Background:
As an American India Foundation Banyan Impact Fellow (https://aif.org/fellowship/), I started working at Doctors For You, my host organization. In this new environment, my curiosity led me to explore and learn. I used to walk near the office in the evening, and one day I noticed some dirty clothes that were thrown here and there. Upon investigating, I discovered that these clothes were not ordinary but were used by people during menstruation. This is not something new I came across but since I am working in the public health space I paused to reflect which intrigued me to think more about this issue.
Primary and Secondary Research:
To understand menstrual hygiene management in nearby communities, I engaged in conversations with nurses, field staff, and other employees at the organization. I found that among the community stigmas and taboos still exist about menstruation. Furthermore, through a detailed discussion with my supervisor, I learned that in the last 5-6 years, the organization has organized massive awareness sessions for girls and women and distributed pads multiple times in the community.
It’s not just my observation or experience; the National Family Health Survey (NFHS-5) conducted in 2019-21 also revealed that 66.6% of women between the ages of 15-19 use clothes, while 67.7% of women aged 20-24 use clothes. 69.9% are from rural while 51.5% are urban residents using clothes. The highest percentage 77.8% belonged to scheduled castes, 69.7% from scheduled tribes, and 67.8% from other backward classes who use clothes as a method of menstrual protection. While the same NFHS data is mentioned at the bottom of the report: “Locally prepared napkins, sanitary napkins, tampons, and menstrual cup are only considered to be hygienic methods of protection.”
Discussion Leads to Destiny:
Once I identified the problems and existing gaps, I began exploring possible ways to bridge those gaps and sought to minimize and prevent them. Since my supervisor shared an interest in this issue, we had multiple discussions. As working for the pioneer healthcare organization I am privileged to have a supportive team that guides and provides a safe space to think, innovate, design, and experiment. After conducting background research on the issues and the location, I proposed the idea of setting up a sanitary napkin (pads) vending machine along with incinerators at the hospital premises.
Pic Credits: Author
While the idea of setting up such a machine was well appreciated, questions arose about how to install it in hospital settings, its sustainability, impacts on people, the quality and certification of the pads and machine, and hygiene, among others. These questions prompted me to conduct more in-depth research and engage in critical thinking, leading to successful results.
Photo Credits: Santosh DFY staff.
Government Initiatives to Tackle This Issue:
The government of India is also running various schemes and initiatives, such as Pradhan Mantri Bhartiya Janaushdhi Pariyojna (PMBJP), which plays a vital role in ensuring the health security of Indian women. On August 27, 2019, the Jan Aushadhi Suvidha Oxo-biodegradable sanitary Napkins launched aimed to offer pads at a price of only 1 rupee. As of November 30, 2023, the cumulative sale of Suvidha napkins is 47.87 crores rupees. Similarly, railways have also installed such machines at various stations and in trains. However, this innovation remains a dream for under-resourced rural communities and institutions. Under the Mukhyamantree Kishore Svaasthy Yojana, the Bihar government provides 300 rupees annually for buying sanitary napkins.
Solution-Driven Successful Collaboration:
Having prior experience working on Menstrual Hygiene Management (MHM), I have an understanding of this issue in a larger context. During my backend research, I came across an organization named Netrahat Old Boys Association Global Social Responsibility (NOBA GSR). This organization is extensively working on Menstrual Hygiene Management across Bihar and Jharkhand. We approached them to explore possibilities for collaboration. On December 11, 2023, they successfully installed a Pad Vending machine with pads along with incinerators on the premises of Vistex-DFY Charitable Hospital after engaging in multiple conversations. Now, people can get a sanitary pad by inserting just 2 rupees themselves. The machine requires very little electricity to run. To maintain its sustainability, this entire model will operate on a no-profit-no-loss basis through collaboration between both organizations.
Photo Credit: Author
Impact:
Every day, around 70-100 OPD patients visit the hospital. Of this, approximately 60 to 70% are female, and most are from low-income groups. They may not afford and prioritize buying pads. For such a population this technology-based innovation provides pads at a very low cost. It allows anyone to avail themselves as per their needs and convenience. Unlike buying pads from shops, where people may feel shy and ashamed, the machine’s location ensures that anyone can go and take it.
Photo Credit: Anshu DFY staff
The responses have been impressive and progressive in the one month since its installation, as people become familiar with it and started using it. People are curious to know and understand this as well. Not only the patients but girls from the nearby school and staff who visited the hospital also use this machine for sanitary pads. People/patients using pads have the added advantage that after using the pads they can dispose them properly through the incinerator which is being installed in the hospital campus.
References:
https://rchiips.org/nfhs/NFHS-5Reports/Bihar.pdf
https://janaushadhi.gov.in/pmjy.aspx
