In Meghalaya, the complex issue of menstrual hygiene has been a source of concern for years. In the recently concluded autumn Assembly session, the issue was brought to light once again when the Minister-in-charge of Health and Family Welfare attested to the data points hashed by the National Family Health Survey – 5.
NFHS-5 statistics paint a bleak picture, showing that only 65.3% of women aged between 15-49 resort to hygienic menstrual protection methods. This distressing figure ranks Meghalaya third from the bottom when compared to other Indian states.
Comparatively, NFHS-4 data, gathered five years prior, reported a similarly concerning figure of 64.2% for the state. This near-stagnant growth rate over a five-year period signals that the roadblocks in addressing menstrual hygiene in Meghalaya are deep-seated and intricate.
Further insights from a 2019 survey conducted by Menstrual Health Alliance India reveal that a significant portion of Indian women – over 40% – rely on old, often reused, cloth as a menstrual product. When this national statistic is used to gauge the situation in Meghalaya, given its existing low numbers, the scenario appears even more troubling.
The impact of such statistics is profound, going beyond mere numbers. For any region, a healthy female workforce is the backbone of socio-economic progress. Yet, when faced with these health challenges, women’s participation in the workforce diminishes.
Furthermore, the ramifications of poor menstrual hygiene practices permeate the education sector too. Inadequate knowledge and resources can lead to irregular school attendance among female students. This ripple effect continues – an interrupted education can limit career prospects, resulting in a cycle of economic dependency.
A recent UNICEF study reported that 71% of teenage girls in India are uninformed about menstruation until they experience their initial menstrual cycle. This lack of knowledge often leads many to drop out.
A 2019 report from Dasra further emphasised that each year, 23 million girls in India leave their education because of insufficient menstrual hygiene resources, such as access to sanitary products and menstrual education.
The same is true for Meghalaya, where at the core of the State’s health metrics lies a taboo-impacted narrative that intertwines societal paradigms and cultural practices, which is not easily overturned despite attempts via policy. Many still adhere to traditional beliefs and practices that might deter open conversations around menstrual health.
Such cultural barriers, combined with infrastructural and educational limitations, make addressing these challenges a complex task.
The issue of women’s health in the state is also best looked at through the lens of family planning and reproductive health, which is again one of the core challenges that the state has been dealing with.
The NFHS-5 data reveals that a mere 2.1% of men and 2.7% of women in the state use condoms. The repercussions of this low usage are multifold. From the looming danger of unintended pregnancies to the increased risk of STIs, the implications are grave.
For a clearer perspective, consider the national statistics. According to the World Population Review 2021, India’s average condom usage hovers around 5.6%. Meghalaya’s figures, almost half of this national average, underscores the critical need for intervention in this domain.
Furthermore, Meghalaya’s Total Fertility Rate (TFR) adds another layer of concern. TFR denotes the average number of children a woman gives birth to during her reproductive years. As per NFHS-5, Meghalaya’s TFR is a striking 3.1, a figure that stands in sharp contrast to the national average of 2.2. This glaring difference signals a gap in the state’s family planning initiatives.
Slow but Steady Changes
Of the many policy interventions that are being tried out by the Meghalaya government, since the initiation of the National Rural Health Mission (NRHM) in Meghalaya, a key policy intervention has been the deployment of Village Health and Sanitation Committees (VHSC).
The VHSCs, formed at the village level, consist of essential stakeholders from the village and act as a platform for planning, supervision and information dissemination at the local level. Typically, Village Council members also participate in VHSCs.
This participatory form of health governance ensures that services reach every segment of the village population. Members of the VHSCs oversee the availability of health service professionals during immunisation or Village Health and Nutrition Days (VHND) and communicate with higher authorities if there are any unforeseen changes to these schedules.
Each VHSC, once properly established and guided, receives an annual fund of Rs. 10,000.
VHSCs are also largely contributing to the steady reduction of Maternal Mortality Rates (MMR) in the state due to the immediate primary steps that are available. From 241 deaths in 2020-21, the MMR of Meghalaya has now come down to 158 in 2022-23.
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Such steps, both at a macro and at a micro level are the need of the hour in Meghalaya. Comprehensive interventions, including awareness campaigns tailored to the cultural nuances of the region, infrastructural development to ensure easy access to menstrual products, and sex education programs to demystify reproductive health, are some of the steps that are slowly setting pace, but need to be scaled eventually.
However, further discussion is required to break the taboos surrounding these topics, which have been adversely impacting women’s health in the state.
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