Problem Addressed

Although menstruation is a natural physiological process, a lack of menstrual health management (MHM) is a large scale problem for women in India due to social stigmas, social-cultural myths and taboos, scarcity of information or misinformation, unavailability and scarcity of toilets and sanitary napkins, and environmental concerns associated with the disposal of sanitary napkins. This problem involves a cycle of neglect. There is a lack of involvement from women and girls in decision-making regarding their own lives, a lack of information and awareness regarding menstrual hygiene and why women menstruate, and a lack of access to sanitary materials and facilities.

The impact of this problem is large and can be seen in the habitual absenteeism of girls from schools during menstruation, which affects their education and ability to keep up with schoolwork. The high prevalence of reproductive tract infections, depression and low self-esteem among girls and women in areas without MHM, as well as the inability to do normal daily activities and the seclusion of women from the public realm during menstruation, negatively effect outcomes. Considering these negative impacts, MHM can be linked with gaps in achieving Millennium Development Goals (MDGs), especially those focused on universal education, gender equality, women’s empowerment, and environmental sustainability.

Innovative Approach

Vatsalya is currently the only organization working in Uttar Pradesh on community-led Menstrual Health Management (MHM) programs. They are unique in their approach because they seek to increase WASH awareness and build WASH infrastructure by focusing specifically on MHM, which requires water and sanitation infrastructure to sustain. They are especially innovative in the way they include all community members, including men, to be stakeholders in establishing access to sanitary napkins and promotion of safe sanitary practices. This includes the use of cotton cloths and raising awareness on MHM, as well as building and maintaining toilets.

Program Solution

“Breaking Silence” is a comprehensive WASH program with a specific focus on Menstrual Health Management (MHM). The program, supported by WaterAid, aims to improve the health and dignity of girls and women by providing knowledge about hygiene and menstrual management, access to safe water, access to a private and clean place to change sanitary napkins, and a living environment free of harmful waste.

The program structure is three-fold. Vatsalya first enhances access to sanitary napkins by mobilizing female shopkeepers and potential female entrepreneurs to sell sanitary napkins in their communities, training ‘change agents’ like ASHA’s and Anganwadi workers to educate girls on MHM and encourage them to use sanitary napkins, as well as coordinating supply channels for sanitary napkins by acquiring them at wholesale prices.

Second, Vatsalya creates awareness on MHM in the community by engaging with men, women and adolescent girls on issues of general hygiene and sanitation. They create student led ‘Wash Brigades’ for championing and monitoring WASH issues in school and train change agents to educate their communities about MHM, especially girls who are not in school. Finally, Vatsalya develops sanitation infrastructure by assisting in construction and maintenance of toilets, encouraging the construction of incinerators next to girls’ toilets to facilitate easy disposal of sanitary napkins in schools, and constructing, restoring, and helping the community maintain safe water sources.