Lok Sabha Question No. 3400 (UNSTARRED), answered on 2015-12-18
Subject: Menstrual Hygiene
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RANGASWAMY DHRUVANARAYANA, SANJAY HARIBHAU JADHAV, ANURAG SINGH THAKUR

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3400 TO BE ANSWERED ON 18 TH DECEMBER, 2015

## MENSTRUAL HYGIENE

## 3400. SHRI R. DHRUVA NARAYANA: SHRI SANJAY HARIBHAU JADHAV: SHRI ANURAG SINGH THAKUR:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government has taken cognizance of report by UNICEF that many girls in India drop out of school because of menstruation related problems;
- (b)if so, the details thereof and the reaction of the Government thereto;
- (c) whether the Government is cognitive of the taboo surrounding menstruation, especially in rural areas and if so, the details thereof;
- (d) whether the Government conducted any surve y or study regarding the same and access of sanitary pads amongst the country, if so, the details of key findings and recommendations and if not, the reasons therefor;
- (e) the steps taken by the Government to bring awareness against tabooing of menstruati on; and
- (f) whether the Government runs any programmes regarding awareness in schools, colleges or with ASHA women in this regard and if so, the details thereof?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE

## (SHRI JAGAT PRAKASH NADDA)

(a) & (b): UNICEF  has  not  shared  any  report  with  Ministry  of  Health  and  Family Welfare on number of girls in India dropping out of school  because of menstruation r problem.

However,  there  are  two  case  studies  related  to  menstrual  hygiene  available UNICEF w ebsite.

Details of the above mentioned case studies   are in A nnexure A and B

(c): Yes, Government  has  taken  cogni zance  of  thetaboos  surrounding  menstruation, especially in rural areas which have been noted through various studies and field visits.

Government is implementing Promotion of Menstrual Hygiene for Adolescent Girls (aged 10 - 19 years) in select districts across the country. The objectives of the scheme are :

- To increase awareness among adolescent girls on Menstrual Hygiene .
- To increase a ccess to and use of high quality sanitary napkins to adolescent girl rural areas.
- To ensure safe disposal of Sanitary Napkins in an environmentally friendly manner

Easy access is ensured by the distribution of sanitary napkins by the ASHAs who h excellent access to the beneficiaries in the villages.

- (d): No,      Government  has  not  undertaken  any survey  and  study regarding  the taboos surrounding menstruation and access tosanitary pads .
- (e): Yes, Government of India has undertaken awareness program me against tabooing of menstruation in the form of communication materials such as posters, leaflets, mid m audio -video and interpersonal communication materials.

Regular capacity building of frontline health workers  is carried out under the s

- (f): ASHAs  conduct  a  monthly  meeting  wherein  issues  pertaining  to  adolescent  healt including menstrual hygiene are discussed.

## Case Study b y Sugata Roy

## (Source : http://unicef.in/Story/122/Menstrual - Hygiene- Key- to - Keeping- Girls -in - School#sthash. NAP0qqeL.dpuf )

Krishnagiri, India, 19 March 2011 -Asha, a topper in her class, w ould have been a school dropout, for a reason which will be surprising to most of the students in urban areas. continuous struggle to attend schools during her menstruation cycle almost cost her dre complete her studies.

Culturally here in souther n Indian state of Tamil Nadu as in many other parts of India, menstruation is considered dirty and impure and during periods girls are discouraged to school and stay at homes. The unavailability of sanitary pads, inadequate sanitation and absence of separate toilet for girls in schools, compounds the problem and has a huge imp on girls school attendance and is a major reason for dropouts of g i r ls from schools. 'There was no privacy to change when required and I was hesitant to seek permission to g o home. The agonising pain, cramps and shame almost forced me to stay away from school,' says

Asha recounting her tough days.

'Over two - third girls studying in standard 8 and 9 skipped schools during their periods. hampered their studies and eventuall y one - third of these girls would drop -out,' remarks George Jessunesan, headmaster of Asha's M.C.Palli Girls High School.For some parents this stage also signals a sign of maturity for girls and time to get them married. 'My parents wanted me to leave stud ies and get married,' adds Asha, now studying in standard XI.

## Interventions in the schools

Identifying sanitation and hygiene as the need of the hour, Sarva Siksha Abiyan (SSA), Government of Tamil Nadu and UNICEF initiated the Menstrual Hygiene and Man agement (MHM) intervention in eight high schools in Krishnagiri in 2009.

'Improve sanitation facilities along with adequate hygiene services have great impact on improving girls' attendance,' explains Arun Dobhal, Water, Sanitation and Hygiene Specialist at UNICEF.

The programme focussed on the capacity building of adolescent girl students like to Ash demystify taboos surrounding menstruation, orienting them to manage the menstrual proce provide access to sanitary napkins and disposal of soiled one s.

UNICEF has developed the counselling kit and has designed low cost incinerator attached the girls' toilet for the disposal of soiled napkins in the schools.

'Through intensive one -on- one counselling process, the myths and taboos on menstruation stand d ispelled.'

'A counselling team consisting of two female teachers and four students reach out to girls with correct information and skills to manage their periods. The benefits of using sani napkins over cloth as absorbents are discussed,' informs Jessunesan.

Sanitary napkin vending machines have been installed in schools to promote privacy and access. Now girls can easily access their requirement during school hours.

Improved water and sanitation facil ities in school girls' toilets including the incinerator for the safe disposal of soiled napkins have shown its impact on the school attendance.

'Counselling team informed us about the use of sanitary pads, which are hygie nic and comfortable. I can easily access them along with my friends from the vending machine installed in our school. Its only two rupees' acknowledges Asha, now an important member of the counselling team in her school.

'After the programme has been introduced in the school, the dropout and absenteeism has come down to near zero and the performance of the students have improved,' says Jessunessan. Supporting her headmater's claim, Asha echoes the programme has indeed saved her from discontinuing my studies.

## Empowered girls carry message to households

The impact of the menstrual hygiene management programme can also be felt in the community. The girls feel empowered to carry the messages on hygiene practice into thei households and community.

'We could break the culture of silence and feel free to discuss the issue with our moth er, elder sisters and other girls in our community. We are able to guide girls in our community a schools in their preparation for their first menstruation cycle. We feel empowered,' expressed Ramiah, a member of the school counselling team and a friend of Asha.

Girls have managed to dispel myths and discussion on menstruation is no more a taboo, informed K.L.Selvarani, science teacher and a member of counselling team in M.C. Palli school. 'Girls are able to discuss the issue freely with their family members.'

Demanding the need for privacy for managing their periods, girls like Asha and Ramiah, could convince their parents to construct toilet at home.

'Over thirty families have constructed toilets in their homes after persistent demand from the g irls. These girls are slowly bringing a social change in their community,' confirms Selvarani.

## Scaling Up

The menstrual hygiene programme has been linked with the life skills training programme the schools with active involvement of female teachers. To provide a caring environment for menstrual hygiene separate toilets with incinerators are being constructed in the schoo issue needs be discussed to break the culture of silence and set aside the myths and fa The  interventions  in  the  M.C. Palli  High  School  have  demonstrated  that  confidence  and capability to handle the menstrual process without fear and discomfiture and this emp the adolescent girls to a significant extent, emphasizes Arun Dobal.

The model intervention in M .C.Palli ha s triggered Sarva Siksha Abhiyan, Government of Tamil Nadu to scale up of the programme in 150 high schools in Krishnagiri.

(Source : http://unicef.in/Story/122/Menstrual - Hygiene- Key- to - Keeping- Girls -in - School#sthash. NAP0qqeL.dpuf )

## A Case Study by Sangeetha Rajeesh

## (Source : http://unicef.in/Story/573/Menstrual -Hygiene- and- the - girl -child - A - CaseStudy#sthash.WGDqYURa.dpuf )

Deepika  is  seen  dropping  the  Rs  2/ - coin  in  the  sanitary  napkin  vending  machine.  The thirteen -year - old is unprepared for the onset of her menstrual periods. Yogeshwari, her f and classmate has accompanied her to the staffroom. Deepika is terribly emba rrassed but is relieved to avail of a sanitary napkin in time. This is the common case with most ado girls her age and the napkin vending machine in the school premises is a blessing in di

'Menstrual cycles begin at the tender age of ten for many girls and in the rural areas, keeping them  in  school  is  a  challenge,'  explains  Banumathy,  Assistant  Headmistress,  Nemmeli School,  'particularly  if  they  have  come  unprepared.'  She  says  that  the  napkin  vending machine  sponsored  by  UNICEF  and  Shri  Cheema Foundation,  a  CSR  initiative  by  TVS Electronics Ltd is a boon to the girl students. The community in and around Kancheepu District are low income groups and cannot afford sanitary napkins and so the adolescen use  the  age - old  cloth  method.  But  no w,  the  Tiruvidenthai  Akshaya  Self  Help  Group manufacture and supply low cost sanitary pads for just Rs 2 and these are being used vending machine. The school also has an incinerator for the safe disposal of sanitar installed by the Tamil Nadu Government in 2004 under Total Sanitation Campaign.

'When the doctors  first  came  to  speak  on  menstruation,  we  were  all  very  shy  and  did  not know how to clarify our doubts,' reflects Seetha of Class IX B, looking at her batch mates, 'but when they starte d talking about how important it is to keep ourselves clean, I realise I wasn't doing the things I ought to do.'

Menstruation in India has always been accompanied by myths and taboos and adolescent gi find it difficult to even discuss the issue wi th parents or elders in the family. Most of them turn to their teaching staff for advice on menstrual hygiene. 'The girls feel comfortable asking us questions and we are glad to help,' smiles Banumathy. Shri Cheema Foundation conducted classes  on  menstrual hygiene  and  dealing  with  puberty  for  classes  VIII  to  XI  at  Nemmeli School and the students have benefited from it.

Mohana is fourteen and her menstrual cycle began when she was barely ten years old. 'I have been using cloth as pads till then and I used to wash them for reuse,' she says embarrassed, 'but  after  I  heard  the  trainers  speak  on  the  harmful  effects,  I  switched  over  to  sanitary napkins.' In fact, Mohana takes home five sanitary napkins from the vending machine during her menstrual cycle!

The girl students of the rural school are now aware of the reproductive tract infections the menstrual hygiene practices that need to be followed during the menstrual days. 'I used to change my napkin after 12 hours but now I have realised the importance of changing it at least every 5 hours from the talk the doctors gave us,' twelve -year - old Rajeswari tells us.

Nemmeli School girl students have understood that personal hygiene especially during menstrual cycle is even more vital and have decided not to g o back to their earlier unhygienic habits.

(Source :http://unicef.in/Story/573/Menstrual -Hygiene- and- the - girl -child - A - Case- Study#sthash . WGDqYURa.dpuf )

## ANNEXURE B