I live in Hyderabad, Andhra Pradesh, and have had the opportunity to work with both Healing Fields Foundation (HFF) and LV Prasad Rural Eye Care Institute. While at Healing Fields Foundation, I worked on revising and editing the training workbook for the Community Health Care (CHC) workers, as well as monitoring and evaluating the microenterprise sanitary napkin unit in Bihar. The CHC workers are local village women that HFF trains to teach other women in their communities about health and sanitation. Additionally, the CHC workers help women create health savings groups that will insure them against emergencies and help them to gain a bit of autonomy.
The issue that has astounded me during my time here in Hyderabad and India as a whole is the issue of women in Indian society. Women and girls in India face numerous obstacles and are viewed as second class citizens. At the beginning of my time here, I used to think that I felt many things because I am a foreigner here. However, after speaking to several of my colleagues and friends in India, I realized that the women and even some of their male colleagues here feel these issues as well.
Despite the numerous obstacles women face in India, I want to focus on the lack of availability of necessary products for women. According to an article from the Times of India, "Only 12% of India's 355 million menstruating women use sanitary napkins." 1 This is just one example of the lack of access women have to feminine products. It is very difficult to get birth control pills, it is almost impossible to find tampons, and there are very few areas for women to buy lingerie or any other feminine needs and desires. If a woman wants to buy these products and is able to afford them, she has to buy them from a man behind a counter at the pharmacy or beauty store. One can imagine how intimidating and uncomfortable this would be for a young girl or conservative woman.
When my colleagues and I sat down to discuss these matters, we thought about how to create a market to get these products to women. However, we were struck by the fact that there is not even a market for the products these women need. Thanks to the program set forth by the National Health Mission (NHM) of India 2, some young girls and women living in places reached by this program have access to sanitary napkins. However, the program has not reached many of the women in poorer and more rural sectors. If the NHM's program has not come to their district, many cannot afford the retail prices for these crucial products.
One successful example of a sanitary napkin unit program is Healing Fields' own program, which I evaluated. HFF goes into rural communities and recruits women from the local microfinance institutions to become local Community Health Workers. This way, the women are already trusted members of their communities and can have a more direct impact. These women lead health education groups that teach young girls and mothers about menstrual hygiene and its importance. Then they offer them affordable sanitary napkins that they have made from their own microenterprise unit3.
So where does development come into play here? The fact of the matter is that the development space in India, for the most part, has failed women thus far. The demand for products is present, and the supply is not reaching the demand – which is inevitably sustaining high prices. The high prices drive a lack of purchasing power and last mile distribution problems. It is clear from HFF's work in providing affordable sanitary napkins and toilets that it is possible for women to have access to sanitary napkins, toilets, birth control, etc4. However, there needs to be major scaling up of these types of programs and a partnership with the government to effect change.
To tackle scalability, you have to get to the source of the problem. The problem is two-fold: a lack of knowledge and a lack of economic market for the product. A two-fold problem requires a two-fold solution. First, where does the lack of knowledge about these crucial products for girls and women in this society begin? It starts in the homes of each young girl. We can reach the homes through discussions in schools and with community members. We need to educate young boys in schools and the parents of all children about critical issues for women in this society. Education for both young boys and girls should include sections on health and sanitation. This will help to create a dynamic where speaking of girls' needs is not taboo. It should not be a burden for young women to deal with natural issues such as using the toilet and having a menstrual cycle.
Additionally, we need mothers and grandmothers to stand up for their daughters and granddaughters and fight for them to have access to these human rights. The second part of the solution will result from this raising of knowledge about menstrual hygiene. An increase in awareness for the need of the product at hand will create more openness around buying these products and increase demand, which will help to reduce cost. We need to tackle the issue from all sides of the coin: from individual to family, to community, to government. This is the only true way to ensure success in scalability and sustainability.
We also have to examine the cultural barriers and how to tackle them. How can we break through the cycle of women and women's issues being taboo in a society? Let's start teaching boys in homes and schools about respecting the women in their homes and societies. Let's teach the young boys the critical roles that women play in their lives to start creating value for them. Value is essential to the recognition of the importance of an issue. If we start at a young age to talk to these boys about issues it stops the perpetuation of a taboo.
Next, we should encourage mothers and grandmothers to stand up for their daughters' needs. We can run community outreach programs to teach women the importance of breaking the pattern that they were taught. We need to educate them on such issues as the repercussions of not having hygiene products and safe toilets, such as reproductive tract infections. Let's be bold.
Once we get the siblings, families, and communities on board, we can begin to build partnerships with government programs and private companies to create markets for the products. We need a way to channel the products for women to make them feel comfortable and at ease in buying these products. These tactics can include social enterprises that create pick-up points for young women to receive the products they need from other women in their society. This strategy would also create jobs, income, and autonomy for stay-at-home wives, mothers, and daughters.
Tackling the needs of young girls and women is an obstacle that India absolutely must face. It may seem to be an overwhelming or daunting task, but it is clearly feasible through the evidence of successful programs such as the work of HFF and the start of the National Health Mission. Women make up half the landscape of India, so let us take bold actions in creating necessary access to the basic human rights they need to make this nation what it is truly capable of becoming.