Problem Addressed

The reproductive health needs of adolescent girls, particularly those related to menstrual hygiene, remain largely unrecognized, unexplored and under-served. For example, only 12% of India’s 355 million menstruating women and girls use sanitary napkins. The other 88% resort to alternatives, such as unsanitary cloths, ashes and husk sand. Because of this, about 70% of menstruating women and girls suffer from reproductive tract infections (RTIs). It is also estimated that inadequate facilities and resources for menstrual management protection make adolescent girls miss at least 5 days of school in a month, which is about 50 days a year. Around 23% of these girls then end up dropping out of school.

Additionally, talking about menstrual health is still a societal taboo. Women are barred from entering temples and kitchens while menstruating, and some don’t even take baths during their periods. Because they are unable to talk about menstruation, adolescent girls also have insufficient knowledge of menstrual hygiene. Most of them consider menstrual blood impure, as they don’t understand how or why they menstruate.

Innovative Approach

Aaina works with tribal and vulnerable populations in Odisha to bring awareness to menstruation. Since people with disabilities and women have always been the focus of Aaina’s work, their Menstrual Hygiene program is consciously designed to include them as the primary stakeholder along with other girls and women.

Aaina has designed an innovative method of working with adolescent girls in these traditionally overlooked communities, approaching them in a peer learning model through its Kishori Mandals, or girl groups. These groups are led by peer leaders who are able to create intergenerational change by using their knowledge to influence the other female members in their families. This allows Aaina to affect change at a larger scale and in a more sustainable way.

Program Solution

Aaina works to improve the health and well-being of adolescent girls through better menstrual hygiene management (MHM). Aaina promotes menstrual hygiene, breaks the culture of silence, and encourages girls to raise concerns related to reproductive and sexual health through mobilization, awareness and training. They also lobby various government departments to focus their discussion on MHM issues and create a platform where everyone can work collaboratively to break the silence and support MHM.

The program structure includes several aspects. The first are block-level community meetings that are organized on a quarterly basis with adolescent girls, their family members, women, high school authorities, government departments, Aanganwadi workers, ANM workers, and ASHA workers in community halls. The meetings discuss social taboos and stigmas associated with menstruation, ways to overcome them, best menstrual hygiene practices, and ways to partner with government departments to address these issues. Another aspect are adolescent girls groups, Kishori Mandals. These are formed in villages, with the support of local Aanganwadi workers, to create awareness among girls about menstruation and promote better menstrual hygiene practices. Sessions are conducted using training modules developed by Aaina, which include videos, information packets, education and communication materials and demonstrations. Special efforts are made so that the menstrual process and other changes related to adolescence are perceived as a natural phenomenon and beneficiaries are comfortable talking about the subject.

A third aspect are meetings with other stakeholders. Meetings with the Parent Teacher Association (PTA), School Management Committee and Mother’s Teachers Association of government and semi government schools are organized by Aaina on a monthly basis. Teachers, schools management committees, parents and adolescent girls are trained on menstrual hygiene management, school sanitation and the reproductive cycle. Village-level meetings are also held to sensitize Women Self Help Groups and Adolescent Girls’ Group members, ASHA and ANMs workers, and parents of adolescent girls on menstrual hygiene management and associated myths on a monthly basis.