OPINION

Unhygienic practices during menstruation: A serious health concern

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What is it that prevents women from openly buying sanitary pads or holding discussions about it? Well, the answer lies in how society views women’s intimate health issues.

By: Ambreen Yousuf

World Health Organization (WHO) defines health as “the state of complete mental, physical, and social wellbeing and not just an absence of disease or infirmity”. From a broader perspective, the definition draws attention towards a certain section of the society ­that is vulnerable to diseases. According to the World Bank report, nearly 5000 million girls and women globally lack adequate facilities for menstrual hygiene. In India, scores of women do not possess adequate knowledge of intimate health and sanitation, thus pushing them towards serious health-related problems. The story does not end here. The unhygienic menstrual practices are closely associated with how different cultural practices, norms, and ‘misunderstandings’ propel it. For instance, the majority of women often hesitate to purchase menstrual products openly. Also, women find it increasingly difficult to talk about the very process of menstruation and the problems related to it. What is it that prevents women from openly buying sanitary pads or holding discussions about it? Well, the answer lies in how society views women’s intimate health issues.

Menstruating women are often excluded from daily activities, religious gatherings, and rituals because they are considered impure across the country. In some parts of India, women are not allowed to enter temples, they cannot take part in religious gatherings, and are prohibited from entering the kitchen and touching any food item. They are kept in isolation where they suffer silently. Menstrual taboos are usually rooted in cultural practices, social norms, and beliefs rather than religion. Religious interpretation of women’s purity is solely based on; maintaining hygiene, avoiding the spread of infectious diseases to their partners. Thus, menstrual taboos are usually rooted in cultural practices, social norms and beliefs rather than religion. Negative and ambivalent feelings are followed by psychological issues, thus deeply impacting the women and undermining their health.[1] Cultural taboos, stigmas, and misconceptions prevailing in our societies limit girls from taking part in various activities during menstruation. This contributes to the development of negative attitudes toward menstruation, placing a considerable physical and psychological burden on young girls.

Maintaining menstrual hygiene is challenging for the girls, lacking proper knowledge or belonging to conservative/low-income families. A growing body of evidence shows women/girls following unhygienic practices during their periods. A study finds some girls are still using cloth during their periods because of the notion that sanitary pads lead to infertility. In India, women from the age group of 18–45 years using disposable pads and reusable absorbent pads, as a result, such women develop symptoms of bacterial vaginosis or Urinary Tract Infection (UTI).[2] It has also led to other reproductive related complications among women.

The absence of basic services including access to clean drinking water, sanitation, and sanitary facilities at public places, schools, colleges, workplaces, and health centres has also become a serious concern for women.

A large chunk of the female population in the country continues to remain unaware of the various healthcare schemes and policies. The lack of suitable products for menstrual health, absence of disposal mechanisms for pads, poor conditions of the toilets, lack of soaps, washbasins are some of the major concerns facing the women. These factors directly impact the girls attending government-run schools. They find it hard to attend schools on a regular basis because their schools lack appropriate sanitation facilities.

Major initiatives taken by the Government of India 

In the past decades, the issues related to menstruation are being addressed and the government has come a long way in framing suitable healthcare policies and implementing sanitary schemes. In 2018, the Union Budget announced the world’s largest government-funded healthcare scheme. At least four schemes were launched (Pradhan Mantri Matritva Vandana Yojan, Pradhan Mantri SurakshitMatritva Abhiyan, Janani Suraksha Yojana) and out of four, three schemes were launched for pregnant women, providing them conditions for safe delivery, child-care, nutritional and health benefits. The fourth scheme called ‘Sanitease’ was launched by the Union Ministry of Youth Affairs and Sports under the social development activity Swachhagraha to promote women’s health and menstrual hygiene. Apart from creating awareness campaigns, it provides logistics for sanitary napkins to women and girls in both urban and rural areas.

The National Health Mission (NHM) of India has also implemented a scheme called Menstrual Hygiene Scheme (MHS) for the promotion of menstrual hygiene among adolescent girls from the age group of 10-19 years. Apart from improving the access to affordable sanitary napkins through Accredited Social Health Activists (ASHA), the government has also created awareness among adolescent girls about safe and hygienic menstrual health practices through videos, audios, and dissemination of reading material.

UNICEF along with its partners has launched some projects in the different states of India. MAHIMA (Menstrual Health and Hygiene Management for Adolescents Girls project was launched in Jharkhand to impart menstrual knowledge and facilitating behavioural change. GARIMA project was launched in Uttar Pradesh for menstrual hygiene management of adolescent girls particularly from rural areas from the age group of 10-19 years. A women’s self-help group supported by UNICEF was launched in Gujrat. Under it, women are facilitated to produce biodegradable sanitary napkins at affordable prices. UNICEF sponsored projects have given a platform to women breaking myths around menstruation while improving health conditions.

Initiatives taken in Jammu and Kashmir

In Jammu and Kashmir, the government has initiated setting up of sanitary napkin vending machines for girls in schools. An initiative ‘Saathiya’ is also encouraging discussions about health problems including menstruation among adolescent girls. Under this scheme, two male and two female adolescents are selected per 1,000 population which educates girls on sexual education.

In Kashmir, several persons associated with different fields have taken novel efforts for creating awareness regarding menstrual hygiene and its management. Auqib Peerzada, a civil engineer (also called a real-life padman) is promoting menstrual hygiene and safety among women. He is also providing eco-friendly, biodegradable and organic sanitary napkins to women. Peerzada is importing eco-friendly organic pads from different countries and selling them under his brand name ‘SEHA’ (An Arabic word for health). According to Peerzada, the pads are made from 100 percent cotton with an anion strip that controls the growth of bacteria. Moreover, pads are sold at affordable prices and each pack of six pads is sold at Rs 45. “With each pack of six pads, we also provide six disposable bags for free.”

Dr. Auqfeen, who after finding that girls are using cloth during periods instead of the pad, has set a mission to help girls to overcome this unhygienic practice. She is also educating young girls on how to maintain menstrual hygiene. According to Dr. Auqfeen, They have registered 200 adolescent girls whom we provide pads at subsided rates every month. “We have held several awareness sessions with these girls where we invited their mothers as well, to make them understand that periods are a natural and biological process.” Besides, Dr. Syed Sehrish Asgar, during her stint as a Deputy Commissioner took some important initiatives to raise awareness among young girls about menstrual hygiene. In her interview with The Indian Express, she said, “All the incinerators and sanitary napkins dispensers will be placed at 106 higher secondary schools, five-degree colleges and one ITI in the district. Also, sanitary napkin dispensers will be placed at the DC’s office as well as at the Srinagar international airport that falls in the district.”

Conclusion

Proper health and menstrual facilities not only improve individual health but also facilitates gender equality. Inadequate health facilities hinder progress, mental stability, and undermine the overall health of women. National and international concerns about menstrual hygiene have been spearheaded through water, sanitation, and hygiene (WASH ― an umbrella term) programs in schools and policy and programming frameworks to improve knowledge and infrastructure to manage menstrual hygiene. According to 2011 census estimates (the latest available census data), 10% of India’s population were female adolescents aged 10-19 years, which translates into approximately 120 million girls. The last few years have seen significant changes in terms of menstrual hygiene, speaking of which there is a 12 percent increase in the number of girls using pads.

Recommendations

Government has broad outreach to its citizens and on local and international levels. It can hold multi-stakeholder meetings and co-partner with brands and corporates assisting in setting up the new models on health/sex education and menstrual hygiene management.

Menstrual hygiene must be promoted under religious guidelines. Both men and women if given guidance under religious teachings must have positive outcomes.

Encourage the participation of men in awareness campaigns and menstrual education and management through religion and encouragement through religious modes.

Strategize the cultural, religious and social taboos associated with menstruation.

The government must ensure building enough toilets at public places and schools with proper sanitation facilities and safety for women.

The government should monitor the psychological illness of young girls who suffer trauma in their periods.

Each family should educate women and girls regarding menstrual hygiene and should play an active role in obliterating the taboo around it.

By running awareness campaigns in rural areas on an individual as well as common levels Eg. 24-year old Anurag Chauhan is teaching rural women how to break the taboo around menstruation.

Awareness campaigns, short films/documentaries, booklets, comics and short courses.Eg. Harvard University has launched a programme called Problem Driven Iterative Adaptation (PDIA) an approach for problem-solving.

The government must ensure free sanitary napkin schemes for rural areas. Besides, running health systems in educational institutes would make a bigger difference. For instance, Procter & Gamble’s partnership with the Goa Government in India to introduce an educational module on menstrual hygiene management as part of the Education in Government Schools curriculums.

– Source: www.jkpi.org

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