Menstrual Health in India: An Update

The history of menstrual hygiene management in India is marked by a shift from silence and stigma to increased awareness and normalization of the issue. The government has dedicated May 28 as Menstrual Hygiene Management Day, and a program on MHM has been launched in the country. Despite progress, social barriers continue to be a challenge, with deep-rooted norms and social sanctions preventing girls and women from accessing services and managing their menstruation hygienically. According to the National Family Health Survey-4 (2015-16), only 58% of women between 15-24 years use a hygienic method of menstrual protection. The social norms that periods are impure and make girls and women unclean have added stigma and led to their social isolation during menstruation. The government's efforts to address menstrual hygiene issues are fragmented, with different ministries working on separate aspects of the problem. The Ministry of Health and Family Welfare works on awareness and supply of napkins, while the Ministry of Drinking Water and Sanitation handles toilet construction and disposal. The Ministry of Women and Child Development addresses the needs of girls who are not in school. However, the lack of cohesive data and information on the work done by each ministry makes it difficult for those working in the sector to coordinate their efforts. Civil society organizations and social businesses have committed to addressing menstrual hygiene issues, with a focus on raising awareness, destigmatizing menstruation, and improving access to information and commodities to manage menstruation and disposal of menstrual waste. Newer options of sanitary pads, such as reusable cloth pads, washable, compostable, and biodegradable pads, are available in the market. However, quality, cost, and ease of access and disposal are key deciding factors for the choice of product. The availability of sanitary napkins has led to the installation of vending machines, but more evidence is needed to assess the effectiveness of this approach. The use of disposable sanitary napkins has also raised concerns about safe disposal, with the Ministry of Chemicals and Fertilizers introducing an oxo biodegradable sanitary napkin called 'Suvidha'. However, robust studies on new products are necessary prior to expansion in the public health sector. Menstrual Health in India is not just a commodity issue but a deep-rooted cultural practice that requires sustained efforts, including the involvement of men and boys. Convergent action by the government, civil society organizations, and social businesses can make the program more effective and address the social and structural barriers around menstruation in the country.