6 minute read
Secondary Research
“A 2014 report by the NGO Dasra titled ‘Spot On!’ informed that almost 23 million girls in India drop out of school annually, because of lack of menstrual hygiene management facilities, including availability of sanitary napkins and awareness about menstruation.”
“In India, 71% of girls report having no knowledge of menstruation before their first period. Girls often turn to their mothers for information and support, but 70% of mothers consider menstruation “dirty,” further perpetuating taboos.” (Menstrual Health in India 2016)
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“All women (including transgender people) at Zomato can avail up to 10 days of period leaves in a year.” (Zomato, 2020)
“Despite national-level eforts, ~53% of all households in India lack a toilet, requiring women and girls to use communal or public toilets, which may be far away, or defecate in the open, increasing women’s vulnerability to violence.”(Menstrual Health in India 2016)
“A study done on 119 women in Puducherry, India showed that only a third of those with a menstrual complaint (36%) seek treatment from a health facility. The rest of them resorted to home remedy (10%), self-medication (6%), or did not take any measure (43%).” (Laksham, Selvaraj,et al. 2019)
Common Menstrual Disorders
Premenstrual Syndrome (PMS)
PMS is any unpleasant or uncomfortable symptom during your cycle that may temporarily disturb normal functioning. These symptoms may last from a few hours to many days, and the types and intensity of symptoms can vary in individuals. Common symptoms of PMS include bloating, anxiety, headaches.
Amenorrhea
Amenorrhea is characterized by absent menstrual periods for more than three monthly menstrual cycles. There are two types of amenorrhea: Primary amenorrhea: Menstruation does not begin at puberty. Secondary amenorrhea: Normal and regular menstrual periods that become increasingly abnormal and irregular or absent. This may be due to a physical cause typically of later onset.
Polycystic ovary syndrome (PCOS)
Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs Symptoms: Irregular periods, Painful periods, excess androgen (male hormone)
Endometriosis
Endometriosis is an ofen painful disorder in which tissue similar to the tissue that normally lines the inside of one’s uterus — the endometrium — grows outside the uterus. Symptoms: Painful periods, Pain with intercourse, excessive bleeding
Dysmenorrhea
Dysmenorrhea is characterized by severe and frequent menstrual cramps and pain associated with menstruation. The cause of dysmenorrhea is dependent on whether the condition is primary or secondary. With primary dysmenorrhea, women experience abnormal uterine contractions resulting from a chemical imbalance in the body. Secondary dysmenorrhea is caused by other medical conditions, most ofen endometriosis. Symptoms: Lower back pain, Lower abdomen pain, cramping, nausea
Summa Health (2016)
As a part of f\digital ethnography, the researcher joined Facebook groups and forums related to menstrual health. It was found that several women were sharing their doubts and stories online. Women rely on a support network and gain insights from each others experiences. However, there is a large part of the Indian population that does not have access to the Internet. As per a report from the Digital Empowerment Foundation in 2018, around 90% of India’s population is digitally illiterate.
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Image 13 Images 9-13 are screenshots of posts from Facebook groups and forums. Names have been anonymized for privacy Image 14 Image 15 Images 14-15 are screenshots from online events
The COVID-19 pandemic made it possible to attend events and conferences online. Through these online events, the researcher had the opportunity to meet with people working in the Menstrual Health and Hygiene Management sector. These events gave clear a idea of the menstrual health landscape and on-field challenges in different parts of India.
Existing Government Initiatives
Listed below are some government initiatives launched by the Government of India to under-privileged women.
Pradhan Mantri Matritva Vandana Yojana: Maternity benefits programme, introduced in the year, 2010 and implemented by Ministry of Women and Child Development. It is a conditional transfer scheme for both pregnant and lactating women of 19 years of age and above for 1st live births. This scheme provides, conditions for safe delivery, Child care and good nutrition. Also, the scheme covers the wage loss suffered by these women during child birth. (Manjunath,2018)
Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A): is a programme that essentially looks to address the major causes of mortality among women and children as well as the delays in accessing and utilizing health care and services. (Oxfam India, 2018)
Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) was announced with objectives of correcting regional imbalances in the availability of affordable/ reliable tertiary healthcare services and also to augment facilities for quality medical education in the country by setting up of various institutions like AIIMS and upgrading government medical college institutions. (Oxfam India, 2018)
Accredited Social Health Activist (ASHA):The role of an ASHA is that of a community level care provider. This includes a mix of tasks: facilitating access to health care services, building awareness about health care entitlements especially amongst the poor and marginalized, promoting healthy behaviours and mobilizing for collective action for better health outcomes and meeting curative care needs as appropriate to the organization of service delivery in that area and compatible with her training and skills. (National Health Mission, 2014).
Image 16: Contraceptives and ORS at Primary Healthcare centre
Existing Non-Government and Charitable Organizations
Though there are several organizations working towards bettering menstrual health and hygiene in India, listed below are a few that have made a significant impact. It was observed that very few organizations are focussing on improving menstrual health for older women. Most of these organizations are working with adolescents.
WaterAid India: WaterAid India is part of the global WaterAid network which seeks to improve access to clean water, decent toilets and good hygiene for everyone, everywhere. (1986)
Menstrupedia: Menstrupedia is a friendly guide to periods which helps girls and women to stay healthy and active during their periods. (2012)
Goonj: A social enterprise that is addressing the gaps and challenges of menstrual hygiene and management for the last women by engaging comprehensively with all key stakeholders. (1999)
Myna Mahila Foundation: Educates girls on usage and disposal of sanitary napkins and openly discuss periods as a shameless bodily function, making them feel comfortable and confident while they are menstruating. (2015)
TATA Trusts: The Trusts’ interventions in RMNCHA+ are focused on programmes in Madhya Pradesh and Rajasthan, covering 8 districts and over 80 facilities. The Trusts are involved in providing training to accredited social health activists (ASHAs) and auxiliary nurse midwives (ANMs) in identifying and treating high-risk pregnancies. (1919)
RMNCHA+ is short for Reproductive, Maternal, Newborn, Child and Adolescent Health. This is a strategy developed under the national health goals by the National Health Mission (NHM) of India.(National Health Mission, 2013)
Image 17: Image from comic book Menstrupedia (2020)
