According to the fourth National Family Health Survey (NFHS-4) in 2015-16, half the women in rural India (52%) do not use hygienic methods of protection during their menstrual period in India. Available data reveals that Menstrual Hygiene Management (MHM) remains deprioritized due to factors such as deep-seated social gender construct, cultural myths, and discriminatory traditions. This was the case even when there was no pandemic.
Since last year, a series of restrictions due to COVID-19, including a nationwide lockdown, impacted production and access to menstrual hygiene products for millions of girls and women. With health services focussed on COVID-19 care, sexual and reproductive health care services been severely impacted, especially for vulnerable population groups such as young women and girls. With schools remaining closed for the better part of the last year, access to sanitary products has been curtailed. Findings from a recent study conducted by Population Foundation of India in Rajasthan, Uttar Pradesh, and Bihar in April-May 2020, showed that more than half the young girls interviewed reported having an unmet need for sanitary pads.
Lack of access to information: In India, only 48% of adolescent girls are aware of what menstruation is before getting their first period. Young people do not have access to reliable and correct information about their reproductive health and rights. The stigma around menstruation leads to parents, teachers and other community stakeholders being reluctant to talk about periods. An overall lack of scientific knowledge about menstruation also gives way to myths and misconceptions.
A 2016 landscape analysis titled Menstrual Health in India observed that of nearly 355 million girls in India who have reached menarche, 71 percent reported having no information about menstruation before their first period. The study further explains that many girls believe that they may be dying or ill, the first time they menstruate. Due to societal norms around gender and menstrual taboos, feelings of shame, impurity around their menstrual cycle are common amongst girls.
Lack of access to menstrual hygiene products and facilities: Menstruating women and girls in India often face challenges in accessing menstrual hygiene products due to several factors such as a lack of agency among girls and young women, unavailability of hygiene products, poverty and social norms.
Lack of enabling environment in rural communities: Even today girls and women are socially ostracised during their period, their mobility is restricted, they are considered impure, and are not allowed to enter religious places or the kitchen. The unaccommodating social surroundings put them into a situation of discomfort, pain, and great distress.
Around 23 million girls in India drop out of school every year due to a lack of menstrual hygiene management facilities – clean toilets with running water and disposal bins – as well as a lack of access to sanitary napkins and awareness about the issue. Social taboo also leads to women cleaning and drying reusable menstrual hygiene products under unsanitary conditions, which can increase a woman’s chances of contracting cervical cancer, Reproductive Tract Infections, Hepatitis B infection, various types of yeast infections and Urinary Tract Infection.
Risk of related disease: Poor MHM in rural areas risks young girls and women from developing menstrual hygiene-related diseases like fungal, urinary tract, and reproductive tract infections. Affecting their health and well-being.
Low income and poverty certainly limit a family’s ability to manage menstrual hygiene. Cost of hygiene products, washing facilities, and waste management is an expensive affair. Women from the highest wealth quintile are more than four times as likely to use a hygienic method as women from the lowest wealth quintile (89% versus 21%). (Source: NFHS-4). Reduction in income, loss of livelihood due to COVID has further added to the gap.
In India, the number of women in the reproductive age group (15–49 years) is more than 31 crores (Census 2011). The ability to manage menstruation hygienically is fundamental to the dignity and well-being of every woman. There may not be direct mention of menstrual health and hygiene as human rights but it is well recognized that poor MHM practices will adversely affect the fundamental right to health, right to live, and right to development. Poor MHM can have a negative impact on critical social outcomes like empowerment, education, fertility, physical and mental health, economic independence, and the environment. All menstruating girls and women deserve correct information and resources to manage their menstrual health and we on our part will continue to work with all stakeholders at the grassroots level to make a difference.
Ensuring menstrual hygiene for girls and women should be one of the important developmental agendas which calls for urgent and intensive action from all relevant stakeholders to change. We should not let COVID undermine our efforts made so far to change the current menstrual hygiene scenario in India and step ahead by prioritizing our actions and investments for better Menstrual Hygiene and Health.
The present pandemic situation has reiterated the need to invest in the health of the young population as they are the foundation for healthier and resilient generations. And sexual and reproductive health rights are inevitable to basic health.