The 21st century has been a time of modernization in the way we live, in the things we read, in the technology we use, etc. Unfortunately, the same isn’t the case with our views. Our society still considers natural processes like Menstruation to be a big taboo- as a result of which, the importance of menstrual hygiene and health is reduced to zero. This acts as a collective failure for our society. Through this article, the author tries to address this issue, the existing efforts to ensure menstrual hygiene in our country, the loopholes in the same, and the possible road ahead.
MENSTRUATION AND RELATED ISSUES
Menstrual health1 is an extremely integral part of a female’s life. There should be absolutely no doubts regarding the importance the process of menstruation constitutes in a woman’s life. However, for something as important as menstruation, there has hardly been any focus on maintaining the health and hygiene of the same.
Unfortunately, even in the 21st century, a huge taboo surrounds something as natural as the process of Menstruation. Conversations about menstrual health and hygiene are still not encouraged and are hushed aside. Nevertheless, we, as a society have to acknowledge that conversations become an imperative starting point. If we are to bring a change, then we have to start by first talking about the issue.
This becomes all the more important in view of the prevailing status of menstrual health and hygiene among Indian girls. A 2016 study of 1 lakh girls, titled ‘Menstrual hygiene management among adolescent girls in India2 showed that nearly 50,000 or 50% of the total girls surveyed, were not aware of Menstruation till the time they got their first period. The unawareness results in girls not knowing how to respond to their initial menstrual cycles- thus, leading to responses of hysteria and stress rather than handling it with responsibility and calmly.
Further, the 2015-16 National Family and Health Survey3 came out with the observation that only 58% of the total Indian menstruating population used hygienic means during their cycles. This brings forth a worrying statistic- that there are still 42% of the Indian female population who are either not aware or do not have access to hygienic menstrual products during their monthly cycles.
MENSTRUAL HYGIENE MANAGEMENT: WHAT AND WHY?
Menstruation isn’t and shouldn’t be considered to be an alone issue. It has wide effects on the overall health status of a female and leads to having effects on the socio-economic factors involving the larger society as well. The report by Dasra NGO, titled ‘Spot On!’4 provides a lot of insight on the current status of menstrual hygiene in the country. The lack of menstrual hygiene leads to serious infections like dermatitis, urinary tract infections (UTIs), genital tract infection, alteration in the pH balance of vaginal secretions, bacterial vaginosis. All of these infections increase the female’s susceptibility to cervical cancer- which is on the rise each and every day, especially in India. A study by the US-based George Institute found that 25 percent of the total deaths due to cervical cancer occur in India.5
Menstrual hygiene management becomes even more integral in view of the larger health problems it results in, if not taken seriously. In addition to the dire health situations resulting from poor menstrual hygiene, it affects the female’s socio-economic functioning as well. Due to the unavailability of good sanitation facilities at schools, girls usually end up dropping out which affects their education and ultimately, leaves them nowhere in the job market.
A study undertaken by AC Nielsen, titled “Sanitary Protection: Every Woman’s Health Right”6 found out that about a quarter of teenage girls enrolled in Indian schools drop out due to problems during their menstrual cycles. While those who continue to remain in schools, record at least five days of absence during the days of their periods.
Not being able to pursue a stable education, further increases the literacy gap between males and females; thus proliferating already persisting gender inequality in our society. Additionally, ignoring vital issues like menstrual hygiene, takes our society two steps backwards rather than going forward.
The 2013 National Rural Health Mission study found out that of the total 14,724 government schools surveyed,7 only 52% of the total had a separate and hygienic girls toilet facility. This data clearly shows the severity of the issue and how India is still far behind on the aspect of ensuring Menstrual health to all Indian females.
Various studies and surveys have certainly come to prove how important Menstrual hygiene is. No society can afford to neglect it. In what was considered a groundbreaking speech by Indian Prime Minister, Narendra Modi on the occasion of Independence day of 2020- PM Modi mentioned at length the aspect of women’s health. He further highlighted that his government had worked on distributing sanitary pads at just re 1, in over 6,000 Janaushadhi clinics.8
Without any doubt, governments over the years not only in the Centre but also in different states have come up with different schemes and programs to deal with the issue of deteriorating menstrual health and hygiene status in the country.
The most prominent among all such schemes is the Menstrual Hygiene Scheme (MHS)9 under the Centre’s National Health Mission. The scheme included promoting menstrual hygiene by supplying as well as encouraging Self-Help Groups (SHGs) in rural areas to make sanitary napkins. However, such policies fail in reducing the burden since they do not address the key issues- that of unawareness regarding menstrual hygiene and healthcare products.
Focussing on this particular scheme, we realize that it fails to address how to actually impart training regarding actually using sanitary napkins. This becomes a pertinent loophole considering the fact that a 2014 study found out that only 45% of the females in rural areas10 are actually aware and use sanitary napkins.
Secondly, there is a major issue of disposal of the sanitary napkins that most of the policies do not adequately focus upon. Even when it does, the policy only talks about two ways11 of disposing of the sanitary napkins- one is the deep-pit burial or burning. However, none of them are ideal ways from the perspective of the sustainability of the environment.
It is important that to address the issue of menstrual hygiene and health at a larger level, we have a policy and administrative interventions for the same. Undoubtedly, we do have a lot of policies already in place to address the issue. But for the policies to actually be of some use, there needs to be an acknowledgment of the existing flaws in them.
The governments need to begin from the ground level. In a society where we are still not open to discussing issues of menstrual hygiene openly, we definitely have a lot to improve. For this, policies regarding menstrual hygiene and health need to begin with stressing on the aspect of universalising the awareness of Menstruation, not only limited to females but extending it to men and boys as well. Governments need to come up with modules which can profess this crucial information in a sensitive manner.
Following the awareness component, a lot of stress also needs to be put on the aspect of accessibility to menstrual healthcare products. Good menstrual hygiene can only be ensured when menstruating females can easily afford products like sanitary napkins, tampons, etc. The majority of girls and females still can’t afford good quality menstrual hygiene products. And studies have indicated that about 88% of the Indian females12 still opt for homemade alternatives.
It is imperative for the benefits of such policies to reach all the sections of females in India, especially the poorest-of-the-poor women and girls. There needs to be initiatives from the Government that actually end up having an effect on the ground. For this, a strong network for policy implementation is to be created, in addition to policies that focus on the crucial aspect of awareness and accessibility/affordability in the case of Menstrual hygiene.
We, as a society have to recognize the value of menstruation, good menstrual health, and hygiene. It is with this first step that we will hopefully begin to combat the taboo around a simply natural and integral process. With this realization will also come to a better society-more girls going to schools, more women in the job market, less unfortunate deaths due to lack of menstrual hygiene and most importantly, more conversations about things that matter, that should be addressed.