It is going to be five years since the Modi government launched the Swachh Bharat Mission (SBM). While the campaign has made tremendous strides in installing toilets in far-flung corners of the country, when it comes to the issue of menstrual hygiene management, Youth Ki Awaaz’s on ground reports from four Indian states reveals that a lot still remains to be done.
Menstrual hygiene management has always remained a less-spoken aspect of the Swachh Bharat Mission, and when it comes to promoting safe menstrual hygiene practices, YKA found that multi-faceted challenges continue to hamper its implementation in rural India.
The first obviously relates to the priority the government accords the issue. According to questions answered by the government in Lok Sabha about Swachh Bharat Mission-Gramin (SBM-G), the government stated that it neither allocates money separately for MHM nor assesses the impact of the many drives it runs.
The second and most pressing one relates to attitudes towards menstruation and the work that needs to happen to bring about behavioural change on the ground. While the government claims that it has been working to increase awareness about the issue and has also worked towards improving access to low cost sanitary napkins, YKA found that on ground, knowledge about safe menstrual hygiene practices was largely lacking.
This lack of knowledge coupled with a stronghold of myths and non-availability of low-cost sanitary napkins not only means that a large percentage of women in rural India still suffer due to unsafe menstrual practices, but that the situation is unlikely to change in the near future because of the lack of priority the government gives to the issue.
Such is the level of awareness on menstruation in Jasondi, a tribal village in MP’s Betul district, that many women YKA spoke to said most girls don’t even know what a pad is, with hardly 2-5 per cent of them using them. Adolescent girls also told YKA that ninety percent women still prefer to use cloth during their periods.
So, even though the nearest Anganwadi does sell pads, women don’t use them, with the cost being a major deterrent. In villages farther away from the district headquarters, women still use ash during their periods.
BL Bishnoi, district officer of the Women and Child Development department, said they run awareness campaigns to educate girls about menstruation.
An NGO – Sashakt Nari Sashakt Samaj – has even kickstarted a sanitary pad bank in Jasondi to provide free napkins to women who can’t afford them. When it comes to attitudes towards menstrual hygiene though or of women using the bank, things looked bleak at best.
Sixteen-year-old Ashima Khan, a student of class 10 at the government girls school in Sitapur, UP said when she first started menstruating two years ago, she had no idea what was happening to her. When she told her mother about it, her mother told her to not talk about it with anyone.
Ashima came to know about the process of menstruation when some counsellors visited her school. Since then, she says she is aware why maintaining hygiene is important during menstruation. She says she also takes iron pills provided to students in school during this period.
Kusum Srivastava, the counsellor at the Mishrick block Community Health Centre, told YKA that girls who have attained puberty usually don’t receive the necessary information from their mothers, because the mothers themselves are unaware about the process. At Sitapur, the focus still remains on providing girls basic information about menstruation in the hope that girls pass on knowledge to their mothers.
Social worker Madhulika, who works in the tribal district of Dungarpur told YKA that even today, women in the tribal region of Dungarpur, Rajasthan don’t use sanitary pads, choosing to instead use the same cloth for months on end at times. Consequently, they become prone to infections and diseases.
Women YKA spoke to drew a blank when we discussed menstruation practices with them. While Haru Devi, a resident of Aligarh, 40 kilometres from Udaipur, had no idea what a sanitary pad was, Amari Devi, 39, said she used cloth all her life. It was only when her daughter Pooja started getting sanitary pads from her school two years ago that Amara Devi says she started using pads.
Arvind Chobisa, the coordinator of SBM in Dungarpur said that they had carried out many awareness programmes at the panchayat- and gram sabha-level. A district-level workshop was organised in Dungarpur last year where menstruation and the myths related to it were openly discussed. The drives, however, have not translated to any clear behavioural change on the ground.
Recently, awareness drives have started in several tribal-dominated pockets of Odisha. Not much seems to be coming out of them as women still remain unaware about basic hygiene practices.
Srimati Hembram, the Sarpanch of Baunsanali, a tribal-dominated area situated in Joshipur block of Mayurbhanj district, stated that women and girls in the area have been shying away from even discussing menstruation.
She explained that it’s only girls who go to school who use sanitary napkins as they are provided napkins by the school. However, after they pass out of school, they stop using pads as their financial background deters them from buying it.
The ASHA and Anganwadi workers regularly conduct awareness meetings in their villages to educate the girls and women on the importance of menstrual hygiene, methods of using sanitary napkins and their safe disposal. However, more than 80% of women and girls under her panchayat limits still use old clothes.
On its part, the government seems to be aware of how difficult it is to bring about a behavioural change when it comes to menstrual hygiene, having cited the same as one of the reasons for lagging behind in promoting it. With the Swachh Bharat Mission finishing five years, however, this may be a good time for it to revisit its goals and put the pedal on implementing the objectives it set out for itself in promoting menstrual health.