India is a country where only 58 % of menstruating women have been exposed to safe and hygienic methods of menstrual protection. The remaining face risks of severe health vulnerabilities arising out of the use of homegrown alternatives such as hay, dried leaves and old rugs.
This discrepancy in the choice of menstrual products varies according to factors including area of residence, lifestyle, income group, etc. Such a difference in preference for menstrual products is directly linked to the risk of contracting infections. For instance, poor menstrual hygiene has caused an alarming 70% increase in incidences of reproductive tract infections.
The government launched the National Menstrual Hygiene Scheme under the ‘Rashtriya Kishor Swasthya Karyakram’ program in 2014. The objective of the scheme was to promote menstrual hygiene among adolescent girls in rural areas by supplying as well as training self-help groups to make sanitary napkins.
These sanitary napkins are sold under the brand ‘Freedays’ at a subsidised rate of Rs 6 for a packet of six napkins. An Accredited Social Health Activist (ASHA) is appointed to sell these.
However, as a study conducted by the Post Graduate Institute of Medical Education and Research in 2018 pointed out, even though 80% of the women are aware of sanitary napkins, a mere 30% of them actually use it. This scheme is also plagued with problems of irregular and inadequate supplies of sanitary napkins according to the same study.
Additionally, this policy remains silent about how it plans to impart training on the usage of sanitary napkins. The rural women, amongst whom the sanitary napkins are distributed, are probably using the products for the first time. Thus, they need to be given proper training on its usage: on how to wear it, with what frequency it has to be changed to avoid the risk of contracting infections, and on its proper disposal mechanisms.
This could be one of the primary reasons why only a few menstruating women in India use sanitary napkins, despite it being projected as the dominant product for menstrual hygiene right from the school level.
The policy also remains tight-lipped regarding the reason for endorsing sanitary napkins specifically as the product for menstrual hygiene. There is a normalisation created around the usage of sanitary napkins at large – be it in the form of an adolescent welfare scheme or even practices of the state.
For example, it is common practice to distribute sanitary napkins as a freebie during elections. During the 2019 Lok Sabha elections, the Election Commission itself adopted a strategy to incentivise women to vote by distributing sanitary napkins.
The government needs to realise that by merely distributing sanitary napkins, it neither ensures their usage nor an awareness surrounding menstrual hygiene. It can, in fact, lead to a host of problems such as infections due to improper usage and clogging due to improper disposal.
Issues with disposal
A report indicated that India generates approximately 12.3 billion disposable sanitary napkins every year. Sanitary napkins come with a lot of added instructions in connection with their disposal.
The Solid Waste Management (SMW) Rules mandate that every waste generated must be segregated into wet, dry and domestic waste and that sanitary napkins be properly wrapped, put in the dry waste category and be handed over separately. Such guidelines, however, are seldom adhered to at the ground level which leads to a clogging of drains, contamination, etc.
The present policy mentions only two ways of disposing sanitary napkins at the community level. These include deep-pit burial and burning.
This is further reflected in a study conducted by the ministry of drinking water and sanitation which has recorded that out of the total sanitary napkins used in India, 28% are thrown alongside regular waste, 28% are disposed of in the open, 33% are buried and the rest are burnt openly. All the above-mentioned modes of disposal invariably lead to environmental degradation.
While composting sanitary napkins is common practice, it is limited only to a select category of biodegradable sanitary napkins. It, however, necessitates the proper segregation of waste, which is missing in India. Thus, the tussle between environmental risks in both incinerators as well as land-fills is highly problematic.
A whole range of sustainable alternatives to sanitary napkins exist and, if subsidised, can go a long way in improving menstrual health amongst women in India. For instance, there are products that seek to empower rural women by beginning a small-scale production of an organic washable (reusable) product for menstruation.
While these reusable pads are sold at a price of Rs 200 each, the government can either subsidise these products or begin the production of such eco-friendly menstrual products and sell it.
Furthermore, reusable products also tackle any potential problems regarding irregular supply. Compostable pads are also produced by Aakar (its pads are called Anandi), Saathi Pads, and Sakhi (under the Vatsalya Foundation). The per-cycle cost to the customer is Rs 96 and above.
It is more economically viable since it is a one-time investment. Women may also prefer such reusable products as they are similar, but more hygienic, than their existing practices of using clothes as absorbents.
Raagini Ramachandran is a third-year student pursuing law at the National Academy of Legal Studies and Research (NALSAR), Hyderabad.