Status Check: How Well Has The Scheme To Promote Menstrual Hygiene Fared In India?

Posted by Abhishek Jha in #IAmNotDown, Menstruation
May 12, 2017

In February this year, Congress MP Sushmita Dev wrote to Finance Minister Arun Jaitley asking him to scrap taxes on sanitary pads. The politician also sent a public petition to Arun Jaitley, Maneka Gandhi, and J. P. Nadda on International Women’s Day reiterating the same demand.

The change.org petition that Dev wrote to union ministers lists multiple reasons like better livelihood opportunities for rural women manufacturing these napkins and increased attendance of girls in school for making sanitary pads tax free. However, it is Dev’s response to a question from a journalist that tells us why the issue of universal access to menstrual hygiene has remained largely un-addressed in the country.

Dev, for instance, told TheNewsMinute that affordability would be redundant for women in rural areas unless they are aware of sanitary practices around menstruation and given access to resources required for implementing those practices. In fact, accessibility and awareness are issues that need urgent addressing as the government’s own assessments show.

Take for example the Scheme for Promotion of Menstrual Hygiene started by the government in 2010 for providing sanitary napkins to adolescent girls at a nominal cost, for safe disposal of used napkins, and for spreading awareness about menstrual hygiene. Started as a pilot in 112 selected districts in 17 states under the National Health Mission, the scheme was extended to 162 districts in 20 states in 2015. It has been run in convergence with sanitation programmes (currently Swachh Bharat Mission) to enable further access to sanitation measures.

Data available with the government, in fact, shows that the apprehensions Dev has about the success of her campaign might remain unattended unless governments take up the matter seriously. And while the efforts may be well intended, when it comes to implementation, the results are patchy at best.

Expenditures under the scheme aren’t recorded by the central government but audit reports and annual reviews of the NHM show that there is enough scope for improvement. An audit done during 2014-15 by the Comptroller and Auditor General of India (CAG) for schemes meant for Scheduled Tribes found poor implementation, particularly in the states of Gujarat, Chhattisgarh, and West Bengal.

Of the eight selected districts in Gujarat, the scheme had been implemented in only two districts, the CAG found. Moreover, 73 percent of the napkins supplied to the two districts were lying unutilised till September 2014. In Chhattisgarh, no sanitary napkins had been distributed by any level of health centre under the scheme. West Bengal had not held any promotional campaigns for menstrual hygiene.

Similarly, the 2015 annual review of the National Health Mission found that the “uptake of napkins under Menstrual Hygiene Scheme (MHS) was low, largely due to poor quality as reported in Himachal Pradesh and irregular supply of the sanitary napkins as informed in Delhi, Himachal Pradesh and Odisha”. ASHA workers had also not organised the monthly meetings for awareness generation in Uttarakhand, Haryana and Karnataka – as required under the mission.

According to another 2015 CAG report for the state of Maharashtra, the central government had found in October 2013 that efforts made by the state for “demand generation were weak resulting in low awareness about the importance of menstrual hygiene”. Poor quality of these napkins was another issue identified for the state in the report.

Safe disposal of used napkins is also a part of the scheme. A CAG report for Tamil Nadu found that the funds allocated for it had become idle investment. “The indecisiveness in finalising the implementing agency and the technology to be adopted” had led to Rs 8.45 crore just lying idle in the project director’s account for nearly a year.

Needless to say, these numbers don’t bid too well as far as the issue of menstrual hygiene management is concerned. A number of these issues have been repeatedly flagged for various states in the annual review of the NHM done by the central government. While reducing or scrapping the tax on sanitary napkins is definitely a sensible thing to do, not fixing schemes that already exist and that the government funds directly impacts a sizeable population of our country which continues to live without access to or awareness about menstrual hygiene. It is about time the government works in these areas and fixes these problems too.

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