Menstruation – taboos, stigma, constraints still persist, reveals study

A study shows that the natural and normal cycles of menstruation continue to hinder young girls and women from living life to the fullest. Sarita Brara has the details of a study conducted by the Sulabh International Social Service Organisation. Clearly, a lot still needs to be done for proper MHM in terms of facilities and environment and to change the mindset towards menstruation

Regular menstruation cycles are indications of a woman’s proper development and good health. Yet, there is a stigma attached to it. Menstruating women are considered taboo in many Indian villages – they are not allowed to cook for their families, or even enter the kitchen. They are not permitted to take part in religious rituals. Most women, not only in villages but in urban areas too, avoid going to temples when they are menstruating. And another aspect is that lack of means and facilities for proper management of menstruation hinders girls’ education, growth and self-confidence.

The Sulabh International Social Service Organisation recently published the results of a study it conducted on menstrual hygiene. The aim was to understand the experiences of women at the ground level, make recommendation for better menstrual hygiene management, fill the gap between policy and practice, and also break the ‘silence’ around the subject. The project was carried out from February 2022 to April 2023 in 14 districts spread across f Assam, Bihar, Chhattisgarh, Haryana, Maharashtra, Odisha and Tamil Nadu, covering diverse communities. The study covered menstruating women between the ages of 20 and 49.

Is an adolescent prepared for this cycle? What are the constraints women face from menarche till menopause? What are the structural-institutional challenges? These were the main areas of focus of the study. A total of 4,389 women were surveyed on aspects including social customs, taboos and myths attached to menstruation. The study showed that during their periods:

• 83.4 per cent of women are not allowed to visit religious places
• 72.3 per cent are not allowed to participate in rituals
• 72.1 per cent are not allowed to carry out their routines at home
• 30.5 per cent are not allowed to socialise
• 57.4 per cent avoid travel

The lack of menstrual material and facilities for its disposal were also highlighted:

• 53 per cent talked of lack of adequate menstrual materials
• 52.6 per cent brought up unavailability of places for changing menstrual material at schools
• 62.7 per cent said they were unable to dispose of used menstrual material
• 51.2 per cent said they were unable to dispose of menstrual material in a proper way

With regard to comfort and hygiene during the menstrual cycle, the study found that

• 43.5 per cent felt uncomfortable keeping used menstrual material
• 30.1 per cent were uncomfortable about changing menstrual material even at home
• 32.6 per cent worried about hiding menstrual materials from others
• 66.4 per cent felt uncomfortable carrying menstrual materials to change outside the home
• 58.4 per cent felt uncomfortable about changing menstrual material outside their homes
• 60.4 per cent women said they were unable to change material as needed when they were away from home

The study made several recommendations for better management of menstruation. These included:

• setting up state-level Menstrual Hygiene Management (MHM) committees to integrate women’s menstrual health and wellbeing, especially in remote areas
• the need for MHM to disseminate information on menstrual hygiene and spread awareness in schools and  knowledge on menstruation products and safe disposal of menstrual waste among older women at the district, block and gram panchayat levels

The study recommended that national schemes like the Jal Jeevan Mission should be integrated with MHM. This could help in focusing on water supply in rural schools, villages, anganwadis (nurseries), community, livelihood spaces (such as markets) and places of work (such as farms and factories). Community spokespersons said that owing to poverty, water shortage, lack of toilets and remoteness, women beyond school years lack opportunities for adequate MHM. They should be provided free or heavily subsidised sanitary pads, sanitary pads / absorbent material should brought within reach for marginalised communities, and disposal systems should be provided and monitored. Pad-vending machines at every anganwadi and self-help group premises would also help, the study showed.

Other recommendations
1. Schools and toilets should be made ‘period safe’
2. A monthly or quarterly compulsory health check-up should be organised in villages.
3. Young menstruating girls feel extremely uncomfortable going to school for four to five days during menstruation, owing to lack of or poor toilet facilities in schools.  To ensure that girls’ education remains uninterrupted by their menstrual cycles, teachers, school counsellors and social workers should be motivated to call for proper infrastructure. They should also make sure school sanitation facilities are monitored regularly.
4. Educating children entering puberty is a prime need in all villages. Growing girls need to have physical and reproductive knowledge of their body and wellbeing. If menstruation is not given a proper place in discourses in an adolescent girl’s life, they can experience isolation, stress, embarrassment and confusion over this issue.
5. Another suggestion was exploring the possibility of providing micro-credit facilities through women’s self-help groups in villages to increase the earning capacity of women and enable them to take active decisions on MHM and health.

Though the percentage of women in the 15-24 year age-group using hygienic methods of protection during menstruation has increased from 57.6 per cent in 2015 to 77.3 per cent in 2019-21 (as per NFHS-5, 2019-21), there is still a stark gap at two levels –  beyond the age of 24 years, and girls outside educational institutions. Not all girls have the privilege of attending school or receiving regular MHM services or infrastructure. NFHS-4 estimated that out of 336 million menstruating women in India, only about 121 million used sanitary napkins. Another study revealed that nearly 23 million girls drop out of school when they reach puberty due to menstruation-related barriers (Dutta & Bhaskar, 2018).   

(The writer is a senior journalist who lives in New Delhi.)