Working with PATH on sanitation and menstrual hygiene projects several years ago, I kept stumbling over the ‘hush hush’ subject of menstruation. Having had similar experiences myself, of being secretive about periods, purchasing sanitary pads, and disposing them, I connected with this work instantly.
With the support from multiple organisations working on the issue, the first national consultation on menstrual hygiene management – Bejhijhak – was organised by WASH (or Water, Sanitation and Hygiene) United in 2014. Since then, the products and policy landscape around it have evolved significantly in India.
A global systematic review of what women use during their periods shows an association between incidence of reproductive tract infections and improper menstrual hygiene health management. This includes lack of access to safe products and unhygienic practices related to the use of traditional cloth.
Many girls and women in rural areas use cloth without appropriate washing and drying, and use the same cloth for 12 hours or more. Lack of awareness, safe spaces for changing cloth/pads, and access to appropriate products are contributing factors to this problem.
Access to products has increased over the last few years. Multinational companies have led the way in creating a market for feminine hygiene health products through both low-cost and aspirational variants of disposable, non-biodegradable sanitary napkins.
In recent years, government programs have defrayed the cost of these products for adolescents, leading to an increase in uptake. The India National Family Health Survey 2016 says 48.2 per cent of rural girls in the age group from 15 to 24 currently use sanitary napkins.
We at PATH estimate current market access to be as high as 36 per cent of the 336 million girls and women experiencing menstruation in India. This is a significant increase in access, which was pegged at a mere 12 per cent according to an AC Nielsen study in 2010.
While access has increased, most of it is in the form of disposable, non-biodegradable sanitary napkins, and every month it’s estimated that more than 1 billion used pads are going into urban landfills and rural water bodies and fields. While environmentally safe products like menstrual cups, compostable pads, and cloth/hybrid pads exist, their reach is limited due to low awareness and high cost owing to small scale.
The collective challenge is to continue the work on increasing access while catalyzing the industry in a direction that makes these sustainable innovations available at scale. Girls and women need to be given choice through access to information on health and environmental impact and the products available to them. Policy measures like taxation and minimum product standards can influence the industry to offer more sustainable and safe choices to girls and women.
As a basic premise, menstrual health products should be considered a necessity and not a luxury. For example, contraceptives are tax exempt owing to public health benefits. Similarly, menstrual health products are essential toward the socioeconomic and physical well-being of girls and women.
Under the new Goods and Services Tax schedule proposed in May 2017, tax on disposable sanitary napkins (both compostable and non-compostable) is 12 per cent and menstrual cups (made of medical grade silicone) is likely to be as high as 18 per cent, due to lack of clarity on categorization. Rates for cloth pads are unclear but would likely fall in line with taxes on textiles (yet to be defined). Under the schedule, only sanitary napkins are specified under the miscellaneous category with no mention of other products.
To provide women with a comprehensive choice, taxation should ideally define product categories (disposable, compostable and non-compostable sanitary napkins, menstrual cups, cloth pads, and others). Relative tax structure should reflect evidence on user preferences, environmental impact, and life-cycle cost to the consumer. Accordingly, taxes on compostable and reusable solutions, which fare better on these accounts, should carry lower tax than disposable, non-compostable options. Favourable taxes and exemptions for raw materials for these products would also help push large scale manufacturers to adopt them. This is essential considering the impending waste load on our urban and rural waste management systems from non- biodegradable products, but further research is needed to further understand the issue and find solutions.
The world must recognize menstrual hygiene as a basic right, and work to ensure women and girls have access and choice when it comes to hygienic products.
– Tanya Dargan Mahajan works as a consultant with PATH, the leader in global health innovation. PATH is also a partner organisation that Dasra works with through an engagement with Bill and Melinda Gates Foundation.
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