Challenges in Ensuring Women’s Menstrual Health

In several areas, especially in the rural and tribal regions, women’s
health is not a priority for male family members

Dr. Sanya Khan

All women go through menstruation, which is a normal natural occurrence. All
women of reproductive age practice menstrual management worldwide. In our
country, we have several programmes for women's empowerment and other
health programmes geared specifically toward women. We also have the Mission
Shakti scheme under the Ministry of Women and Child Development, and under
its guidelines, special emphasis is placed on the BBBP (beti bachao beti padhao)
component to make sanitary napkin vending machines and sanitary pads
available, particularly in educational institutions, although this does not reach all
girls and women of reproductive age.
Another scheme run by the Ministry of Health and Family Welfare attempts to
enhance menstrual hygiene among girls of reproductive age in the rural areas.
Rural women are given a box of six sanitary napkins called Freedays for Rs 6.
The Accredited Social Health Activist (ASHA) worker is responsible for distributing
the packets of sanitary napkins to rural and tribal women in the region where she
lives on a monthly basis. However, the bulk of rural and tribal women are still not
receiving them.
The second and most essential point is that menstruation and menstrual practices
continue to face various societal, cultural and religious limitations, which pose a
significant barrier to menstrual hygiene management. In many regions of the
state, particularly in the rural and tribal areas, girls are not prepared or aware of
menstruation. They face several obstacles and challenges at home, school and
even at places of employment. While conducting frequent fieldwork in several
areas of Jammu and Kashmir, it has been discovered that a lack of knowledge and
inaccurate or inadequate knowledge about menstruation is a significant

impediment to personal and menstrual hygiene management. Girls and women
know very little or nothing about reproductive tract infections caused by poor
menstrual hygiene.
Women in rural and tribal communities do not have access to sanitary products,
or they have limited knowledge of the types and methods of use, or they are
unable to buy such products due to their high cost. As a result, they largely rely on
cloth, which they wash and reuse. Also, the needs and requirements of girls and
women are ignored, and male family members do not perceive menstruation
hygiene to be a major issue.
To further comprehend this topic, an interview was conducted with rural and
tribal women in Doda district.

Q1. What cultural beliefs and restrictions do women face during menstruation?
Menstrual hygiene practices are affected by cultural norms, parental influence,
personal preferences, economic status, and socioeconomic pressures. We faced
various beliefs and norms regarding menstruation. These norms are the barriers
in the path of good menstrual hygiene practices. Many women have restrictions
in cooking and work activities, sexual relations, bathing, praying, and eating
particular foods. These restrictions were imposed due to the opinion that
menstruation was dirty and polluting. They also believe that menstruating women
and girls are dirty. The respondents stated that women were not allowed to pray
during menstruation because they were considered impure.


Although they did not understand why they were regarded as impure, women
said it was ordered by Allah, and as Muslims, they are required to accept
this. The belief that menstruating women are dirty and polluted is common in
many developing countries and cultures. They believe that women should not
bathe during menstruation since washing during menstruation caused the flow to
stop. Another widely held misconception among rural and tribal women is that
eating cold/sour foods during menstruation might trigger abdominal and vaginal

cramp. Even touching menstruating women is prohibited. They are prohibited
from cooking and from consuming certain foods like pickles. These limitations are
more prevalent in the rural areas. They are not permitted to join in religious
activities or to come in contact with religious objects such as the Quran.

Q2. What do women usually use for menstrual hygiene management?
Most ladies use woolen cloth and wash it with water and detergent for reuse.
Washing and drying are done secretly or in a hidden corner so that others,
particularly male members of the family, do not see them. Menstrual fluids are
also believed to be used in black magic, so women prefer to wash the cloth only
at night when everyone else is asleep. Menstruation is also viewed as dirty,
contaminating, and shameful. Therefore, women hide the cloth they use.
Q3? Have the women ever seen or used a sanitary napkin?
Yes, they said they had seen them, but had no idea how to use them. Because
sanitary napkins are so expensive and their husbands’ income very low, they
cannot afford them. So, they use woolen cloth. They don’t even buy any new
cloth, instead opting for old shirts that are torn into strips and using them.
Q4. Do the women know that ASHA workers sell sanitary napkin packets for Rs
6 each?
They said they didn’t know anything about it. Their ASHA representative never
notified them about it. Also, because they are dependent on their husbands, they
said they could not ask them for money to purchase pads.

Q5. What is the contribution of male family members to women’s menstrual
hygiene management?
Gender inequality is one of the key reasons why menstruation is taboo and
menstrual hygiene is ignored. Women’s voices are silenced in households,
communities, and even with regard to development programmes. Menstruating
women are not allowed to use sanitary pads and are often even barred from entering their homes because they are considered dirty. As a result,
comprehensive menstrual hygiene programmes involving both men and women
need to be implemented.
Men can help and influence women and girls in a variety of ways, including as
husbands, fathers, brothers, students, instructors, coworkers, leaders and
officials. Men never help women when it comes to menstrual hygiene, and they
never discuss period problems with their wives or daughters. As family decision-
makers, they frequently refuse to provide funds for sanitary pads because they
believe it is a waste of money. Often, due to low family income, men hesitate to
give money for such costly products. So, women have to compromise their
menstrual needs and personal hygiene.

Most men are unaware of menstruation and the physiological changes that occur
in women during the menstrual cycle, making it difficult to change their attitudes.
It is difficult to discuss menstruation with men and boys due to their
unwillingness, myths, prejudices and misconceptions. However, by involving them
in group discussions and regular community meetings, we can modify their views
and make them aware of their responsibility in menstrual hygiene management.
Men can assist women and girls by providing financial assistance for menstrual
products. As the decision-making power is in men’s hands, making household
budgeting for sanitary materials supports and empowers women.

Q6. So, what can we do to improve the situation?
First and foremost, Mission Shakti and the health department should educate
families about menstruation and the fact that there is nothing to be ashamed of.
Interacting with mothers and fathers aids in bridging the intergenerational divide
as many myths and incorrect information are passed down from generation to
generation. Often, the taboos lead to the isolation of menstruating girls, forcing
them to live in separate locations and being treated as impure. Above all, it is
necessary to involve both boys and girls.

Menstrual hygiene management is a broad concept, and access to sanitary
napkins is simply one component of it. Other equally important issues must be
addressed, beginning with accurate and scientific knowledge regarding the
menstrual cycle.
So the next step is to understand what menstruation is, why it is necessary, and
how it is a normal physiological function. This can be accomplished through
educating girls, women, and families through peer education, schools, and public
awareness campaigns.
It is important to give access to sanitary supplies, such as reusable sanitary pads,
homemade cotton pads, or even cotton cloth. This involves understanding how
they should be worn, washed and sundried, as well as teaching girls how to clean
their private areas and maintain good hygiene.
Menstrual awareness campaigns are also urgently needed in rural areas. Few
rural and indigenous women understand the concept of menstrual hygiene, and
even fewer use sanitary napkins. The majority of women continue to lack access
to adequate facilities.



It may be said that women in our state rural and tribal communities have very
little awareness of or knowledge of menstrual hygiene practices. Government
programmes do not reach them due to illiteracy, poverty, nomadic mode of life,
superstitions, traditional neglect, and so on. Also, because they live in rural areas,
they rarely receive information about such schemes.
Neither full-time Women's Welfare workers nor the state government have
initiated any specific menstrual hygiene programmes for poor and tribal women.
Unless and until the government implements a free specific menstrual hygiene
programme, progress for these women will remain a faraway dream.
They call into doubt the lofty statements of the government and other
organizations working for their welfare, who talk of women’s rights and
empowerment while failing to provide fundamental requirements. Not that they don’t want the programmes. Their faces, their eyes, reflect their inner emotions,
their helplessness.


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