This cross-sectional comparative study used mixed research methods to assess influence of human papillomavirus vaccination on adolescents' worrisome thoughts about being vaccinated and psychological distress. Vaccination predicted worrisome thoughts among the recently vaccinated (adjusted odds ratio: 1.65, confidence interval: 1.13-2.41; p = 0.01). Vaccination predicted distress (1.75, confidence interval: 1.09-2.82; p = 0.02), particularly among those recently vaccinated (1.92, confidence interval: 1.27-2.89; p = 0.001) and those who experienced worrisome thoughts (1.80, confidence interval: 1.06-3.07; p = 0.02). Parental communication mitigated distress (0.50, confidence interval: 0.35-0.72; p = 0.000).