India awakens to 'period poverty'

The film Padman has brought national attention to a long-neglected issue in developing countries.

And with Maneka Gandhi announcing the launch of #YESIBLEED, a national campaign on menstrual hygiene, India is taking the much-needed steps to end 'period poverty.' Menstrual health is a comprehensive, multifaceted issue, and evidences have shown the dire need to address it.

Unfortunately, globally, and in India, young girls grow up with limited knowledge of managing their menstrual cycles, due to a lack of education, awareness and resources about personal hygiene. The United Nations defines adequate Menstrual Hygiene Management (MHM) as "women and adolescent girls using a clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required, and having access to facilities to dispose of used menstrual management materials." According to UN data on MHM, 66% of girls in India are unaware of menstruation before their first period and, for 23-28% of girls in rural India, periods, together with, lack of private spaces and facilities, remains a major reason for being out of school. And only 12% schools have soap available to wash hands. These factors affect the personal development and growth of girls.

For a long time, menstrual health was not a priority in the public health agenda. The Reproductive and Child Health Programme (RCH) in 1997, was not target-driven, hence menstrual health got space, but it was not completely addressed. Social organisations implemented programmes that trained stakeholders on best practices to manage menstruation. They mobilised communities and leveraged government schemes to build requisite infrastructure. Many campaigns have been initiated by various NGOs to break the silence on MHM and much is being done to support self-help groups by establishing production units to ensure access to safe and cost-effective products.

The government strengthened health programmes through the National Rural Health Mission. Menstrual hygiene was included in Accredited Social Health Activist workers' responsibilities, to raise awareness and management. In 2011, the Ministry of Health and Family Welfare initiated schemes under the Rashtriya Kishore Swasthya Karyakram to promote menstrual hygiene among adolescent girls. The scheme was initially implemented across 17 states.

The previous government's flagship sanitation programme (2012), Nirmal Bharat Yatra, in collaboration with Water Supply and Sanitation Collaborative Council, included menstruation management in its agenda. State s joined the distribution wagon and implemented the policy of handing out sanitary napkins to adolescent girls in government schools. From 2014 onwards, the government is funding states under the National Health Mission for decentralised procurement of sanitary napkins to provide rural girls at a cost of Rs 6 for a pack of six napkins. The programme aims at increasing awareness on menstrual hygiene among adolescent girls, increase access to good quality sanitary napkins and their safe disposal.

Sanitation and hygiene needs of women, coupled with a need for privacy, safety and dignity is also seeing special emphasis in the Swachh Bharat Mission. The Ministry of Drinking Water and Sanitation, brought out the National Guidelines for Menstrual Hygiene Management in 2015 that lays down recommendations for state governments, district administrations, technical experts in line departments; and school teachers to support girls and women with MHM choices.

In January 2017, a member of parliament from Arunachal Pradesh tabled a private members' bill - The Menstruation Benefit Bill in the Lok Sabha, and proposed paid leave for all working women in India every month, because of the Women's National Health Service Foundation Trust report that says, period pain can be severe enough to interfere with daily activities in up to 20% women. Last year, two Indian companies were recognised for their initiative to grant paid menstruation leave to their women staff.

Building on this momentum will require working with other civil society organisations within the districts of operation, identifying and involving community-based organisations and ensuring that they are oriented on a sustainable menstrual hygiene management model. A multi-sectoral response involving water, sanitation, urban planning, education, health, and the social sector can ensure that evidence-based, and cost-effective policies are developed for the benefit of all.

(The writer is director, resource mobilisation, Save the Children)