Prof.
(Dr.) Dharmakanta Kumbhakar
(drkdharmakanta1@gmail.com)
In India, menstruation and menstrual practices are still clouded by taboos and socio-cultural restrictions for girls and women. Such discussions are still taboo in Indian villages and across a large section of urban society. Though menstruation is a natural process, most people, even women, hesitate to talk about it. Menstrual hygiene is an issue that every girl and woman has to deal with in life, but surprisingly, there is a lack of awareness regarding menstrual hygiene management (MHM) in our country. As a result, most of the girls and women in our country are unaware of the menstrual hygiene-related practices that they should be adopting and the adverse health impacts of unhygienic menstrual practices on them.
As per the fifth National Family Health Survey (NFHS-5) for 2019–21, only 77.3 percent of Indian girls and women, aged between 15 and 24, use hygienic methods of protection during their menstrual periods. The figures are 89.4 percent in urban areas and 72.3 percent in rural areas. The NFHS-5, 2019–21, also stated that the respective figures are 66.3 percent, 82.9 percent, and 63.8 percent in Assam. The rest use unsanitary old cloth pieces, papers, dried leaves, grasses, etc. These unhygienic practices lead to maladies like fungal infections, urinary tract infections, reproductive tract infections, etc., which can further lead to infertility and even death.
Menstrual hygiene is crucial to the reproductive life of every woman. Issues associated with menstruation and MHM are never discussed, and this burdens Indian adolescent girls by keeping them ignorant of this biological function. About 75 percent of Indian adolescent girls do not have any idea about what material to use to absorb the period flow. Every adolescent girl should have sound knowledge on menstruation and menstrual hygiene-related practices (using sanitary napkins, washing of external genitalia, taking a bath during menstruation, etc.). Ideally, a mother should be the main informant at this tender age.
In India, about 255 million adolescent girls struggle every month to go to school and college because of their periods. About 200 million rural adolescent girls lack basic knowledge of menstrual hygiene. The prices of sanitary napkins are beyond the affordable capacity of a major chunk of girls and women. While about 20 percent of rural girl students can afford costly, disposable sanitary napkins, the rest of the 80 percent can’t afford sanitary protection during their periods. Further, over 40 million schoolgirls have no place for urination, as 40 percent of government schools don’t have separate girls’ toilets. They need to go home for urination during school time during their periods. Most of the government schools in India lack facilities such as adequate and private space for changing sanitary napkins, soap and adequate water for girls to wash themselves and their clothes during periods, and safe disposal facilities for soiled sanitary napkins. Limited access to safe sanitary products and facilities during their periods forces these girls to miss five days of school every month (about 20 percent of the school year). The regular monthly absenteeism in the school often serves as a trigger for school dropouts. As a result, one in five girl students in India is forced to drop out of school because of her period. This is a matter of grave concern, as it can be detrimental to the country’s image and economic progress.
We should concentrate on girl students to ensure that they don’t miss school during their periods, thereby not quitting school. There is a strong need to encourage menstrual hygienic practices among the Indian girl students, and MHM training needs to be imparted to them. They must be taught MHM by female teachers, female health workers, and female members of NGOs in a sensitive and supportive manner. Steps should be taken to encourage and support girls during menstruation so that they do not miss school. MHM involves menstrual hygiene education sessions at schools and colleges along with steps to ensure that girls have separate toilets and sanitation blocks located at a safe location to assure privacy, based on a ratio of one toilet for every 40 girls (and/or one urinal for every 20 girls). The sanitation blocks should be equipped with well-positioned mirrors so that girls can check for stains on their clothes; private bathing or changing units to change their clothes or sanitary napkins; and a place to wash themselves, including a place with a shelf, hooks, or niche to keep clothing and menstrual adsorbents dry; and the provision of sanitary napkin vending machines and incinerators or dustbins for safe disposal of soiled sanitary napkins and cloths. Moreover, officials of the education departments and teachers need to compulsorily undergo MHM training workshops so that girl students get all the information related to menstrual hygiene. Girls can establish girls’ hygiene clubs to ensure peer-to-peer learning and sharing of menstrual hygiene information. Apart from MHM training for girl students, there is a need to talk to adolescent boys, male teachers, and parents about MHM in the context of girls’ access to education and school completion. These will not only boost the confidence of girl students but also improve their attendance in school during their periods.
There is a need to mobilise the girl students to use sanitary napkins. India should aspire to become a 100 percent sanitary napkin-using girl students’ country. The government and other associated agencies should launch a major publicity campaign to make girl students understand the importance of sanitary napkins. Commercial sanitary napkins are not cheap. For most Indian girl students, the luxury of affording sanitary napkins is a far-fetched dream. The need of the hour is to improve the quality of life of these poor girls by providing them with free, highly subsidized and easily accessible sanitary napkins, which will give them freedom and protection from their monthly dilemmas and discomfort. Though there are few government schemes to distribute such sanitary napkins to rural areas and free sanitary napkins to girl students, their reach remains limited. The government should either upgrade the existing schemes or introduce new ones so as to reach out to all girls and students. Providing free sanitary napkins to all the girl students will reduce their absenteeism in school during their periods. It will also be a massive health booster for girl students, greatly enhance their academic and personal development, safeguard their dignity, and lead to greater empowerment of women.