Knowledge of menstrual hygiene management among tribal menstruating females for the successful implementation of government policies in India

Sir,

Although the process of menstruation is a natural physiological process in women and is an indicator of good reproductive health, but due to the myths and stigmas associated with it, often it leads to misinformation, lack of awareness and hiding of management of the same.¹ Lack of proper hygiene during menstruation can lead to increased vulnerability to problems like RTIs (reproductive tract infections) which significantly contribute to female morbidity.^1,4 Therefore, there is a need to exercise menstrual hygiene management (MHM) by menstruating individuals.^2-6

But the problems related to MHM are often magnified in rural and tribal communities, where there is low accessibility towards the facilities required for MHM.² Considering this, the govt. of India has implemented several schemes and policies to make MHM easier for the menstruating population, focusing on the communities where both information and resources remained unreached. This paper tries to highlight the condition of MHM awareness in tribal women, which crucially impacts the successful implementation of Government schemes, programs and policies.

Measures taken by tribal women to manage menstruation

It has been studied that, tribal women are still using traditional methods to manage menstruation like old cloths, leaves, dried ash, etc.^2,3 These methods are often unsafe and can be hazardous to their health causing RTIs and other problems like the fatal toxic shock syndrome, cervical cancer, infertility, ectopic pregnancy, and other range of problems.^1,4 The tribal women remain unaware about the usage of modern menstrual products like sanitary pads, tampons, menstrual cups, etc. because of lack of information, financial constraints and socio-cultural restrictions.^2,3 The Government has introduced some programs that distribute free sanitary products to women or at subsidized rates.⁶ But the tribal women are mostly unaware of these schemes and programs.^4,6

Awareness of tribal women about existing government policies

There have been many Government schemes and policies that have been formulated by the ministry of health and family welfare, under the draft of menstrual hygiene policy (MHP).⁷ Schemes like Pradhan Mantri Bharatiya Janaushadhi Pariyojana (PMBJP) distributes sanitary napkins at very low prices through Janaushadhi kendras.⁷ The napkins distributed through this scheme are oxo-biodegradable and are called ‘Suvidha’. Moreover, the most significant among all of these is the menstrual hygiene scheme (MHS), a part of national health mission (NHM) which provides pads at subsidized rates to rural adolescent girls, that are distributed at schools, Anganwadi centers, or door-to-door visits by health workers.⁷ Under the MHS, the ministry of health and family welfare works to enhance awareness about the significance of menstrual hygiene among rural girls aged 10 to 19.^7,8 It also seeks to improve access to and usage of high-quality sanitary napkins, as well as their safe and environmental-friendly disposal, for adolescent girls in rural regions.⁸ In 2011, this initiative selected 107 districts across 17 states, where packs of six sanitary napkins known as “Freedays” were sold to rural adolescent girls for just six rupees.⁹ The program facilitated the decentralized procurement of these sanitary napkins for women at the cost of six rupees for six pads.^7,9

Is the community ready for these schemes

Even when the menstrual hygiene products are made available to the tribal women, proper utilization and disposing remains a challenge.⁴ Some reuse disposable pads which prove to be hazardous for their own health and the improper disposal of these pads also creates problems for their surrounding environment.³ The effectiveness of Government schemes can be successful only if the community is prepared to accept the facilities provided. Sometimes the tribal communities resist the changes due to deeply ingrained social and cultural beliefs of their own.

Despite government efforts, lack of awareness and unacceptance remains a problem in managing the problems related to MHM in the rural and tribal areas. Myths, taboos, social and cultural bindings, infrastructural challenges, etc. impede the success of the MHM programs overall. It is vital to empower tribal women, initiating a change in their behavioral aspects to manage menstruation. Some measures to ensure improved MHM are establishing more sanitary supplies’ distribution centers in remote tribal areas, in schools, in unreached corners of rural areas for free or at subsidized rates; design awareness programs tailored to the cultural beliefs of the tribal people to sensitize them about MHM; encouraging the involvement of local tribal leaders, teachers and health workers to foster the community participation and lastly, regular assessment of the success of government schemes and making necessary improvements.⁹ Therefore, it can be said that by promoting awareness and accessibility, the government policies and programs can be implemented successfully that can significantly improve the menstrual health and well-being of the tribal women.

REFERENCES

1. 1. Garg R, Goyal S, Gupta S. India moves towards menstrual hygiene: subsidized sanitary napkins for rural adolescent girls-issues and challenges. Maternal Child Health J. 2012;16:767-74.
2. 2. Kumari S, Sood S, Davis S, Chaudhury S. Knowledge and practices related to menstruation among tribal adolescent girls. Industrial Psych J. 2021;30(1):160-5.
3. 3. Mudi PK, Pradhan MR, Meher T. Menstrual health and hygiene among Juang women: a particularly vulnerable tribal group in Odisha, India. Reprod Health. 2023;20(1):55.
4. 4. Kakwani J, Meena JK, Verma A, Dahiya N. Emerging issues and barriers in access to menstrual hygiene management in a tribal district of India. Int J Commu Med Public Health. 2021;8(4):1985-90.
5. 5. Singh A, Chakrabarty M, Singh S, Chandra R, Chowdhury S, Singh A. Menstrual hygiene practices among adolescent women in rural India: a cross-sectional study. BMC Publ Health. 2022;22(1):2126.
6. 6. Shah SP, Nair R, Shah PP, Modi DK, Desai SA, Desai L. Improving quality of life with new menstrual hygiene practices among adolescent tribal girls in rural Gujarat, India. Reprod Health Matters. 2013;21(41):205-13.
7. 7. Ghimire S. Knowledge regarding menstrual hygiene among adolescent girls. International J Res Med Sci. 2017;5(8):3426-30.
8. 8. Karjee S, Biswas PC. Menstrual hygiene practices and its predictors among young women in India: findings from the National Family Health Survey-5 (2019–2021). Nurs Midwif Res J. 2023;19(2):90-104.
9. 9. Zode M, Sodhi B, Basu S. Menstrual hygiene practices, determinants, and association with reproductive tract infection in India: a large repeated cross-sectional analysis (2015–2021). J Biosocial Sci. 2025;8:11-5.