The low-cost sanitary napkins scheme to promote menstrual hygiene is set for a launch
These girls remain confined within the four walls of their homes and are not allowed to go out for a reason, which has long ceased to be any matter of concern in the developed world.
The reason: The monthly menstruation cycle, and since most village girls do not use convenient, disposable sanitary napkins, elders in the family advise them to stay at home away from prying eyes. The girls cannot participate in household activities and are banned from puja or any other religious functions as they are considered “unclean”.
The practise is commonplace all over the country. However, the ground reality may change in the future if a central government-sponsored scheme to provide sanitary napkins to village girls at a subsidised price found acceptance in the countryside overcoming the societal taboo.
To be launched in August, the scheme in the first phase, will cover 25 per cent of target population, which is about 1.5 crore girls in the age group of 10-19 years. Initially, the scheme will be launched in 152 districts of 20 states, including nine districts of Karnataka.
In 107 districts, the girls will be provided with a pack of six sanitary napkins under the National Rural Health Mission’s brand ‘Freedays’, priced Rs 6. Manufactured by HLL Lifecare, the pads will be sold to adolescent girls by the Accredited Social Health Activist (ASHA) in villages. In another 45 districts, self-help groups will supply the pads at a price of Rs 7.50 a pack. The scheme is being supported by the UNFPA.
“Since clean napkin will be available at an affordable price virtually at their doorsteps in rural areas, its use may increase,” hoped a health ministry official. Currently, sanitary napkins are not the first choice of young girls and women in villages, leaving them with little option. Many are compelled to use cloth, straw, ash and numerous other materials, some of which may pose disastrous health hazards.
Anshu Gupta of Goonj, a voluntary organisation that began making sanitary napkins out of waste cloth in 2004, is a repository of harrowing experiences narrated by village women. In Muzaffarabad, a woman desperately used the cover of a winter quilt in peak summer. The heat generated by it led to infection and ultimately her uterus had to be removed.
Many rural women lose their uterus at a child bearing age because health officials advise uterus removal to avoid the chance of infection leading to cervical cancer, notes Mr Gupta, highlighting the scale of the problem.
Evidence suggests lack of access to menstrual hygiene (which includes sanitary napkins, toilets in schools, availability of water, privacy and safe disposal) could contribute to local infections, including reproductive tract infections.
“Reproductive Tract Infection are closely interrelated to poor menstrual hygiene and pose a grave threat to women’s lives, livelihood and education. The new scheme aimed at adolescent girls in the age group of 10-19 years in rural areas, has been designed specially to tackle this problem,” said A R Nanda, a former secretary in the department of family welfare.
Improving maternal health is a long standing national problem and better menstrual hygiene can go a long way in improving the health of would-be mothers. Even though India’s maternal mortality rate – the number of women between 15-49 years dying due to maternal causes for 100,000 live births – improved from 398 in 1997-98 to 212 in 2007-08, the nation still has miles to go to achieve the UN Millennium Development Goal of 109 MMR.
According to government plans, ASHAs will get an incentive of Re 1 on the sale of each pack, besides a free pack of sanitary napkins per month. The idea is to recover the cost on incentives from the sale proceeds. ASHAs are also required to facilitate a monthly meeting with adolescent girls in the village to promote menstrual hygiene, for which they get an incentive of Rs 50.
Gupta, however, is not convinced about the efficacy of the distribution channel. “ASHAs are overburdened. What's the guarantee that they will get the stocks in time. A heavily subsidised scheme as this is also pilferage prone,” he said.
Questions are also being raised about disposal of used pads and introduction of more non-biodegradable wastes in rural environment. “Every woman needs about 7-8 pads, so 7000 to 8000 pads are required a month or about 70,000 -80,000 pads a year.
Non-biodegradable waste generation in villages without proper sanitation or disposal facilities, will lead to serious environment damage,” Gupta said.Reusable pads?
A better solution could be reusable pads which Goonj and many other voluntary outfits make from waste cloth. These pads are comparable in cost, biodegradable and can be used 2-3 times. The government, however, argued that NGOs do not have the capacity to sustain the supply chain for a long time. And that's the reason for HLL getting the bulk of the contract.
“Why can’t the government give some time and seed money to the SHGs and NGOs. Its not a manufacturing technique that requires heavy machinery or investment. The government is all of a sudden blaming the NGOs for not having the capacity. That's unfair,” Gupta fumed.