July 6, 2021 5:33:27 pm
Written by Suryaprabha Sadasivan and Bhavya Sharma
One of the most glaring but under-prioritised gender-related issues is menstrual health, which unfortunately gets compartmentalised as a women’s problem instead of getting noticed as a public health challenge and a barrier to nation-building. According to the National Family Health Survey (NFHS-4) 2015-16, India has over 355 million menstruating women. However, only 36 per cent of women were reported as using sanitary napkins, locally or commercially produced. The percentage of women using menstrual products did improve significantly across the country, especially in Daman and Diu and Dadra and Nagar Haveli, West Bengal and Bihar, as estimated in the first phase of the recently released NFHS-5. Despite this, menstrual health remains a low-priority issue in India marred with taboos, shame, misinformation, and poor access to sanitation facilities and menstrual products.
Societal restrictions during menstruation violate women’s right to health, equality and privacy. Several anecdotes reveal that women and girls are kept in isolation, not allowed to enter religious places or kitchens, play outside or even go to schools during menstruation. A survey conducted under the Integrated Child Development Services (ICDS) scheme by the Ministry of Women and Child Development (MoWCD) in 2018-19 reported that more than one-fourth of total girls enrolled in class VI-VIII drop out of school as soon as they hit puberty. The experience of menstruation for young girls is even more difficult due to inconsistent access to education on menstrual health and puberty. They are dependent on their mothers, grandmothers or women teachers for information and support to access menstrual products — these often come laden with views based on societal constructs and belief systems.
Many employers see menstruating women as a problem as they associate periods with inefficiency in work and reduced participation in the workforce. There are anecdotal examples of corporate workplaces showing insensitivity towards menstruating women fearing loss of productivity.
In the last decade, several schemes, including the Menstrual Hygiene Scheme (2011) and the Rashtriya Kishor Swasthya Karyakram (in 2014), have been launched to promote menstrual hygiene amongst adolescent girls in the age group of 10 to 19. Through the Suvidha initiative, the government distributed more than 5 crore brand sanitary pads at Re 1 from 6,000 Jan Aushadhi Kendras. Apart from central government schemes, state governments have also implemented programmes to distribute sanitary pads in schools in Rajasthan, Uttar Pradesh, Odisha, Maharashtra, Chhattisgarh, Andhra Pradesh, and Kerala. The Bihar government provides Rs 300 under the Kishori Swasthya Yojana to adolescent girls to buy sanitary pads. A major drawback in these programmes is that out-of-school girls remain left out of the system.
There is another question: How viable are programmes that focus solely on access to sanitary pads? Access to sanitary pads is, no doubt, important. But without committed efforts to educate both women and men on menstrual health management and its public health and socio-economic consequences, on ground transformation is likely to be low.
The need of the hour is to focus on a strategy that converges key departments in the government — health, education, women and child development and rural development among others — and improves accountability towards issues related to menstrual health management. The way forward lies in a community-based approach in which local influencers and decision-makers are sensitised to champion the issue and behavioural change campaigns targeted at both men and women are deployed to dispel myths and misconceptions. There is also a huge opportunity to create public-private collaborations to drive such campaigns and increase access to affordable menstrual hygiene products for rural and semi-urban regions. This could be done through the installation of sanitary pad vending machines at key public places, workplaces, schools, and colleges, as well as Anganwadi centres or childcare centres for rural areas.
First, however, it is crucial to acknowledge that menstrual health is not just a women’s issue, but a matter of human rights.
Suryaprabha Sadasivan is Vice-President Chase India and Bhavya Sharma is Associate, Chase India. Views expressed are personal.
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