This article, co-written with Devika Kher, first appeared in Pragati on May 25, 2017 and can be accessed here.
Affordability of a sanitary product is only one pillar of menstrual hygiene; the other two are Access and Awareness.
It is a time for celebration, and one of denigration. While the country scrambles to see how the new GST rates will hit their pockets, women across the country will be quick to notice that the tax rate for sanitary napkins is 12 percent. This is not much of a change from the prevalent tax rate that was averaging at approximately 14% across states. On the other hand, the Ministry of Women and Child Development is working on a National Policy for Women, and the Ministry of Drinking Water and Sanitation has created a set of guidelines to address issues in menstrual hygiene in the country. However, menstrual hygiene remains largely ignored and overlooked within the larger discussion of health and sanitation.
Over the last few months, the discourse of menstrual hygiene has been brought to national mindspace by women across the country demanding that sanitary napkins should be exempt from taxation. They deem the tax as an extortion of their blood (Lahu ka Lagaan), and have argued that women in rural India cannot afford these products. The campaign points out the high rates of school dropouts of teenage girls soon after they attained menarche. The inability of women to follow healthy menstrual practices deprives them of their dignity and inhibits them from venturing into public spaces.
The Flow Problem
Even though the prominent discourse has been about the taxation of sanitary napkins, the fundamental issue with menstrual absorbents is that it is not a cost-based problem. Supply of menstrual absorbents in far-flung, small villages is an important issue and will not be solved by changing the price mechanisms alone. In order to increase the reach we need to look at economic costs such as transportation cost which makes it expensive for the retailers to supply menstrual products. This is further exacerbated with the lack of demand due to lack of awareness.
Other Major Clots
Affordability of a sanitary product is only one pillar of menstrual hygiene; the other two are Access and Awareness. Vatsalya conducted a study on menstrual health and management within a community of 18 villages where 62.5% of women cited awareness and accessibility as the biggest reasons for not using sanitary napkins. Studies claimthat 88% of women in India do not have access to commercial pads and so use old fabric, rags, sand, ash, wood shavings, newspapers, dried leaves, hay and plastic. Another survey showed that women preferred cloth menstrual absorbents over commercial plastic napkins not because of affordability but because of comfort. Similar result can be seen in a study done by Nielsen on behalf of UNICEF, that even though 65% of women knew about sanitary pads from TV ads, 85% of women in the study used a cloth.
The UNICEF study also highlights the lack of awareness among girls, which is the third big problem in India. As per the study, 83% of girls had no idea what to expect when they started bleeding, and nearly half missed school because of menstruation. Awareness is key to any policy on menstrual health because without it, any solution which makes pads accessible and affordable will amount to little.
Disposal mechanisms are also extremely important in menstrual hygiene management. In places with scarce water and no toilets, sanitary napkins spiral into an environmental problem. Subsidising them will exacerbate the problem. For this purpose, the government should be promoting the use of environment friendly menstrual absorbents such as commercially made cloth napkins, menstrual cups etc, which are not even accessible easily in cities.
The Government’s Plug
To be fair, the government has not missed the importance of menstrual hygiene. Under the Swachh Bharat Abhiyan, the Union Government in 2015 came up with National Guidelines for Menstrual Hygiene Management. The Guidelines mentions the framework (see image below) used by the government that focuses on providing, to knowledge and information, access to menstrual absorbents, water, sanitation and hygiene infrastructure, and access to safe disposal of used menstrual absorbents.
In order to improve the supply of sanitary pad in the rural regions, the Ministry of Health and Family Welfare also piloted a scheme for menstrual hygiene in 2013, whereby it ensured supply of sanitary napkins through a centralised supply mode and at highly subsidised rates.
As health and family welfare is a State subject, each state has been taking its own measures to improve the provision of toilets and water, sanitation and hygiene infrastructure. Even before the rollout of the GST, most states in India had reduced the tax on sanitary napkins so that it ranged between 5-14%. States like Gujarat, Rajasthan and Maharashtra had installed incinerators for disposal of menstrual waste. Taking cognisance of this situation, different state governments have implemented schemes and policies right from providing sanitary napkins in schools to mobilising local self-help groups to make cloth napkins.
With the new GST rollouts stabilizing the taxation across regions, it is an opportune moment for the state governments and the relevant ministries to refocus their motives towards increasing accessibility and awareness. As various policies and guidelines show, the problem is complex and involves not only aspects of health but also water, sanitation and even societal norms. It would require an integrated approach by various ministries and departments across the government hierarchy to ensure that high standards of menstrual hygiene are maintained in the country. To add to it, civil society campaigns play an important role in providing a platform to bring such issues into the national discourse, and to demand accountability. We need to continue using such platforms to ensure that the health of women in our country does not get overlooked.