New menstrual hygiene policy will keep girls in school

THE Health Ministry recently approved the Menstrual Hygiene Policy for schoolgirls. This policy not only advocates separate female toilet facilities in all government, government-aided and residential schools, but also, importantly, seeks to provide sanitary pads, free of cost, to female students of Classes VI to XII. Sanitary pads are important in schools because these help girls stay in school, improve their health and reduce the risk of infections. This policy, in particular, will have a great influence on girls’ attendance in school. This is an important takeaway from the policy.

According to a research, only 12 per cent of the menstruating women in India use sanitary napkins. Some cannot afford them, while others are not even aware of such napkins. As many as 82 per cent women in India still do not know what a sanitary napkin is. The research has also shown that in rural areas, over 77 per cent of the menstruating girls and women have been reported to use any old cloth, which is washed often and reused. The usual practice is to keep the washed cloth at some secret place until the next menstrual period. To keep the cloth away from prying eyes, these pieces are sometimes hidden in unhygienic places, which is a dangerous practice for menstrual hygiene.

This problem is found to be particularly acute in rural areas and amongst women and girls of lower socio-economic groups. This compromise in hygiene often leads to reproductive tract infections (RTIs). Severe infection can even lead to removal of the uterus of young girls.

Providing girls with sanitary pads may well increase their chances of staying in school by more than 30 per cent. Studies have found that giving out sanitary pads to girls leads to a significant reduction in sexually transmitted infections and bacterial vaginosis.

In reality, menstruation continues to be a taboo subject in India. At no time are most girls informed by their mothers as to exactly what the process involves. When mothers are questioned about it, they generally say: “What is there to tell? They will soon find it out themselves. We were never told by our mothers either.”

At the school level, teachers are also indifferent and do not consider conveying this information as a part of their responsibility. This lack of information has had severe consequences. As many as 23 per cent of the rural girls are reported to drop out of school when they start menstruating. This stopping of education encourages early child marriage and makes them lose the opportunity to realise their potential.

Adolescent girls constitute a vulnerable group, particularly in India where the female child generally remains neglected. Menstruation is still regarded as something unclean or dirty in the Indian society. The reaction to menstruation depends upon awareness and knowledge about the subject. The manner in which a girl learns about menstruation and its associated changes may have an impact on her response to the event of menarche. Although menstruation is a natural process, it is linked with several misconceptions and practices, which sometimes result in adverse health outcomes.

Hygiene-related practices by women during menstruation are of considerable importance as it has an impact on the overall health in terms of increased vulnerability to RTIs. The interplay of socioeconomic status, menstrual hygiene practices and RTIs is noticeable.

Today, millions of women are sufferers because of RTIs and their complications. Often, the infection is transmitted to the offspring of a pregnant woman suffering from RTIs. Women having better knowledge regarding menstrual hygiene and safe practices are less vulnerable to RTIs and its consequences. Therefore, increased knowledge about menstruation right from childhood may increase safe practices and help in mitigating the suffering of millions of women.

The policy to provide sanitary pads, free of cost, to girl students will also necessitate openness about the female body functions not only among the receivers but also their parents and teachers, which, as stated above, is lacking in India.

Sensitisation of health workers, accredited social health activists and anganwadi workers regarding menstruation could also be followed, so that they can further disseminate this knowledge in the community and mobilise social support.

Not only women but it is also important for men and boys to understand this natural process of menstruation so that they can support their sisters, wives, daughters, mothers and other women, peers, etc.

Even mere discussion among male students on the topic of distribution of sanitary pads, which is bound to follow the implementation of this policy, would lead to important conversations about the need for such a distribution.

There must also be a trained workforce to address these issues. Only a holistic approach can erase the silence and shame surrounding menstruation. The implementation of this policy will be a major step towards it.

Raising awareness regarding menstruation and hygiene practices has remained largely a neglected area in terms of research, despite its increasing popularity among public health organisations. It is clear that multi-sectoral approaches are needed. In order to succeed, there is a need to spread awareness among mothers as well as schoolteachers regarding menstruation.

Last but not least, enhancing the role of a male partner and changing his belief system is also pertinent to combating deep-rooted social beliefs and cultural taboos. It is important for men of all ages to be aware of this phenomenon vitally concerning their womenfolk.