Menstruation Health Management – Challenges to Three A’s

Health Management

The social status of menstrual health management still finds itself entangled in the midst of taboos, segregation, lack of facilities and affordability, and various other issues which should’ve been resolved about a decade ago. WE must remember that menstrual health hygiene (MHM) is not an area which has not been addressed. Efforts in various forms such as creation of low cost pads i.e., ‘Azadi Pads’ and other awareness programs being carried out by Azadi Organisation, Jatan Sansthan’s Safe Menstrual Health Campaign and Uger Pads, The Menstrual Health Hygiene Management Lab at the Great WASH Yatra, Arunachalam Muruganantham’s Jayshree Industries, Girls Glory initiative by Reaching Hand, Anandi Pads by Aakar Innovations and Aakar Social Ventures, ‘Not Just a Piece of Cloth’ Campaign by Goonj and many more, are in place. Other than these several state governments have focused on providing free sanitary pads in government schools as well.

Despite the aforementioned efforts, women in India continue to be deprived of a perfect menstrual health management condition. As per UNICEF, menstrual health management is a system whereby “women and adolescent girls use a clean material to absorb or collect menstrual blood, and this material can be changed in privacy as often as necessary for the duration of the menstrual period. MHM includes soap and water for washing the body as required, and access to facilities to dispose of used menstrual management materials.” Proper menstrual health management is something as basic as washing ones hands, it is important to have the right facilities achieve it and it is also important to know about those facilities. Unfortunately, till date there are women in this country who fail to acquire either of the two. Hence, the 3As – Awareness, Accessibility and Affordability with respect to MHM still go well challenged.


From a Virtual Conference Report from UNICEF Delhi, 2012, we come to know the grave realities regarding the degree of awareness that prevails in India when it comes to MHM. This report which represents Delhi, Madhya Pradesh, West Bengal, Maharashtra and Orissa, talks about how only 13% girls were aware of menstruation before their menarche. At the same time almost 75% did not know what material was to be used to stop the flow, and a majority of them used cloth.

Few major reasons behind this unawareness are rooted in the lack of discussion about the topic in households as the entire concept of menstruation is seen is the light of impurity, shame and secrecy in most areas of the country. Even if awareness campaigns are carried out in schools they require girls to be taken in a separate room while the information is imparted to them, so much so that the topic is not well discussed in classrooms even when it forms a part of the curriculum in basic biology. The kind of awareness campaigns that are carried out are generally so isolated to girls in their approach that the whole idea of menstruation becomes something that cannot be discussed with men or in front of them.


Keeping aside the population of women which is not aware of the concept of menstrual health management, even the ones who are aware fail to use proper instruments of hygiene because of the lack of availability. The same report further reveals how none of the shops in about 65 villages, in a particular area that they studied, had sanitary pads or associated products. India launched the Menstrual Hygiene Scheme (MHS) in 2011 which focussed on supplying Freedays (a centrally procured sanitary pad). Further, in an evaluation published in the International Journal of Community Medicine and Public Health in 2016, it was found that this scheme failed due to irregular supply of sanitary pads.


The area of affordability needs no statistics to exemplify how huge an impact the cost of sanitary pads has on their usage. Because of the issues of affordability, women fail to make use of the right kind of practices when it comes to menstrual health management. Over the past few years, especially after the onset of the GST regime, a lot of debates have come up regarding removal of tax levied on sanitary pads. A uniform verdict regarding the same, taking into consideration the idea of market profits, is something that can be delivered only with time. The problems associated with affordability do not just limit themselves to the cost of sanitary pads. There are a lot of other economical instruments of managing menstruation, like menstrual cups, but the kind of awareness that requires is another campaign in itself.

Hence, it all boils down to an understanding of all the different methods that multifarious bodies are taking up, and the requirement of  a deeper probe and effort in terms of tackling the three key areas of awareness, accessibility and affordability. It is only then that we can visualize an India where women can naturally lead healthy lives.

– Contributed by Richa

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