Adolescent Experience of Menstruation in Rural Kenya Molly Secor-Turner ▼ Kaitlin Schmitz ▼ Kristen Benson Background: Although menstruation is a universal experience, girls in resource-poor areas face unique challenges related to menstruation management. In Kenya, girls miss nearly 3.5 million learning days per month because of limited access to sanitary products and lack of adequate sanitation. Global priorities to address gender inequality—especially related to education—often do not consider the impact of poverty on gendered experiences, such as menstruation. Objective: The aim of the study was to describe the experiences of menstruation from the perspective of adolescent girls living in rural Kenya. Methods: Data for this qualitative study were collected through 29 individual interviews with adolescent girls and separate field observations. Descriptive content analysis was used to identify themes reflective of the data from the individual interviews and field notes. Results: Four themes were developed to summarize the data: (a) receiving information about menstruation, (b) experiences of menstruation, (c) menstrual hygiene practices, and (d) social norms and the meaning of menstruation. Conclusions: Findings from this study describe the impact of menstruation on the lives of adolescent girls in rural Kenya. Menstrual hygiene management and its associated challenges may impact girls’ academic continuity. Experiences of menstruation also reinforce gender inequality and further marginalize girls in low-income, rural areas of Kenya. Consideration of menstruation is critical to promote health and academic continuity for girls in rural Kenya. Key Words: adolescent  Africa  hygiene  Kenya  menstruation  qualitative research  reproductive health Nursing Research, July/August 2016, Vol 65, No 4, 301–305 A lthough menstruation is a universal experience through- out the world, girls in Sub-Saharan Africa (SSA) experi- ence challenges during menstruation—especially in rural and resource-poor areas. A small body of research sug- gests that menstruation affects the daily lives of girls in devel- oping countries and has implications for their school attendance and academic performance (Chege & Arnot, 2012; Jewitt & Ryley, 2014; McMahon et al., 2011). It is estimated that girls in Kenya miss nearly 3.5 million learning days per month because of limited access to reliable hygienic sanitation and sanitary products (Jewitt & Ryley, 2014). School attendance is further limited by lack of access to private toilets, running water, facilities for pad disposal or cleaning, sanitary pads, extra clothing, and funding for sani- tary products (Crofts & Fisher, 2012; Jewitt & Ryley, 2014; McMahon et al., 2011). Pain and lack of access to pain medication for menstrual cramping also hinder school atten- dance (Jewitt & Ryley, 2014; McMahon et al., 2011). Sanitary pads may not be accessible, forcing some girls to resort to al- ternative methods of managing menstrual blood, including the use of old clothes, mattress fibers, cotton wool, and plastic bags (Crofts & Fisher, 2012; Jewitt & Ryley, 2014; McMahon et al., 2011). Barriers to attending school during menstruation are further exacerbated by gender inequalities ( Jewitt & Ryley, 2014; McMahon et al., 2011). This article describes experiences of menstruation from the perspective of adolescent girls living in rural Kenya. In- formed by feminist theory, we examine the intersections of gender, poverty, and education and recognize that girls’ edu- cation in SSA is positioned within a greater social and eco- nomic context (Chege & Arnot, 2012; Jewitt & Ryley, 2014; Kim et al., 2009; Unterhalter, 2012). METHODS Research Setting This research was conducted in Tharaka-Nithi County, a semi- arid region in central Kenya significantly impacted by low and unreliable amounts of rainfall that result in frequent droughts (Meru Professionals Association, 2012). Primary school Molly Secor-Turner, PhD, MS, RN, is Associate Professor, School of Nursing and Department of Public Health, North Dakota State University, Fargo. Kaitlin Schmitz, MPH, RN, is Community Education Specialist, Planned Parent- hood of Minnesota, North Dakota, South Dakota, Fargo, North Dakota. Kristen Benson, PhD, LMFT, is Associate Professor, Department of Human Development and Family Science, North Dakota State University, Fargo. DOI: 10.1097/NNR.0000000000000161 Health Equity Research Series Nursing Research www.nursingresearchonline.com 301 Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.