The recognition of menstrual management’s importance for dignity, health and social participation has led to increased attention in advocacy, research and policies in India. The need lead to the launch of the National Menstrual Hygiene Scheme under the Rashtriya Kishor Swasthya Karyakram (RKSK) program in 2014.
The program’s fundamental principle is to enable adolescents to realise their full potential by making informed decisions about their health and well-being. The program also introduces community-based intervention via peer educators.
Within the program, the government has been running a free sanitary pad service as “Freedays” sanitary napkins to provide packs of pads at a low price for promoting menstrual hygiene. However, such government policies are marred by a lack of funds and questions on sustainability by providing five to six pads per month, which is barely sufficient to cover one menstrual cycle.
The government and other private institutes’ sanitary napkin distribution is based on assumptions that adolescent girls drop out of school due to a lack of sanitary products.
Shradha Shreejay, a menstrual hygiene advocate and educator at Sustainable Menstrual Kerala collective, expresses that girls miss school during periods due to two main reasons. One is period cramps and lack of changing private space and the other is clean toilets. Henceforth, it can be a significant thought that crores of rupees invested in providing free disposable pads to girls can also be taken in use by maintaining the existing toilets with the access of clean water instead?
Where the program is Failing
The aspect of the program and related policies do not justify any reason for endorsing sanitary napkins. The government fails to describe why they found this particular product is more efficient, economical or appropriate to serve the purpose of menstrual health and hygiene in the country.
Only a few national programs are targeting menstrual health management and recommend holistic solutions, and in practice, solutions often remain siloed. The recent menstrual health management guidelines recommend the Ministry of Drinking Water and Sanitation’s role to include building sanitary infrastructure and conducting awareness programs to change community attitudes about accessing sanitation during menstruation. However, in practice, the Ministry’s emphasis has been mainly on building toilets only.
Ministries are encouraged to work together according to the menstrual health management guidelines. To improve the overall implementation of menstrual health programs, Ministries are always in the process of operationalising the instructions and a need for inter-department convergence.
However, the instructions lack clarity on how intersection might look like in action, i.e. who precisely will coordinate or oversee the coordination across departments and levels. This is particularly important because various policies and programs across Ministries overlap in their goals.
For example, Rashtriya Kishor Swasthya Karyakram (RKSK) and SABLA (under Rajiv Gandhi Scheme of Empowering the Adolescent Girls) prioritise creating awareness about menstrual health and hygiene among adolescents. Both show limited clarity on how a counsellor under RKSKs Adolescent Friendly Health Clinics and an Anganwadi worker supported by SABLA may complement each other’s efforts.
Attention to other Groups
The concentration of the menstrual hygiene programs has been focussed on adolescents. Adult women have yet to receive adequate priority. Various initiatives are underway across low and middle-income contexts, including establishing menstrual hygiene improvements as a priority. Reducing taxes on menstrual products needs focus along with other actions.
Another focus of the implementation needs to be for catering to the disabled group. The group has been ignored this date. The existing education materials provided to ASHA and Anganwadi workers do not include relevant aspects or do not cater for different learning requirements for such groups. More research is needed on the grass-root level to understand the experiences and needs of women across the life course, recognising that menstrual hygiene is an essential aspect of women’s lives.