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Why India Must Heed The Call For Effective Menstrual Hygiene Management

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This post is a part of Periodपाठ, a campaign by Youth Ki Awaaz in collaboration with WSSCC to highlight the need for better menstrual hygiene management in India. Click here to find out more.

Menstruation is one of the most crucial biological processes of the reproductive cycle that is surprisingly surrounded by myths and taboo, so much so that it is not considered to be suitable for open discussion. India’s 113 million adolescent girls are particularly vulnerable at the onset of periods. This is when they need a safe environment that offers protection and guidance to ensure their basic health, well-being and education.

The lack of a separate and usable girls toilet in schools and a toilet at home leave adolescent girls and women to face the indignity of open defecation. However, safe and effective menstrual hygiene management, or MHM, is a trigger for better and stronger development for adolescent girls and women.

Menstruation And Gender

Menstruation continues to be a subject of gender disparity in India. Myths about menstruation are largely prevalent, forcing many girls to drop out of school early or be ostracised for the duration of their menstrual cycle every month. In some cultures, women and girls are told that during their menstrual cycle they should not bathe or they will become infertile, look in a mirror regularly or it will lose its brightness, or touch a plant else it will die, or touching some food item or it will perish!

There is no scientific evidence behind these beliefs but these have been inculcated in the minds of the young girls to the extent that they believe these to be right. They even believe in the concept of ‘impurity’ during the time they menstruate and so refrain from entering religious places.

According to a UNICEF report, in 2014, Tamil Nadu had 79% girls and women who were unaware of menstrual hygiene practices. The percentage was 66% in Uttar Pradesh, 56% in Rajasthan 51% in West Bengal. This explains why when girls attain puberty, especially in rural India, they drop out from school that highly affects their future. This is further paired with lack of adequate menstrual hygiene that comprises of availability of disposable sanitary napkin and menstrual health care.

Further lack of awareness makes this even more complicated. In most of the cases, the mothers are themselves unclear about what menstruation is, how it is to be explained to a teenager and what practices could be considered as menstrual hygiene management. Schools in rural area have not been not very helpful as they refrained from discussing menstrual hygiene.

Although the cities have now taken initiative in creating awareness, it has been observed that the teachers do not find it comfortable to discuss this in class openly, especially in co-ed schools. A 2015 survey by the Ministry of Education found that in 63% schools in villages, teachers never discussed menstruation and how to deal with it in a hygienic manner.

All these points make us realise that discussing and attaining proper menstrual health care is absolutely indispensable for the development of women. This can be discussed in various steps like the health concerns, cleanliness and sanitisation and a healthy sexual and reproductive life.

There are various concepts of ‘impurity’ attached to a a woman’s menstrual cycle. (Photo: Nikita Lamba)

Menstruation And The Body

It is very important to understand that the process of menstruation, though common, takes the body through major hormonal changes. The continuous bleeding for 4-5 days induces substantial pelvic pain and discomfort, sometimes leading to complete lack of activity. Not only does it tire the body but also the mind. Sometimes, it gives a feeling of helplessness and not being able to concentrate on anything else. This is what needs to addressed properly.

The pain is real and it will get better with rest. If time and schedules do not allow for it, that then it is important to be hydrated and eat nutritious food to counter it. A hot water bag or a heating pad is a good way to relieve the pain. Here, it becomes extremely important that those who do not menstruate be sensitive towards the entire process.

Certain practices like usage of cloth pads that are not properly clean, not changing sanitary pads frequently, improper usage of tampons, not washing hands properly before and after changing pads may lead to grave ailments. Other problems associated with menstrual hygiene are anaemia, prolonged or short periods, infections of reproductive tracts, as well as psychological problems such as anxiety, embarrassment and shame. Hence, it is essential to ensure the following is fulfilled for proper menstrual hygiene:

1) Access to sanitary napkins,

2) Access to period medication,

3) Water sanitisation and responsible disposal,

4) Information and knowledge of the menstrual process in schools and communities,

5) Family and social awareness, and

6) Support policies and guiltiness by the government.

If each of these simple steps are followed diligently, it would instill a sense of dignity and confidence for women.

Menstruation And Sanitation

The next important aspect in menstrual health and hygiene management is cleanliness and proper sanitisation. In the present scenario, wherein the environment has been grossly affected by non-biodegradable materials, sanitary napkins too contribute towards this. However, banning disposable pads is not the solution unless an equally effective substitute comes up.

Also, it is really surprising to note that out of 355 million menstruating women in India, only 42.6 million have access to sanitary napkins, which is a measly 12%! Recently, the idea of menstrual cups has been popular with the urban population with some of its promising features like being reusable, secure and bio-degradable attracting many towards using it.

However, it is still not suitable for younger girls because it needs to be inserted in the vagina and if not done properly, may lead to injury. Tampons are easier to but comes with a huge risk of infection. Hence, sanitary napkins still remain the best option for many.

Next, it is important to understand that menstrual cycles inflict a series of stress and anxiety accompanied by pre-menstrual syndrome in a number of cases. It becomes really demotivating to deal with all of these and hence, the role of men here is crucial. It is not ‘a tough job to deal with the mental state’ of a menstruating person with care and patience.

Additionally, sexual awareness in this case needs to taken care of specifically. Sometimes, sexual intercourse during periods can lead to the infection of the urinary as well as the reproductive tract. While the urban population may be well aware of such issues, it must be addressed with the non-urban belt as well.

Menstruation And Development

Adequate menstrual hygiene instills health, confidence, self-esteem and a sense of empowerment in women. The government’s role in supporting innovative and sustainable solutions to manufacture and distribute low-cost, yet high-quality sanitary pads and addressing the problem of disposing menstrual waste in an environmentally safe manner has to be major.

Ensuring menstrual hygiene for girls and women should be one of the developmental priorities which calls for urgent and intensive action from all relevant stakeholders to change the scenario of menstrual hygiene in India.

There is also an emerging need for development of indicators under Swachch Bharat Mission Guidelines to measure the extent of achievement in MHM in India. Setting up realistic targets to indicate successful implementation of existing policy and programs would be a welcome move for providing basic hygiene and reproductive facilities to girls and women.

Featured image for representative purpose only.
Featured image source: WASH United/Wikimedia Commons.
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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

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A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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