In a world fast paced with information and high technology; Accessibility, affordability, and attainability are the keys to health care delivery system, while some part of the world needed to emphasize on the awareness as are still strongly bounded with the myths and taboos concerning certain healthcare practices, in which Menstrual Health and Hygiene Management rules out the main concern among the developing countries as it is often linked to “unclean”, “impure” and “restricted to enter temple and kitchen”.
In India, about 20.8% of young women aged 15-24 continue to rely on unhygienic practices, according to the National Family Health Survey of India [2023-24]. Hygienic menstrual practices have risen by 1.6% since NFHS-5, driven by interventions such as the Menstrual Hygiene Scheme and Jan Aushadhi Kendra outlets. The disparity in using unhygienic menstrual products between urban and rural areas is drastic: 10% in urban versus 25% in rural women, with key contributing factors of affordability and wealth, education attainment, and supply chain and distribution.
Especially among low-income groups, Period Poverty makes commercial sanitary napkins unaffordable, leading them to use old cloth pieces, husk, and ash. These unhygienic practices lead to the development of reproductive and urinary tract infections and cervical cancer, which may even cause infertility and death. The wide gap between menstrual knowledge and awareness, and the traditionally abundant myths and taboos surrounding menstruation, such as menstruators being described as “impure” or “unclean”, means they are restricted from entering the temple during their menses. They are prohibited from entering the kitchen and male living rooms to prevent them from imparting dirt.
For instance, in the remote and rural areas of Nepal, restrictions are heavily placed on menstruating women and girls. An extreme practice called “Chhaupadi Pratha” is a tradition of banishing women and girls during their menses to outdoor sheds, often where animals are kept. Family members ostracize these women for a week every month. Although the Chhaupadi tradition was legally abolished in 2005 and criminalized in 2017, it is still widely practiced throughout the far western region and some parts of the mid-western region. Residents believe that stopping this practice would offend the Gods and bring bad luck and misfortune. Some of the impoverished Chinese rural women utilize toilet paper, old cloth, and even bark in cases of extreme poverty to manage menstruation. This condition gets worse with taboos surrounding menstruation.
Gender disparity is vast in terms of accessibility and affordability of facilities in a male-dominated society of lower-middle-income countries, which leads to a lack of political acknowledgment of the importance of women’s menstrual health and hygiene. For example, the Supreme Court recently denied a mandate for a universal, compulsory paid period leave policy across India, saying this act might unintentionally discourage companies from hiring women.
Another lack of political and socio-economic support and accountability leads to a lack of sanitary infrastructure in schools, a main reason teenage girls withdraw from or skip school during their menses, particularly in rural areas. Due to the scarcity of these sanitary facilities, a female child cannot access basic education, which in turn creates a vicious cycle of knowledge deficit and unhygienic period practices, along with widening the gender disparity.
That’s the reality hidden within the poorest of the poor and the remotest of the remotest people around the world. Whether it is period poverty or period taboos, these are the main constraints in menstrual health and hygiene management: the huge gap in the affordability of feminine hygiene products, the lack of menstrual knowledge among women, and the shortage of sanitary infrastructure facilities.
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