Potential States for intervention of MHM Introduction Effective Menstrual Hygiene Management is vital to the health, well-being, dignity, empowerment, mobility and productivity of pre-menopausal adult women and adolescent girls. Victims of poor MHM in developing countries like India are mostly poor women of both rural and slum. Certain socio-economic issues with which the poor women deal with will lead to poor MHM. Menstruation is a natural process; however, if not properly managed it can result in health problems, school absenteeism and increased school drop-out rates among adolescent girls, poor performance of work and difficulty in performing physical work. The impact of poor menstrual hygiene on the psychosocial wellbeing of women and girls like stress levels, fear and embarrassment, and social exclusion during menstruation should also be taken into account. India is said to have approximately 355 million 1menstruating women and out of which 113 million 2 adolescent girls are particularly vulnerable at the onset of menarche. According to National Sample Survey Office/Census (2012) and Pratham (2014) Annual Status of Education Report (Rural), 2013, out of 14,724 government schools only 53% had a separate and usable girl’s toilet. This is directly affects MHM of adolescent girls and will lead to absenteeism. In a study carried out by Nielsen on behalf of UNICEF in rural areas of Bihar and Jharkhand, one of the findings was 93% of girls missed 12 days of school on an average every month. Inadequate menstrual protection make adolescent girls aged between 5 and 12 miss out on classes and about 33% of these children will even drop out of schools according to the a survey conducted by Neilson on 1033 women. A study done by A.C Nielson and Plan India, reveal that only 12% of India’s menstruating women use sanitary napkins. Over 88% resort to shocking alternatives such as unsanitised cloth, ash and husk sand. Incidents of urinary tract infection are 70% higher in these women. Poor menstrual hygiene is considered to be one of the main reasons for the high prevalence of STIs and RTIs in the country. Several studies show the presence of Sexually Transmitted Infections (STIs) and Reproductive Tract Infections (RTIs) being high in Indian states. The prevalence of RTIs and STIs in women (15–44 years old) in India increased by 26% and in Odisha by 126% between 1998–99 and 2002–04 (reported in the two rounds of District Level Household Survey—Reproductive and Child Health (DLHS-RCH)). A study conducted to determine the prevalence of community acquired-UTI in rural Odisha showed that prevalence of UTI in females was 45.2%. 3 The biggest barrier to the usage of sanitary napkin is affordability in the developing countries like India. About 70% of women in India say that they cannot afford to buy them and would rather spend the money on something more useful. In a survey conducted by Neilson on 1033 women, in North 1 ‘Preferred menstrual absorbents, awareness and hygiene practices during mensuration amongst women in chennai, india’, Dr. Afrose Fathima Farid, International Journal of Science, Engineering and Technology Research (IJSETR) Volume 5, Issue 5, May 2016
2 ‘Menstrual Hygiene Management – National Guidelines (India)’, Ministry of Drinking Water and Sanitation – Government of India, December 2015.