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Menstrual Interventions Vary Across Countries; Still A Long Way To Go

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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.

 

As India announced one of the harshest lockdowns in the world, among the many groups that remained invisible in the government policy announcements were menstruating persons. Hygiene essentials for menstruating persons were missed out in the essentials list of items and services announced by the government. The Union Ministry of Health and Family Welfare, in an affidavit filed in the Bombay High Court in response to a petition seeking that sanitary products be declared an essential commodity, said such a decision could only be taken after due process of assessing the demand and supply gap. Disposable pads were added to the essential items list only 6 days later after a collective demand by the public.

While the Indian government dragged its heels in making menstrual products available to an entire population, other countries around the world have taken more proactive and gender sensitive policy decisions.

On 24th Nov 2020, Scotland unanimously passed ‘The Period Products (Free Provision) (Scotland) Act‘. This act makes all menstrual products – disposable pads, tampons, reusable items like menstrual cups and others accessible to all menstruating persons for free.

The United Kingdom, which has seen a rise in period poverty,  formed a Period Poverty Taskforce, chaired by the Minister for Women & Equalities with the UK based charity Plan International and the MNC Procter & Gamble. A British charity, Bloody Good Period (BGP), which has been distributing menstrual products to  food banks, community support groups, those fleeing domestic violence, asylum seekers and refugees, homeless shelters and even NHS frontline workers, said that it was supplying them six times more since the pandemic started.

New Zealand recently made its first systemic move against period poverty by making sanitary supplies like organic pads and tampons free for schoolgirls, ensuring uninterrupted education for more than 90,000 girls. According to the Youth19 Survey on Period Poverty in New Zealand, 12% of  the country’s 9-13 year olds have difficulty getting menstrual products due to cost. This issue affects students from less financially well off communities four times more than usual. The scheme which started in July covering low socio-economic areas with 15 schools will be expanded to cover all state schools by 2021. This decision is an effort towards tackling child poverty and ensuring  that welfare schemes fight any deterrent to this demographic attaining their full potential.

The US enacted ‘The Coronavirus Aid, Relief, and Economic Security (CARES) Act‘, on March 27th, which has made menstrual products a part of the list of items eligible under Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs). This includes tampons, pads, liners, sponges and more sustainable options like period underwear and menstrual cups. CARES Act also includes painkillers for those suffering from period pain to be available over the counter (OTC) without prescriptions.

In all these countries, the understanding of menstrual health and hygiene is tied in with the ideals of fundamental human rights, women’s rights, menstrual equity and dignity. However, menstrual health is beyond access to products. It is tied to larger social cultural structures like patriarchy and socio-political realities such as menstrual taboos, discrimination, exclusion and even violence.

Kenya has recently announced policy measures to go beyond the accessibility of products and touch upon these complex socio-cultural aspects. For its menstrual hygiene management policy, and strategy, civil society and experts in the area of menstrual health have joined hands with the government to strategize and develop menstrual policies and schemes for the country. While the document looks promising and inclusive, monitoring and evaluation, progress indicators are yet to be decided by the government.

Nigeria invested 2 billion US dollars in partnership with UNICEF in a ‘Sanitation and Hygiene Fund’ towards universal sanitation and menstrual health and hygiene. During the times of the pandemic, this ensures in bridging the inequitable and deplorable sanitation and health gaps in Nigeria. In a country where over 83 million people live below the poverty line, this has the potential to address deep rooted negative attitudes such as the belief that menstruating bodies carry bad luck.

UNICEF is also collaborating with Essity, a health and hygiene company in Mexico, to promote awareness on sanitation and menstrual hygiene, especially taboos around menstruation among children. This ‘Hygiene is our right’ campaign addresses the challenges in retaining school attendance numbers in a city that is battling severe water shortages. An average person pays 150 pesos (slightly more than a daily wage earner’s income) for a bottle of water in Mexico city.

Countries in South Asia, India, Pakistan, Nepal, Afghanistan and Bangladesh are yet to address these complex socio-cultural attitudes and indeed menstrual health equity.

The Indian government continues to neglect menstrual health and hygiene (MHH) needs despite  ample coverage on the disrupted supply chain of menstrual products. The only gendered policy response during the Covid pandemic has been a transfer of ₹500 per month for the months of April, May and June of the lockdown to 200 million women Jan Dhan account holders. State governments in India are yet to devise any state specific policies and programs to ensure adequate menstrual health.

In Pakistan, households were given 12,000 as part of the Ehsaas emergency program,  as part of their social welfare package. This, however, excluded MHH access. Bangladesh, which was simultaneously dealing with Cyclone Amphan also missed out menstrual health access. The 2,500 COVID stimulus packages for poor families announced by the government primarily focussed on rehabilitation measures.

Afghanistan, while focusing on Water, Sanitation and Hygiene (WASH) infrastructure, has always neglected MHH needs. The Government of Afghanistan distributed more than 77,000 hygiene kits as part of COVID relief and set up 15,000 handwashing stations. As a conflict region, relief included emergency shelters and non food items (NFI) such as clothes, mats, blankets, soap and bowls.  A recent Household Emergency Report  that assesses household’s NFI needs states that 77% households needed menstrual products. However there is little data to assess whether these needs were met.

The cost incurred per menstruating person to access a quality product is largely dependent on the type of product one chooses to use based on their knowledge and other factors. This is a cost that needs to be factored in when such initiatives are thought out, especially during a pandemic.

Nepal has announced that government schools will be a major chain in the distribution of menstrual products like disposable pads which will start in over 29,000 schools once they reopen. Apart from this, the government in Nepal has little else  in ensuring MHH access. In fact, households in Nepal practice Chhaupadi, where  menstruating women are prohibited from touching communal objects and are banished from the main household during the period. This practice was declared unconstitutional in 2018 and yet continues to be practiced unmonitored.

Menstrual discrimination is practiced in Afghanistan too.

At the community level, we are concerned that women will again have to stay at home after years of social engagement and positive changes in women’s participation,” says a social organizer of a civil society organisation in an OXFAM report titled ‘A New Scourge to Afghan Women: COVID-19.

India and  other South Asian countries need to introduce systemic reforms and implementation of policies and schemes that assert the importance of menstrual equity. The Indian state of Bihar, in 1992, instituted a policy  that provides women state government employees upto two days leave every month during their periods. More conversations, however, are necessary around other aspects such as social prejudice, cultural taboo, economic strata a person belongs to which reveals inequities in access to resources along with other issues related to privilege, power and agency.

Written by Subhiksha Manoj with Inputs from Bharti Kannan

(Originally published in Behan Box)

Boondh is a social enterprise working in the space of menstrual health, literacy, policy advocacy, and sustainable products. COVID X Menstruation is a series of articles that explores menstrual health and hygiene along multiple intersections like menstrual programming, product supply, government policies, civil society interventions, mental health, and more. You can follow them on TwitterFacebook and Instagram.

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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.

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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.

Read more about the campaign here.

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

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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 Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’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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