Urban India is debating the topic of menstruation and the associated stigma.
But breaking the mould in rural areas is far more challenging, which calls for an integrated approach.
What does NFHS data show?
Government data suggest positive developments in the use of hygienic methods of managing menstrual periods.
As per NFHS-4 (National Family Health Survey), 42% women in the 15-24 age group uses sanitary napkins.
Of this, 16% use locally-prepared napkins, while 62% use cloth.
In all, at least 58% are estimated to be using a hygienic method of menstruation.
The data says that nearly 48% rural women in this age group are using hygienic methods.
However, menstrual age of women goes up to 40-45 years, and a large section of women has still been left out of the survey.
The ground reality is a lot different, with several challenges to bring about change in rural areas.
What are the limitations?
Mindset - In rural India, the outdated value system related to periods, sexuality, etc, are much ingrained.
The resistance is severe, and much is kept literally under wraps.
Social structure - The social structure is largely patriarchal; women individuality and needs mostly come second.
There is even lesser sensitivity with respect to women’s sexuality and physiology.
Taboo subject - Menstruation remains one of the biggest taboo subjects, and breaking the notions on such matters are truly challenging.
Financial viability - Making sanitary pads affordable for money-starved rural families is a limitation for promoting its use.
Media - Till date, sanitary pads’ advertisements use blue as the colour to prove the effectiveness of pads.
It is essential that platforms as these turn mature enough to show the liquid and gel with what it should be, the colour red.
What are the notable initiatives?
Chuppi Todo-Sayani Bano (roughly translated as ‘break the silence and grow up’) is an on-ground menstrual hygiene awareness initiative in parts of Rajasthan.
It is a private rural healthcare delivery enterprise for sanitary pads dispensation.
A key effort includes disassociating morality from menstruation.
It aims at replacing the 'right or wrong' debate with that on health, education, and development viewpoints.
Approaching topics such as menstruation with sensitivity, internal workshops are conducted.
They sensitise the field workers along with the network of Anganwadi workers from the villages.
To gain trust, influential people from village neighbourhood are identified and entrusted with implementation.
Student groups are also involved, making the efforts of sensitisation more effective.
What lies ahead?
Poor menstrual hygiene practices have serious health challenges.
They range from urogenital or non-sexually transmitted infections, to yeast, fungal and urinary tract infections, to even cervical cancer.
Thus, the cost of following hygienic practices is far less than bearing the cost for treatment of diseases.
Initiatives as discussed above should be financed appropriately to be scaled to multiple states and remote regions.
For further progress, the discourse on menstruation needs to change in both urban and rural spaces.
A multi-layered approach focusing on awareness, accessibility, behavioural change, and identifying the target groups is essential.
Knowing which group is more approachable helps in drawing out strategies to initiate discourse, educate and trigger behaviour change.
E.g. Schoolgirls, literate and educated women are more willing to listen and contribute. Men who are socially-involved and less politically-invested are easier to convince and engage.
