The return on investment in menstrual hygiene awareness in India is huge. The cost of allowing period taboos to persist is tragic. Government money is there Parmjit Nahil reports.

Ankit on a community visit: “The womenfolk are mostly aware of sanitary pads but would never think about using them. The stigma is huge.”

Festival for Change 2020
Anshika Pandey, Abhay Kumar Ojha, Divya Priyadarshni and Ankit Pandey were finalists in our Festival for Change Challenge where we asked for project proposals for how to ‘Build Back Better’. They were judged by a range of experts. The criteria applied were that the project demonstrates:

■ original practical thinking, drawing on diverse perspectives;

■ a response to changes in the socio, political and economic context post pandemic;

■ it addresses major issues – such as ecological crisis, social fragmentation or economic dysfunction; and

■ communication with  impact – clear, compelling and creative.

You can see further information about our Festival Change and all the finalists here.

We still  have a way to go before we can relax our efforts in achieving gender equality. Patriarchy raises its head in so many ways from differences in social status, pay grades, to tackling glass ceilings and gender violence. On top of all that, in the Global South, we also have other issues including the “period crisis” which is leaving women from certain rural villages languishing at the margins of society with their basic needs neglected.

The Spot On project is working with a local tribal community in Rajasthan called Van Baoria to tackle the stigma and attendant hurdles in fundamental aspects of life that are attached to menstrual bleeding.

Ankit Pandey understands the problem more than most, having completed field research on 350 households and 15 government schools across Bihar as part of his Masters degree. “Girls use whatever is close at hand.” he explains. “They might use dirty rags, newspaper, even sawdust or ash to absorb the blood. Infections are commonplace. Our research has shown that 66% of women manage their menstruation in the open because there are no toilets but of course Covid restrictions have only compounded the problems that girls face.“

Ankit, Divya Priyadarshni and Abhay Kumar Ojha all met as Gandhi Fellows at the Piramal School of Leadership in Rajasthan, India. This is an initiative of the Piramal Foundation, an organisation working extensively for the unserved and under-served populations across India. Here Ankit founded weincluded.org, under which he and his team initiated their Spot On idea. Anshika Pandey joined as the fourth member of his team.

Divya:  “The womenfolk are mostly aware of sanitary pads but would never think about using them. The stigma is huge. Girls can’t go into the kitchen or share utensils. They can’t undertake religious worship, can’t mix in social groups.  Even with family members, the groups are limited to three during menstruation. These approaches and bad hygiene practices are handed down from generation to generation together with the stigma. People continue to be unaware of why menstruation happens and the role of hormones and how to manage it properly.”  

Central government has recognised the problem. It has made funding available to address it. Yet despite all their efforts, little has changed in many places. Strong social taboos cannot be tackled through funding alone. Communities like the Van Baoria traditionally travel from village to village on a seasonal basis, which adds a further level of challenge when it comes to promoting awareness of, and access to, sanitary napkins and influencing behaviour change.

“Our research has shown that 66% of women manage their menstruation in the open because there are no toilets.”

Bholi is a Van Baoria teenage girl who had been helped by Spot On. She, like her elder sister, was routinely banished to a cattle shed during her periods with only the bedding hay to clean herself with. “I stay in the corner of the cow shed where I eat and sleep with the animals, among dung, dust and blood for almost a week,” Bholi says. She agreed to speak with me through Divya because she wasn’t comfortable speaking to me face to face. Bholi supports what the project is trying to do.

“Like my family, I believed it was an essential part of becoming a woman. I once saw my elder sister experiencing a severe stomach pain, which continued even after her menstrual cycle had ended. When the pain became unbearable, she was finally taken to a doctor. There we found out that an insect from the hay had entered through her vagina and had severely infected her uterus. Operating on it was the only option. She now cannot bear a child, ever.”

The Overseas Development Institute has estimated that, in terms of economic productivity, tackling bad hygiene management successfully would bring a threefold return on investment. It has the potential to add 100 billion rupees to India’s gross domestic product over the lifetime of each girl through preventing infections, decreasing absenteeism, increasing levels of education and through prevention of early pregnancy. 

It’s not difficult to see why sanitation for women would be a high priority sector for government investment in India, and investment has been forthcoming in the form of Water, Sanitation and Hygiene (WaSH) schemes aimed at grassroots organisations.  However simply allocating resources to tackle an ingrained social problem like period poverty does not necessarily translate into a successful outcome. There are a number of reasons that impact is lost at grassroots level where it matters:

Loopholes in distribution are exploited and weaknesses in implementation measures means money allocated can disappear before a project has a chance to get off the ground, let alone become established. Qualities such as sensitivity and real commitment are not always readily available, even if government grant money is. Any community development worker will tell you that real integration takes time and human effort in building up the right relationships.

Ankit is under no illusion about the challenges that lie ahead and he intends to use a holistic approach. “This cannot be seen as a womens’ problem. The project has to include everybody in the community if we are to see period poverty being tackled successfully. Three of us have been living in the Jhunjhunu district of Rajasthan amongst the Van Baoria community for some 18 months now. We have been working closely with self-help groups that are already here. The project will be disseminated through the Panchyat, the main decision-making body in the village. This way, the project can be successfully integrated and will continue to be successful even after our project team have left.”

There are, Ankit explains,  basically three elements to the project. The first is about setting up micro-units for production of sanitary napkins; the second is establishing supply points locally and finally there is raising awareness of good menstrual hygiene and management practice which will help stimulate demand for sanitary napkins.

The micro-units, Ankit says, will be equipped with innovative technology. Training will include operation, maintenance and quality control according to a defined specification. The raw materials will be locally sourced: “Everything we need is available within a few miles of the village,” says Ankit.  “The idea is to set up the production of high-quality sanitary napkins which the women can keep going with the sale of napkins so that they will have a source of income. They will also know how to access finance and subsidies for further development once we have completed initial training.

“Other people in the villages will be trained in sales, negotiation and marketing skills so that they can set up distribution channels for the napkins at local retail outlets. This also will help to generate income. Having items easily accessible locally will help sensitise the community and normalise use. This is important in helping to move stock along.”

Dispelling myths and breaking the stigma around menstruation is key and forms the third element. “Women will be educated about the meaning of their monthly cycle.  Sessions will include training in the dos and don’ts of good hygiene practice when using sanitary napkins and disposing of them. Hundreds of blockages are the last thing needed for good sanitation.

“Once social taboos are successfully turned into social acceptance, the rewards that await are immense. Improved outcomes generated range from a better quality of life for the girls and their families to a reduction in the rate of infections and a stronger economy. Elevating the status of women in any society inevitably translates to a better, happier state of affairs for everyone,” Ankit asserts.

I asked the team about the impact that entering their project in the PEP’s Festival for Change has had on them.

Ojah: “FfC enabled us to connect with people and experts which otherwise would not have been possible. It gave our team a platform to engage with young leaders from different countries to talk and take insights from other regions on issues that they face that are similar to ours.”

Ankit: “Through support from mentors from the festival and feedback from the panel members, our team were able to revisit, refine and articulate the idea of Spot On. This immensely helped us to improve the robustness, economic feasibility and practically implementation at the grassroots. We were also encouraged to consider sustainability and scalability in more depth.”

Anshika: “Winning FfC was great. The crucial and sensitive issue of period poverty in India and the impact it has on vulnerable communities has been brought to a far wider audience because of it. Spot On is building up into a national campaign now. We are being approached by community-NGOs, youth networks and individuals to help turn our idea into a reality. We are getting immense support and encouragement from everybody around India.”

And their plans going forward?

Ankit: “We wish to collaborate with institutions and individuals who can help us with scaling-up this project to a national level. Bringing in the right influences will help to introduce policies that are more transparent and implementation will be more effective. Our team will keep working on period poverty and the many related issues around this in India.  We are in it for the long haul.”

Parmjit Nahil

Parmjit is a resilient communities specialist currently living in England.  She has been a Community Developer, Hypnotherapist and a Commissioning Officer in mental health. As founder of the Restorative Network, she …

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