Improving quality of life with new menstrual hygiene practices

among adolescent tribal girls in rural Gujarat, India

This paper examines the menstrual health and hygine practices among adolescent girls in tribal,
South Gujrat and their experiences using old cloths, falin cloth and sanitary pads. The governement
of india started a new scheme to provide sanitary pads at a subsidized rate. Data in terms of
qualitative and quantitave were collected over a period of six months with pre and post design
amongst 164 girls. A baseline of 90% girls were using old cloth pads was used. At the end of the
study 68% preferred falin cloth and 32% sanitary pads.

The papers introduces by highlighting the general attitude towards menstruation in India, which
includes restriction of food,movement , participation in rituals and social events. Particularly in the
sate of Maharashtra it was found that awareness prior to menarche was low among both rural and
urban adolescents. And information got passed inormally from mothers, who also lacked knowledge
due to low literacy and socio-economic status. Lack of mentrual hygine resulted in reproductive
tract information. Increased awareness can result in reduction of infections. The paper also speaks
about the the usage of sanitary pads in high income countries results in management of menstrual
blood . In indian scenario only 12 % of women are using sanitary pads with 70% citing cost as an
barrier.

In june 2011 the Government of india launched a scheme where subsidized sanitary pads were made
avaliable at the cost of Rs 6 for six pads via accrediated social health activist(ASHA). Added to this
it encouraged manufacturing of sanitary via the SHG’s.

Sharda mahila vikas yojana smvs a voluntarity organization working in rural tribal area of jhagdia.
While implenting a health and awarenss program in the region , It observed problems with respect
to the use of subsidized sanitary pads which include , irregual supply, lack of awarenss, quality
control issues and non avaliability of means of disposal resulting in low adoption of these pads.
Instead adolescent girls were using old clothes ranging from their mothers petticoats to bedsheets.
Which are resued after wasshing them. They also came across falin(wool like cloth with good
absorption properties) cloth, which were accesible,affordable and resusable. The organization
observes low awarenss among the adolescent tribal girls with regards to menstrualtion and to learn
more SMVS launched a study regarding menstruation and menstrual practices.

Methodology ,data collection and analysis

The study was conducted from january to june 2011 in the eight project villages.All school going
and non school sgoing adolescent girls residing in the villages were registered for the study
resulting in a total of 168 participants. Verbal consent and aproval was obtained from various
stakeholders and personaly identification information was removed in order to ensure privacy of
participants.

The study consisted of introducing falin cloth who previously used cloth and later sanitary pad was
offered in later stage of study. Inititaly falin cloth was offered at a subsidized price of rs 10 for three
months. ASHA workers were trained and incentivised for their particiaption in the study. Later
subsidized sanitary napkins were offered for three months at cost of Rs5 for 8 pads.

Quantitative and qualitative methods of data collection were used. Open ended questions
were asked to know their perspectives.SPSS-17 was used for data analysis.6 indepth interviews and
two focus group discussion with 26 adolescent after establishing sufficient rapport.
Findings
The mean age of the 164 adolescent girls was
13.7 years (range 12–22 years). 148 (91%) were
tribal, 131 (80%) were living in low-cost mud
houses, 153 (93%) had at least primary level
formal education, 55 (33.5%) were school-going,
the rest were labourers 58 (36.6%) or did housework 45 (27.4%), 75% were from below-poverty-
line
families. Two-thirds of their mothers and onethird of their fathers were illiterate. 49 (30%)
were underweight (BMI<18.5). Only 26 (16%)
of the girls had adequate bathroom facilities
available at home and the rest had makeshift
bathrooms (navniyu) whose walls were made
of sticks and plastic without a door, roof or
running water.

Falin was prefered as it was easily avlaiable , good aborbable capacity also the color of the cloth
was red.

Only few opted for sanitary pads , but were positive to their use. But lack of disposal facilities and
also their use resulting in spoiling of clothes they were not favored over falin cloth.
Discussion
and recomendation.
The study shows that most of the girls lacked appropriate knowledge with respect to mentruation
leading to unhygenic practices including various restrictions imposed. The study compares with
similar studies carried out across south asia. Community based health programes can play a major
role in raising awareness regarding improvemnet of menstrual hygine.
This study highligghrd the need for stratergies to improve menstrual hygine and need for
adolescent friendly services.