In a country like India, access to education is disproportionate along the lines of gender, class, (dis)ability, and caste, and their intersection. It is observed that “quality” education is more accessible to certain sections of society, which are composed mainly of upper-caste, upper/middle-class able-bodied children. In rural areas of the country, access to education is also prominently divided along the lines of gender, wherein boys have access to education over girls. There has been an increased focus on making education accessible to girls from both rural and urban backgrounds, but one issue that has often been ignored on this front is Menstrual Hygiene Management (MHM).
According to Columbia Public Health, UNICEF and Columbia University in 2014 joined hands to hold the first meeting for ‘MHM in Ten’ which established a ten-year agenda (2014–2024) to be achieved by 2024 to make “girls around the world knowledgeable about and comfortable with their menstruation” and to help them “manage their menses in school in a comfortable, safe, and dignified way.” In the same year, a report titled Spot On! Improving Menstrual Health and Hygiene in India conducted by NGO Dasra reported shocking yet unsurprising data about the state of menstrual health and hygiene in the country. It revealed that around 23% of girls in India drop out of school every year because of menarche. It also reported that after household work and societal gender norms, menstruation was the second leading reason for girls to drop out of schools.
There are a number of reasons why girls drop out of school as soon as they reach puberty. There is shame and taboo associated with menstruating women in India. In several parts of the country, menstruation is not understood as a biological process important for reproduction but as a marker of sin, shame, and impurity. The lack of awareness of menstruation in both men and women contributes to the perpetuation of superstitions (menstruating women should not enter the kitchen, bed sheets should be changed if a menstruating woman sits on the bed, menstruating women should not enter religious places, etc.). A lot of this shame is internalized by young women who feel impure when they are menstruating. In a cultural context, menstruation also signals that the girl has now become a woman and should be married. This belief leads families to force their daughters to drop out of school and marry them off. Another issue is the insensitivity of the teachers, particularly male teachers, who often do not let girls use the washrooms during their classes. In certain parts of the country, there is also the issue of the unavailability of separate toilets for boys and girls, and even if separate toilets are available, there is the issue of cleanliness, the unavailability of proper disposal facilities, as well as the lack of sanitary napkin vending machines or similar alternatives.
A later study on the same subject was conducted in 2019 and published in 2020 titled Menstrual Hygiene Preparedness Among Schools in India: A Systematic Review and Meta-Analysis of System-and Policy-Level Actions by Shantanu Sharma, Devika Mehra, Nele Brusselaers, and Sunil Mehra. The study evaluated the functioning of a ‘menstrual hygiene friendly school’ which it defined as having eight components: teachers had proper and adequate knowledge about MHM; school administration took actions to promote menstrual health; good sanitation facilities in schools; the awareness of MHM in the girls; men in school are sensitized to MHM; regular monitoring of the schools for MHM; availability of education materials on MHM; and waste management facilities in the premises. The data analysis of the aforementioned factors highlighted the lack of and poor MHM in India.
The current condition, or rather lack of MHM in India, calls for immediate action. There have been policies and schemes formulated by the government and several organizations working towards the cause. Some of them are:
Menstrual Hygiene Scheme (MHS) in 2011, which aimed to promote menstrual hygiene among adolescent girls of 10-19 years of age in rural areas by increasing awareness among the intended group, enabling access to and use of high-quality sanitary napkins for the girls, and assuring safe disposal of sanitary napkins in an eco-friendly manner. It included the freeday pad scheme, which provided subsidized sanitary napkins to girls from rural areas.
SABLA Scheme launched by the Ministry of Women and Child Development in 2011, to enable adolescent girls’ self-development and empowerment and to create awareness about health, nutrition, reproductive health, and sexual health.
The Nirmal Bharat Yatra in 2012, organized by WASH United, WSSCC and GOI, which aimed to promote awareness and create behavioral change around sanitation and hygiene in India.
Rashtriya Kishor Swasthya Karyakram (RKSK) in 2014, launched by the Ministry of Health and Family Program, which aimed to provide holistic development of the adolescent population and ensure that they develop into healthy adults. According to National Health Mission, the programme aimed to provide better education and awareness of reproductive health, sexual health and MHM in adolescents and expanded the scope to include “ambit nutrition, injuries and violence (including gender-based violence), non-communicable diseases, mental health and substance misuse” through peer-education models.
There are several international development organizations working towards the cause, such as the Water Supply and Sanitation Collaborative Council (WSSCC), WaterAid, WASH United, United Nations Children’s Fund (UNICEF), and USAID.
There are many social businesses and non-profit organizations such as Aaina, Aakar Innovations, Eco-Femme, and Goonj among others, which are making efforts to ensure better menstrual health for girls and women in India.
There are many good policies in place, but their effective implementation is lacking. It is important to record and track the implementation of these policies in schools to monitor the MHM situation in schools. Schools can and should become a significant platform to promote MHM and menstrual health so that girls do not drop out of schools and are able to avail the same education as boys without any fear of shame, fear, or hygiene-related issues in the school premises.
Written by ~ Khushi Gupta