Co-authored with Deepika Saluja
2020, in particular, has made the menstrual hygiene-related concern all the more critical, given the current COVID-19 pandemic context. Last year’s theme “it’s time for action” strongly re-emphasised on the message that periods don’t stop in pandemics, and also assert on the urgency to act upon addressing the menstrual needs of millions of women and girls across the world.
As per the NFHS-4 data, only 56% of the women use sanitary pads or tampons or in combination in India. During COVID-19 times, only 15% of women had access to menstrual health products such as sanitary pads. In remote areas, people have to travel 10 to 40 km to get the sanitary pads, aggravated with limited mobility, transportation, and physical distancing measures. Women using clothes have reported not being able to wash it with clean water and soap or put it out to dry in sunlight, deterring their usage of hygienic sanitary and menstrual health products and also, potentially leading to various reproductive tract infections and further, cervical cancer. Hence, there is a need to not only make the sanitary products available to girls and women at economical rates but also address the taboos and myths associated with it, by providing them with accurate and timely information.
In an attempt to address this need, we want to appreciate two such attempts by a government and private player in the Indian context.
Nobel Hygiene is one such private player, which has launched RIO heavy pads flow, in early 2020. This company claims to attempt in changing the conversation around menstruation.
There are multiple taboos and myths around menstruation and menstrual hygiene. For instance, women are not allowed to enter the temples, eat sour food, sleep in the same bed, enter the kitchen and the list goes on. These taboos and myths create negative internalisation around menstruation as a concept, a biological process, thereby making it a rather prohibited subject to talk about. Owing to limited or no conversations around menstruation, families and communities are not adequately informed and equipped in providing social support to the girls and women.
Further, men in India are reported to have a very myopic understanding about menstruation. In a study in India, one of the boys interviewed said, “Menstruation is a sort of disease in which blood come out mouth. Girls feel giddiness and fall down anywhere”. Another boy said, “They should not sit near us. They should not touch. We should not drink the same water which they drank. Their food we should not eat. They should not come to temple”. These quotes depict the poor menstrual knowledge among men, who in turn act as agents perpetuating these myths and taboos around menstruation. As a result, they will be unable to provide any social support to females in their families and communities when they need it, particularly during their menstrual cycles. Reportedly, Rio Pads is actively engaging in bringing this topic to the fore front and has become the first pad in the country to show the red color of blood in their advertisements.
This advertisement, which intended to start a serious and much-needed conversation around menstruation at the national level, sadly received severe backlash across the country. These complaints stemmed out from the internalised misogyny and shows how ignorant we are about menstruation in this country. But by showing the color of blood as red and hence, real and airing it on prime-time channels is somewhat indicative of RIO‘s attempt to start a healthy conversation in the community about menstruation.
Another scheme that provided support in managing their periods and sustained livelihood during the pandemic, is Asmita scheme, initiated by the Maharashtra Government. Based on one of the principles of ‘Dashasutra’, Asmita aimed to focus on health and hygiene of women with regards to menstruation and followed a four-pronged strategy to target the issue at hand: a) by starting the ‘Asmita Rath’ (a vehicle) conducting rounds in different villages informing the citizens about menstruation; b) by reducing the costs of the sanitary pads and making them affordable for women from all socio-economic backgrounds; c) by making it accessible to the rural and remote communities by collaborating with women Self-Help Groups (SHG) network; and d), lastly by bringing a source of livelihood to these SHG women and contributing to their social transformation.
Launched in March 2018, Asmita made the sanitary pads accessible at a very low cost of eight pads for Rs 5 and Rs 24 for young girls and women, respectively. It follows the four A’s – Availability, Accessibility, Affordability and Awareness. Despite the well-intentioned efforts, the scheme did not receive a positive response in its initial days of launch, due to the poor quality of pads.
As explained by an SHG woman, women in Moi village had stopped using the Asmita sanitary pads with complaints on its poor soaking capacity, smaller size, lesser durability etc. Some women even rated their home-based cloth arrangements better than these pads. The Maharashtra Government paid attention to these complaints and feedback received from the community women, and worked upon improving the product as well as the delivery mechanism, rather than dropping it, unlike many other government schemes that do not take off after their initial failed attempts. Their intention to improve, commitment to their mission and sustained efforts in that direction deserve a big applause. After several rounds of testing and trials, they improved on various aspects of the sanitary napkins, including size of the sanitary pad to 280mm in length and 160mm in breadth, with increased absorption capacity to more than 70ml.
With these revised specifications designed as per the community women’s requirements, and improved supply chain management (delivery till doorstep through Department of Posts, Government of India), the scheme was relaunched in 2019 as ‘Asmita Plus’. To enable smooth delivery of Asmita Plus orders to the SHG women, the Maharashtra State Rural Livelihood Mission tied up with the India Post, to deliver bags of 100 packets of sanitary napkins to the doorstep of SHG women, thereby reducing delays and discomfort to the women in transporting the packets. Since the scheme launch in 2018 till July 2020, nearly 1.6 crore sanitary pads have been sold through 29,875 SHGs to the adolescent girls and rural women across the state at highly subsidized rates.
Asmita Plus has not only made sanitary pads available to women and adolescent girls living in rural and remote areas but has also transformed the lives of women through its partnership with the SHGs. The transformation has been to such a great extent that these SHG women from rural areas of Maharashtra made Asmita Plus sanitary pads available to women in urban slums of Mumbai during the COVID-lockdown. This was made possible by tying up with different NGOs. For instance, SHGs in Pune and the nearby areas tied up with an NGO called, “Red is the new Green”, who in collaboration with UNICEF’s Jeevan Rath provided sanitary napkins to the poor as a part of the essentials kit.
Multiple orders were placed and fulfilled through Asmita Plus vendors to various parts of Mumbai and were distributed by NGOs across urban slums as part of essential kits. SHGs engaged in the sale of Asmita Plus have largely benefitted from this opportunity, financially. It has supplemented SHG women’s household income during the unprecedented times like COVID-19 outbreak when they had limited access to livelihood opportunities otherwise. SHGs registered under Asmita Scheme continue to receive bulk orders from urban areas and have contributed to sustaining livelihood for many SHG members.
To conclude, these schemes have supported women during the pandemic in multiple ways (a) by breaking the taboos and myths around the menstruation (b) by providing them safe and reliable pads with increased size with improved absorption capacity, thus, giving women extra comfort with reliable pad material that can last longer in times of excessive bleeding (c) by acting as a helping hand to the women in rural areas by providing them a sustainable living during pandemic and to women in urban areas by providing them pads when they need it the most (d) and most importantly, by helping in initiating much needed open conversations around menstruation. While we work towards busting the myths and taboos around menstruation and make sanitary pads available to women and girls across the country through innovative and affordable mechanisms, we equally need to pay attention to the environmental impact of these sanitary pads, and shift our manufacturing processes towards more environment-friendly and sustainable methods, like biodegradable sanitary pads, re-usable cloth pads and even menstrual cups for those who are comfortable.
Deepika is a Ph.D. in Public health policy, working as an independent consultant, and also the co-founder of the Women in Global Health India Chapter.
Featured Image Source: CNN