Currently, approximately 336 million girls and women experience menstruation in India. With more girls and women having access to toilets than ever before, Swachh Bharat Mission (SBM) has critical implications for their ability to be able to manage their monthly menses in a safe and hygienic manner.
Good menstrual hygiene calls for the use of clean material to absorb or collect blood that can be changed in privacy and as often as necessary, using soap and water for washing the body as required and having access to facilities to dispose of used menstrual management materials. The ability of a girl or woman to maintain hygiene during her menses, is therefore intimately linked with the availability of water, sanitation, and hygiene facilities in her home or community, school, place of work, and other public spaces.
The extent to which clean water, decent toilets and good hygiene facilities are available for menstrual hygiene management varies across settings.
Households toilets: Under the ongoing Swachh Bharat Mission, 2,51,879 villages are open defecation free (as of 23 May 2018), which indicates that the girls and women living in those villages have a household latrine that they can use during menstruation.
School toilets: Now in its fourth year, the Swachh Vidyalaya Abhiyan has ensured that government schools across the country have separate toilets for girls and boys, with some state governments (e.g., Chhattisgarh, Kerala, Uttar Pradesh, Maharashtra, Odisha) distributing sanitary napkins in schools, and installing sanitary pad vending machines and incinerators for discarding used napkins in school toilet blocks.
A new WaterAid-UNICEF global report shows that in South Asia, where schools are making progress in providing decent toilets and menstrual hygiene to their students, work remains to be done. According to the report, up to two-thirds of girls in the region do not know about menstruation before starting their periods, and as many as 1 in 3 miss school days every month during menstruation.
Toilets in work sites/places of work: Little is known about the status of toilets for women in places of work. Many women are involved in the informal (e.g. daily wage labour) and formal workforce, highlighting the urgent need to ensure separate toilets for women with water and hygiene facilities in various work place settings like construction and other labour sites, office buildings and complexes, and factories. Portable toilets may be available at construction sites (mostly restricted to metros like Mumbai, Chennai and Delhi) but the extent to which exclusive toilets for women workers exist that also meet other menstrual hygiene needs is unknown.
Public toilets: With women often struggling to find public toilets in urban India, initiatives like the Sulabh Public Toilet Complexes and “She Toilets” have attempted to provide women with clean and safe sanitation facilities in cities through a pay and use basis. “She Toilets” are specially designed toilets for women in public spaces, some of which are semi or fully automatic (e-toilets), and often include sanitary pad vending machines and incinerators. Sulabh Toilet Complexes are found in many metro cities. Though these attempts are in the right direction, a lot remains to be done. Additionally, in many of the tier-2 and 3 cities, small and medium towns and public places in rural areas, there is a dearth of such facilities.
The ongoing Swachh Bharat Mission has made immense progress in ensuring that our women and girls have access to toilets and can manage their menses safely and in a dignified manner. However, with more toilets being built, sanitation facilities need to be responsive to the menstrual hygiene needs of women. This includes, but is not restricted to separate toilets for girls and women. Other essential considerations are:
- Safe and private toilets, that are well lit
- Availability of soap and water for washing (hands and the body)
- Safe disposal facilities (e.g. dustbins with cover, or incinerators that meet Central Pollution Control Board standards)
- Other amenities such as shelves and hooks to store personal items
Arundati Muralidharan, Manager-Policy at WaterAid India says:
“Today, we have a critical window of opportunity to provide girls and women across India with clean water, decent toilets and good hygiene, and ensure that these facilities are responsive to their monthly menstrual needs. The benefits conferred by such actions will complement ongoing efforts to improve the health and wellbeing of adolescents, and to keep them in school on reaching puberty. These will be equally important for women of reproductive age as well.
The Government of India is a frontrunner globally, instituting policies and schemes on menstrual hygiene through various departments. The time is ripe to further catalyse collaborative action, with several states demonstrating how menstrual hygiene for adolescent girls and women can be improved in a comprehensive manner through access to information, responsive water, sanitation, hygiene (including disposal) facilities, and an enabling policy environment.”
This Menstrual Hygiene Day (May 28), WaterAid India is calling for the Government of India to further its programming on menstrual hygiene management using a three-pronged approach, focusing on:
- Social and behaviour change communication (includes education, health promotion, combatting negative social cultural taboos among girls and their influencers)
- Water, sanitation and hygiene (including disposal) infrastructure that are responsive to menstruation needs
- Enabling environment (includes safe spaces for girls, capacitating influencers to support girls, and responsive and convergent policies)