Menstrual Health and Hygiene Management for Persons with Disability

PwDs are assumed to be asexual and are seen as being incapable of managing their sexuality. As a result, they are denied information about sexual and reproductive health (SRH) and menstrual health and hygiene management. They are excluded from routine awareness outreaches due to this stigma and misconception.

Based on four cited studies dated between 1997 and 2009, most of the available MHHM resources are mostly text-heavy with little imagery and are not inclusive or tailored to marginalised groups, including PwDs. The report adds that PwDs who have trouble grasping mainstream resources face a substantial setback in accessing even the available information. 

Unavailability of information about sexual and reproductive health and lack of stakeholder training has led to caregivers and even medical professionals being ill-equipped to communicate effectively with PwDs. This is particularly evident in the case of families of hearing-impaired persons, where the Indian Sign Language (ISL) is not known to them. Further, when ISL-trained educators are brought in to give information, their personal biases become part of the narrative.

Interviews with key informants brought to attention three areas that need improvement with regards to educating stakeholders and tackling outdated norms. Firstly, the report states, behaviour change and informative communication documents are scarce at the institutional and family levels, and existing resources do not place PwDs at the centre of focus. Secondly, there are definite gaps in the information published. Some topics that need covering include premenstrual syndrome, menstrual disorders and possible redressals. Thirdly, existing resources not being shared across different organisations working in the same field lead to restriction of access and duplication of efforts if new materials are developed. 

The disposable sanitary pad market in India is valued at over INR 2,800 crores – this is despite the 10–12 per cent decline in 2020 due to Covid-19. Even so, the product presents considerable issues to PwDs with locomotive challenges in terms of comfort, coverage, adhesiveness and absorptive capacity. 

Social norms also play into the care menstruating PwDs receive. In some households, the caregivers themselves are considered impure when attending to their menstruating ward.

PwDs miss approximately seven days of school each month during their periods, as they are unable to receive assistance at school. Inadequate WASH facilities further accentuate the problem, leading to adolescent PwDs often dropping out of school after attaining puberty. 

Focus and Factoids by Nandini Ranganathan.

PARI Library’s health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.