Menstrual Hygiene in India: Policy, Challenges, and the Debate on Menstrual Leave

Context:

• This article is based on an Editorial “Women in red: On an optimum menstrual hygiene policy” which was published in The Hindu. Recently, the Supreme Court of India gave the Centre four weeks to finalize an optimum menstrual hygiene policy with focus on the distribution of sanitary napkins. 
• Directions to prepare a national model for the number of girls toilets per female population across government-aided and residential schools in the country has also been given. 

Insights from NFHS-5: Enhancing Menstrual Hygiene Practices in India

• Menstruation: It is a biological reality for women of a particular age demographic. 
  • It is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. 
• High Adoption of Menstrual Hygiene Protection: As per the survey, 73% of rural women and 90% of urban women use a hygienic method of menstrual Hygiene protection. 
• Chosen by Young Generation: Significant proportion of women aged 15-24 use a hygienic method of protection during their menstrual cycle (58% in NFHS-4 to 78% in NFHS-5).
• Close link between Education and Preference for Hygiene: The survey revealed that women who have received 12 or more years of schooling are more than twice as likely to use a hygienic method compared to those with no schooling. 

Breaking Barriers: Addressing Menstrual Hygiene Challenges in India

• Access and Affordability: Commercial sanitary pads can cost ₹50-100 per pack, which is unaffordable for women in rural areas or urban slums who live on daily wages. 
  • In rural areas, pharmacies are far and women lack access to pads. 
• Social Taboos and Stigma: In some communities, menstruating women are considered “impure” and barred from entering temples, kitchens, etc., which leads to exclusion and mental distress.
  • Periods are still a taboo topic at home and schools and myths persist due to lack of open discussion in families, schools and the media.
• Lack of Awareness and Health Education: Myths like menstrual blood being ‘dirty’ or ‘impure’ are still prevalent. Many women use alternatives like cloth, ashes, hay etc., due to lack of scientific knowledge about infections.
• Poor Sanitation Facilities: Girls have to miss school during periods if there are no toilets or if toilets are dirty, broken or lack water. At workplaces too, lack of clean restrooms makes it tough.
• School Dropout Rates: Girls dropping out after puberty is common, mainly due to lack of menstrual hygiene facilities, products or shame in asking teachers for help.
• Reproductive Health Issues: Using dirty rags can cause urinary tract infections, bacterial vaginosis, etc., which further can affect their reproductive health.
• Lack of Safe Disposal: Sanitary waste is often disposed of unsafely (burned, reused or thrown).
• Policy Gaps: Though schemes exist, large gaps remain in implementation. Menstrual hygiene has not received due priority in policy making.
• Socio-cultural Restrictions: Many communities impose food and mobility restrictions on menstruating women, impacting daily life, health and economic opportunities.

Advocating for Menstrual Leave: Recognizing Women’s Health Needs in the Workplace

• Severe pain, cramps and heavy bleeding can make work difficult. 
• For gender equality as women face unique health challenges that need to be accounted for.
• Allows women to manage periods respectfully.
• If women get leave during periods, they can work more efficiently on other days.
• Menstrual leave makes periods a legitimate reason and is a step towards ending stigma.

​​Challenges and Concerns Surrounding the Implementation of Menstrual Leave Policies in the Workplace

• Employers may be reluctant to hire women due to additional leave.
• It could reinforce gender stereotypes that women are weak or less efficient.
• It is difficult to implement as verifying and monitoring can be subjective and complicated.
• If menstrual leave is paid, it effectively reduces annual work hours for female employees.
• Taking extra leave periods could negatively impact women’s growth and opportunities.
• Some argue that allowing only women to take menstrual leave is unfair to male employees.
• Since not all women experience disabling periods, some may get undue leave.

Conclusion:

• A policy is only half a revolution, to achieve this entire respectful revolution, it is crucial for the government to ensure access to affordable menstrual hygiene products, cleaner toilets and water. Also, steps must be taken for the awareness of menstrual hygiene and elimination of taboos as the equality, rights and dignity of menstruating people fundamentally depends on menstrual health.

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