Shunning age-old menstruation practices crucial to ensure girls and women live with dignity

Every month, for five days, 17-year old Karamala Yogitha, who lives in a slum of Madanapalle in Annamayya district, Andhra Pradesh, is often upset, irritable, and sad. This is not because she suffers from premenstrual syndrome, but because she cannot have curd, step inside the house or go outside the compound. She is not even allowed to eat eggs.

Though mood swings during menses lead to frustration, for Yogitha, it is the age-old myths and taboos that she has been forced to obey since she attained puberty. Thankfully, when Yogitha was studying in primary school, she joined the child collective by Child Rights and You's (CRY) partner organisation in Andhra Pradesh, Peoples Organisation for Rural Development (PORD). In the children’s group, the young girl attended sessions on menstruation and puberty, wherein she learnt about the key tips to follow during menstruation, certain myths associated with it, and how they impact the girl child.

When Yogitha started facing the same age-old traditions at home, she understood that it was time to break the culture of silence and pass on her knowledge to other adolescent girls in her own community and outside. She got a flip chart from the PORD team and started educating adolescent girls and their parents on menstrual hygiene management (MHM) in her colony. After gaining extensive knowledge and skills, today Yogitha is not only an expert on MHM taking sessions in nearby schools and explaining the issue and the myths associated with it, but she is also a young champion of MHM spreading the message that menstruation is a natural process and it needs to be discussed openly.

However, there are many Yogithas across the states of South India, who are fighting their battles to quash menstruation myths and are encouraging adolescent girls/women to live a dignified life by adopting hygienic methods of menstruation.

The latest National Family Health Survey (NFHS-5) reveals that in four states of South India, approximately 84.2 percent women (in the age group of 15-24 years) in Karnataka, 98.3 percent in Tamil Nadu, 85.1 percent women in Andhra Pradesh, and 92.1 percent women in Telangana use hygienic methods of protection (locally prepared napkins, sanitary napkins, tampons, and menstrual cups) during their menstrual period.

The same data-set also highlights that only 79.8 percent rural as compared to 90.9 percent urban women in Karnataka, 98 percent compared to 98.6 percent in Tamil Nadu, 82.5 percent compared to 90.6 in Andhra Pradesh, and 90.3 percent compared to 95.2 percent in Telangana use hygienic methods of menstrual protection.

If we look at the rural-urban women comparison above, rural women in all four states except Tamil Nadu (which is almost at par) still lag behind when it comes to practicing hygienic methods during menstruation.

And that is essentially due to several challenges that they face including lack of knowledge of menstruation, low access and inability to afford period products, low awareness about tackling the taboo linked to menstruation, the impact of not using menstrual supplies on their reproductive health, and most importantly, a lack of understanding to identify the interlinkage between menstruation and girls/women empowerment.

After all, gender inequality is deep-seated in our society.

Jalla Lalithamma from PORD who has been working on the issue of MHM for the last 13 years and has been helping CRY change the narrative around menstrual health and hygiene, says that, “when it comes to educating women on MHM, men often oppose the idea or deter women from interacting with us on the issue as they feel that steps like these will threaten their traditions.”

However, significant efforts have been made by the government and civil society organisations to change the narrative around menstrual health and hygiene. Initiatives like the inclusion of MHM for the management of sanitary waste in Swachh Bharat Abhiyan and the introduction of Menstrual Hygiene Scheme by The Ministry of Health and Family Welfare promote menstrual hygiene among adolescent girls in the age group of 10-19 years in rural areas.

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Over the last four decades, CRY has been working on children’s rights including their right to good health. The organisation has also been extensively working on generating awareness around menstrual health and hygiene as an integral part of children’s health. Particularly CRY’s intervention in MHM in states of South India has been a major focus since the last decade.

Besides identifying and working with all its project partners on generating awareness to break the myths and traditional practices associated with MHM, CRY published Life Skills modules that also focused on MHM. Field staff were trained to conduct sessions on MHM for adolescent girls, but these activities have been hindered by COVID-19. And then there are young girls like Yogitha whom CRY, along with its project partners, have been able to shape into MHM experts/champions. The have played a key role on the ground during COVID-19 by teaching others how to stitch sanitary pads at home due to lack of access to menstrual supplies during the lockdown.

However, ensuring access to sanitary pads and supplies at affordable price is only one among the many solutions to MHM. For adolescent girls, having separate toilets is not enough for their MHM; it is crucial that there is proper disposal and sanitary waste management in place in school toilets and all other public spaces accessed by girls and women to mitigate the risk of infections.

Other factors such as increased supply of sanitary napkins and other menstrual supplies across channels and robust sharing of information on critical topics like reusable sanitary cloth pads, protection against infections, unhygienic menstrual products and safe practices of using reusable and disposing menstrual products can be generated through different mediums, be it audio-visuals on social media or messaging platforms, webinar discussions on MHM or through media channels like radio and television are equally important.

Most importantly, it is crucial that citizens too take steps and do their bit to help the government and CSOs create a ripple effect in bringing about a wave of positive change around menstruation. By raising awareness, promoting MHM practices in their respective households, debunking age-old silence and myths around menstruation, and ensuring a hygienic disposal system at home and in their communities, etc citizens can pledge their support to ensure menstrual health and hygiene among girls and women in low-income families and rural families.

After all, these vulnerable communities have already suffered enough with MHM, and much of the progress that had been made in this field over the past few years was undone during the COVID-19 pandemic.

Girls and women do need protection against unhygienic practices and age-old traditional beliefs just as they need protection from coronavirus infection with face masks and sanitization. Only a proper understanding of menstrual health and hygiene and a positive intent to spread the knowledge among girls will ensure that they live with dignity.