Social and economic causes of not using sanitary napkin
Menstrual or Periods is still a social stigma in our society in this 21st century. Women especially teenager faces various physical and psychological difficulties during this time. The theme of this year's Menstrual Hygiene Day is "Periods in Pandemic". The aim of this theme is to highlight how the challenges faced by women during menstrual have worsened due to the ongoing pandemic. This thyme is very relevant to Bangladesh where women and girls are facing various social obstacles in achieving their right to food, health, education and work. Bangladesh is a developing country with population of 166.59million--among them almost 50% are female. According to World Bank about 34.55% female are actively engaged in labour force and about 30% female are in reproductive age.
The situation at household level:
Preliminary findings from the National Hygiene Assessment (NHA)--a countrywide survey on hygiene facilities and behaviours conducted by icddr, b--indicate that 57 percent of adolescents and 65 percent of adult women had not heard about menstruation before their first time. Over 90 percent of women and girls surveyed across households received their information on menstruation from female relatives, indicating little presence of formal or verified information to help women understand this process better. The assessment found that most women and girls use old cloth to manage their menstrual bleeding.
While some do use sanitary napkins, especially in urban areas, these products are not affordable or accessible for an overwhelming percentage of women. Across households, approximately 80 percent of adolescents and women use old cloth. However, women are often not aware of the importance of washing these cloths with soap and water and drying them in the sun. 30 percent of rural women wash their sanitary cloths in open or unprotected water sources. Many women also face trouble managing these cloths after use, with 40 percent or more women and girls having to dry and store their clothes in hiding, which can result in storage in dark, dam and unsanitary places.
The difficulty in managing menstruation in schools means that one in four girls in rural areas and one in five girls in urban areas miss school during this time. The survey also found that over 30 percent of girls think menstruation interferes with their school performance. The lack of knowledge, adequate facilities and affordable products mean that health problems associated with menstruation are not uncommon, and seem to be more prevalent across the school-going adolescents surveyed. 23 percent of this group reported itching, irritation or similar problems within the last six months of the survey, and 14 percent reported unusual discharge.
The fact that women report health problems in the genital area even when not menstruating may indicate fungal or bacterial infections from poor MHM. For those who sought medical help for menstruation related problems, the average cost for one incidence was Tk 2,193. This is a staggering figure, especially when compared to their average monthly per capita income of Tk 2,344. An additional Tk 325 is incurred indirectly from loss of work days. These figures should raise serious concern about how much poor menstrual hygiene management is costing one of the most disadvantaged groups in society in just monetary terms, let alone more comprehensive measures.
One of the survey (in Dhaka City 2017-18)conducted by Magnum Management Consulting about the causes of not using sanitary napkin though they are aware about the health hazard of using unhygienic cloths and other methods. Out of the 731 respondents, a little more than 75% uses "Sanitary Napkin" as the protection method during the monthly cycles. These users are mainly students and professionals. Around 16% uses other methods such as cloth, tissue and cotton with sanitary napkin and these users are dominated by housewives and factory workers like garments workers.
Lower income classes mostly use cloths (constituting 4% of the users) as well some other methods like cotton, tissue, papers, ashes etc. This class is usually employed as clerks, attendants or maids. Among them 37% find it inconvenient to use sanitary napkin and 30% find it costly though they are aware about hygiene issues regarding not using sanitary napkin. Some of them believe that using cloths, tissue, papers, ashes are not unhygienic and the cost that incur to buy sanitary napkin is not worthy as it does not make any impact to their beauty.
Good health and well being is one of the goal of sustainable development and in the country like Bangladesh where 57% of adolescent do not have any idea about menstrual before their first time, where only 15% of them only use sanitary napkin, it is very difficult to meet the goal without creating awareness among the population. Because of the lack of awareness female population rather use beauty product worth of Tk 100 instead of using sanitary napkin.
In this scenario, Govt. and private sector can play role to enhance the awareness regarding hygiene, especially for menstrual. Social campaign and advertising through news, TV and social media may create awareness among female population which will have both social and economic impact on the economy.
The writer is executive director, Innovation Influence Impact (I3) Ltd