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Opinion: Prioritizing Menstrual Health And Hygiene Management During Emergencies

According to experts, with closure of schools, on which many girls depended to access menstrual hygiene products, girls’ ability to manage menstruation with safety and dignity is at stake

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Opinion: Prioritizing Menstrual Health And Hygiene Management During Emergencies

Over the last few years, as the World witnessed accelerated action to achieve the SDGs (Sustainable Development Goals), especially SDG 5 on Gender Equality and Women’s Empowerment, there has been significant interest in menstrual health and hygiene management, as a critical factor in girls’ education and women’s participation in many spheres of life. In India, increased attention led to the introduction of evidence-based guidelines and schemes to enable access to menstrual hygiene products. It also fostered innovation towards expanding product choice and sustainable menstrual waste management.

Also Read: Menstrual Hygiene Day 2021: Celebrities And Netizens Join Red Dot Challenge To Raise Awareness About Menstrual Hygiene

While the progress is encouraging, an area that continues to stymie the work on menstrual health and hygiene management (MHHM), is the emergency context. Today, a number of states are confronted with the challenge of addressing menstrual health needs amidst dual disasters: cyclones and/or floods and the continuing COVID-19 pandemic that has been devastating in its scale and impact. Like other emergencies, COVID-19 has had a differential impact, exacting a heavier toll on women, girls, and sexual and gender minorities. Menstrual health and hygiene is an area that most strongly unmasks this.

“Periods do not stop for emergencies” has been a common refrain, especially during the first wave of COVID-19, with organizations and media highlighting how access to essential sanitary pads was abruptly curtailed due to the lockdown and restrictions on transport and mobility. Some of these challenges have been addressed this year with essential supplies continuing uninterrupted. Yet for many women and girls continued access to safe menstrual products, safe and hygienic sanitation facilities, and information on MHHM remains a challenge.

With closure of schools, on which many girls depended to access menstrual hygiene products, girls’ ability to manage MHHM with safety and dignity is at stake. Many poor families facing severe economic stress, are having to choose between spending on food and other essentials such as rent, and buying sanitary pads. The challenges are not only about access to menstrual hygiene products. Women and girls from low-income households have also been facing difficulties in managing menstruation in the changed circumstances where family members are present at home for most part of the day in small, confined spaces. For women and girls living with disability who may not have access to care-givers in these circumstances, managing menstruation has been even more trying.

MHHM must therefore be integrated as a priority in the response to emergencies, to ensure women and girls’ privacy and dignity. Living with dignity, even during disasters, is a fundamental human right. In 2020, UNFPA and WaterAid in consultation with experts and practitioners in the field of MHHM and disaster response across the country, developed a framework for action on MHHM during emergencies in India. The framework calls for the integration of MHHM across the continuum of emergency response – disaster preparedness, disaster response, and recovery. The framework also highlights the need for integrating MHHM into essential health including sexual and reproductive health services, and protection services where they exist.

A comprehensive approach to MHHM in emergencies includes:

1. Provision of essential menstrual products;

2. Dissemination of information to address access barriers;

3. Essential support to manage menses hygienically by equipping quarantine facilities/relief shelters with accessible, safe and usable toilets, washing/bathing areas, and waste disposal solutions.

Also Read: Opinion: Safeguarding Menstrual Health During A Pandemic

Product distribution is the mainstay of relief efforts. This may be accomplished through provision of hygiene kits with sanitary pads and essential items such as underwear, soap, towel, paper to discard used pads, and usage information; establishment of pad banks or pad ATMs in relief centres; or cash transfers to facilitate purchase of menstrual products. Some interventions have considered reusable cloth pads or cotton cloth to meet the needs of cloth users. In supporting product distribution for relief, efforts must keep in mind the product usage patterns and preferences in the community, the need for supportive materials such as underwear along with sanitary pads, and whether products will be needed once or on a recurrent basis.

Relief efforts by civil society organisations (CSOs) have indicated that product distribution accompanied by information dissemination about MHHM is most effective in meeting the needs of women and girls, during disasters. Girls and women need to know how to use, maintain and discard products safely with limited resources. Many older women, may be unfamiliar with sanitary pads, and girls may use a product for a longer duration given limited supplies.

Challenges related to MHHM during emergencies may be further intensified by menstruation-related discriminatory norms and taboos that impose restrictions on women and girls. Dissemination of accurate and scientific information is an important tool for tackling such discriminatory norms and the stigma associated with menstruation. Norms that stigmatize menstruation can erode the dignity and self-esteem of women and girls, as well as transgender men and gender-diverse individuals who menstruate. According to a survey conducted by the Water Supply and Sanitation Collaborative Council (WSSCC) and Youth Ki Awaaz (YKA) in 2020, 80 percent of the respondents reported experiencing a negative emotion when they had their first period. The stigma and taboo related to menstruation has also had a far-reaching impact in terms of preventing an integrated public health response to menstrual health management for many years in both development and emergency settings.

Also Read: Menstrual Hygiene Day: Access To Sanitary Napkins Getting Worse During The COVID-19 Lockdown

Gender-sensitive sanitation is another essential aspect of MHHM in emergencies. In many disaster settings, temporary or mobile toilet and bathing facilities are established, segregated by gender. However, menstrual waste disposal remains a challenge. Some simple, temporary solutions include providing containers with lids in or near toilet stalls to collect menstrual waste, and digging of disposal pits near the women’s toilet facility. These should be marked for menstrual waste to aid appropriate disposal. Long term relief settings or established relief centres can institute other solutions such as quality incinerators and disposal chutes attached to a deep burial pit or burning chambers. Central to disposal is the need for discrete, usable and culturally relevant solutions. For instance, incinerator solutions may not be appropriate for introduction communities that have strong beliefs around burning of menstrual waste.

Efforts for MHHM product distribution, information dissemination and ensuring hygienic sanitation during emergencies can only succeed with sensitized and trained frontline responders to understand and address the needs of girls and women. This is particularly relevant in light of the culture of silence around women’s sexual and reproductive health, including MHHM needs. Incorporation of brief sessions on the needs of girls and women including MHHM needs, in the capacity building initiatives for those involved in disaster response, can help mainstream the issue and strengthen the efforts for integrating MHHM in emergency response.

There is a lot to be learned about integrating MHHM in emergency response from states such as Kerala, Odisha, West Bengal, Bihar, and North Eastern India, that face natural disasters frequently. A few of these states have demonstrated how integration of MHHM in disaster preparedness can be done in simple ways: routine MHM interventions delivered in schools and in communities can impart basic information on menstrual health and hygiene, and equip girls and women with the knowledge and capacities to manage their menses safely during disasters. Girls can be given information on making their own emergency hygiene kit with sufficient menstrual materials, underclothes, soap, and other essentials. Schools, Anganwadis and health centres can prepare themselves to be depots for menstrual products that girls and women can access when disaster strikes. Such measures also help in the recovery phase.

Also Read:  Menstrual Hygiene Day: Project Baala Provides Over 2.7 Lakh Sanitary Pads For Free To 90,000 Poor Women During The COVID-19 Pandemic

Some states have initiated vulnerability and capacity assessments before disasters using participatory tools to engage communities to predict, plan for, mitigate, and effectively respond to emergencies that are likely to affect them. In some Gram Panchayats, adolescents and women have engaged in community discussions, planning and mitigation efforts, resulting in essential information being imparted to girls and women in the community, provision of menstrual products for all, ensuring availability of and access to safe sanitation facilities during the disaster, and disposal options for menstrual waste as a part of overall waste management.

Finally, ensuring appropriate budget allocation is critical for integrating MHHM in emergency response efforts. Funds need to be apportioned for menstrual product distribution, and facilities that meet MHHM needs. For instance, if mobile toilets are being installed, the budget must accommodate for sufficient number of separate toilets for men and women. Fund raising and mobilization of in-kind resources must consider the duration of the emergency, whether certain supplies may be required regularly, and the number of girls and women who are in need.

Menstrual hygiene supplies, akin to food rations, will be required regularly, and not just during immediate relief efforts. They must be factored into budgets for continued support to communities till normalcy is restored.
Ensuring that women, girls, transgender men and gender-diverse individuals are able to manage menstruation with dignity during emergencies is a matter of human rights. This Menstrual Hygiene Day, we ask you to join us to commit to ensuring MHHM as a basic right to be protected and advanced, in emergencies and beyond.

Also Read: Menstrual Hygiene Day 2021: Five Things To Know

(The article was co-authored by Argentina Matavel Piccin, UNFPA Representative India and Country Director Bhutan and VK Madhavan, Chief Executive, WaterAid India)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

24,06,78,961Cases
20,23,40,977Active
3,34,39,331Recovered
48,98,653Deaths
Coronavirus has spread to 195 countries. The total confirmed cases worldwide are 24,06,78,961 and 48,98,653 have died; 20,23,40,977 are active cases and 3,34,39,331 have recovered as on October 18, 2021 at 4:17 am.

India

3,40,81,315 13,596Cases
1,89,6946,152Active
3,34,39,331 19,582Recovered
4,52,290 166Deaths
In India, there are 3,40,81,315 confirmed cases including 4,52,290 deaths. The number of active cases is 1,89,694 and 3,34,39,331 have recovered as on October 18, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

65,91,697 1,715

32,230 994

64,19,678 2,680

1,39,789 29

Kerala

48,54,321 7,555

88,186 3,292

47,39,270 10,773

26,865 74

Karnataka

29,83,459 326

9,479 58

29,36,039 380

37,941 4

Tamil Nadu

26,87,092 1,218

14,814 208

26,36,379 1,411

35,899 15

Andhra Pradesh

20,60,472 432

6,034 159

20,40,131 586

14,307 5

Uttar Pradesh

17,10,028 9

119 10

16,87,011 19

22,898

West Bengal

15,80,530 624

7,421 24

15,54,132 634

18,977 14

Delhi

14,39,390 32

320 6

14,13,981 38

25,089

Odisha

10,35,077 443

4,542 68

10,22,250 508

8,285 3

Chhattisgarh

10,05,654 16

183 2

9,91,901 14

13,570

Rajasthan

9,54,390 2

42 2

9,45,394 4

8,954

Gujarat

8,26,290 10

207 6

8,15,997 16

10,086

Madhya Pradesh

7,92,684 5

84 12

7,82,077 17

10,523

Haryana

7,71,076 15

123 9

7,60,904 6

10,049

Bihar

7,26,026 5

48 4

7,16,317 1

9,661

Telangana

6,68,955 122

3,924 55

6,61,093 176

3,938 1

Assam

6,06,468 205

3,436 46

5,97,082 245

5,950 6

Punjab

6,02,035 27

227 8

5,85,264 16

16,544 3

Jharkhand

3,48,430 7

122 1

3,43,173 8

5,135

Uttarakhand

3,43,756 9

178 1

3,36,181 8

7,397

Jammu And Kashmir

3,31,062 95

843 12

3,25,793 107

4,426

Himachal Pradesh

2,21,437 131

1,303 5

2,16,414 125

3,720 1

Goa

1,77,522 60

604 6

1,73,572 62

3,346 4

Puducherry

1,27,396 52

585 13

1,24,961 64

1,850 1

Manipur

1,22,737 104

1,422 0

1,19,418 102

1,897 2

Mizoram

1,12,848 249

11,633 1,143

1,00,829 1,389

386 3

Tripura

84,321 16

104 4

83,401 12

816

Meghalaya

82,953 55

845 32

80,673 86

1,435 1

Chandigarh

65,302 3

25 3

64,457 6

820

Arunachal Pradesh

54,987 7

140 30

54,567 37

280

Sikkim

31,749 4

174 8

31,184 12

391

Nagaland

31,611 40

248 12

30,689 28

674

Ladakh

20,878 2

36 10

20,634 12

208

Dadra And Nagar Haveli

10,676 1

4 1

10,668

4

Lakshadweep

10,365

0 0

10,314

51

Andaman And Nicobar Islands

7,641

9 0

7,503

129

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