Menstrual Hygiene Day 2022: Time to break the stigma around menstruation and period products

Photo courtesy: @UN | Twitter

One of the biggest drivers in improving girls' health, education, and well-being is enhancing their chances of getting access to menstrual hygiene products. Menstrual health is a public health and human rights issue which is crucial in achieving gender equality and sustainable development goals. Inadequate options for managing periods are a barrier to girls' education and health in low and middle-income countries.

The National Family Health Survey 5 (NFHS-5) report, which was released in March 2022 has found that women with 12 or more years of schooling are more than twice as likely to be using a hygienic method as compared to women with no schooling. (90% versus 44%). The survey has also found that women in the highest wealth quintile are almost twice as likely to use hygienic methods of menstrual protection as compared to women from the lowest wealth quintile.

Despite all the progress the government claims it has achieved in the area of menstrual hygiene, 27% of rural women in India still don't use hygienic methods of menstrual protection. The survey notes that Bihar (59%), Madhya Pradesh (61% ) and Meghalaya (65%) have the lowest percentage of women using safe methods. The highest period product usage was reported in the Andaman & Nicobar Islands and Puducherry, where almost 99% of the women reported using safer methods of menstrual protection.

According to the NFHS-5 data, when women in the age group between 15 and 24 were asked what method or methods they use for menstrual protection, it was found that only 64% used sanitary napkins, 50% used cloth and 15% used locally prepared napkins. Overall, it was identified that 78 percent of women in this age group used hygienic methods of menstrual protection.

There was also a difference in the usage of period products between women from urban and rural communities. 89.4% of women in urban areas versus 72.3% of women in rural sectors. However, the gap in the usage of period products between urban and rural areas has reduced compared to the data released in 2015-16. The percentages were 76% and 49% during that period.. These numbers show that India has definitely made positive strides in certain aspects related to menstrual hygiene, but much deserves to be done when it comes to access to menstrual hygiene products for women in low-income groups.

The data released by the Ministry of Health and Family Welfare also has interesting details that emphasise not just the importance of education in addressing menstrual hygiene related issues but it also notes that the levels of education are equally significant. For instance, the survey shows how the percentage of girls and women using period products with different education levels changes as their education levels rise from the no schooling stage to 12 or more years of schooling. While only 43% of girls with no schooling or formal education use period products, it was found that over 90% of girls who have done 12 or more years of education used period products.

Percentage of women using period products across education levels | Source: NFHS-5 India Report (2019-21) | Graph: Karan Babbar

Apart from the problem of access, another critical aspect that leads to lower levels of use of safe menstrual hygiene products by women are the issues related to pricing and affordability. Research has found that the period product usage percentage saw a significant rise as we went from the poorest to the wealthiest income strata.

Percentage of women using period products across wealth index | Source: NFHS-5 (2019-21) | Graph: Karan Babbar

It has also been observed that the women who are more aware of their surroundings and who watch television are more likely to use period products. Television and mass media have a massive impact on women regarding the choice they make related to their menstrual health and the use of period products.

Percentage of women using period product across television viewership | Source: NFHS-5 Raw Data (2019-21) | Graph: Karan Babbar

The exhaustive data from the government clearly indicates the focus areas in the implementation of schemes related to menstrual hygiene in India. While we make significant strides towards improving the period product usage in India across women in low and middle-income groups, the need of the hour is to also look at making available a wide array of choices when it comes to women's menstrual hygiene. It is equally important to make eco-friendly and sustainable period products available to millions of menstruating women in the country.

The most common menstrual hygiene product in India today is the regular sanitary napkin, which is manufactured by various brands. Sanitary napkins are disposable, and they can cause an adverse impact on the environment. However, there is little to no conversation on how to dispose of these period products. Therefore, it is imperative that women are given access to alternatives to sanitary pads like menstrual cups, tampons, and eco-friendly sanitary pads.

In India, there are still many stigmas associated with menstruation. In many regions in India, women are forced to bury their menstrual clothes to prevent them from being overtaken by evil spirits. There are multiple taboos and stigmas associated with menstrual products also. For instance, many women still consider menstrual cups and tampons to be unsafe.

In India, there is also a lack of conversation around menstruation from a gender perspective, and there is a lack of data on trans and non-binary individuals. The feminisation of menstruation is highly problematic as it completely ignores the trans and non-binary individuals who menstruate. It is essential to bring the conversation around trans and non-binary individuals into the discourse around menstruation. Government organisations, international bodies, and NGOs have a prominent role in starting the conversation around menstruation, taking into account all menstruating individuals, including non-cis-gender individuals (trans and non-binary).

When it comes to data related to menstrual hygiene, studies conducted by various NGOs, international bodies, and governments are usually conflicting. The disparity between the data related to menstrual hygiene speaks volumes about the need to collect data more scientifically and accurately. It is in this background that days like the Menstrual Hygiene Day are important as it throws light on issues related to menstrual health. The day is observed on May 28 globally as an annual awareness day to highlight the importance of good menstrual hygiene management (MHM). The day was initiated by a German NGO in 2013 and was first observed in 2014. The annual observance of the event has led to an increase in awareness across the globe on issues concerning women's menstrual health and hygiene.

To conclude, we may have achieved a higher usage of period products at national levels. However, we are still caught behind in the race towards sustainable menstruation and recognising the needs of the sexual and gender minorities who menstruate. Thus, it is essential to conduct educational interventions to improve awareness of sustainable menstruation products and bring trans and non-binary individuals into the discourse around menstruation.

Karan Babbar is a PhD scholar at Ravi J Matthai Centre for Educational Innovation, Indian Institute of Management, Ahmedabad.