Menstrual Hygiene- Necessity, not Luxury

Proper management of menstrual hygiene is extremely important for every woman, not only due to their health concerns, but also when it is about giving birth to a healthy child. If menstruation hygiene is not properly maintained, it would have a long term impact on the number of patients having complications due to unhealthy practices during menstruation, that would consequently have an adverse effect on the entire health system.

Maintaining hygiene by reusing old cloths and rugs is a complicated process. Using disposable items, such as sanitary pads, assures proper hygiene followed by an easy usage. Nazneen Akhter, who is a Public Health and Policy Planning expert, said, “There always remains a question of the affordability of such products. Is it possible for everyone to avail it? No. Sad, but true – they are not getting it.” According to the Bangladesh National Hygiene baseline report in 2014, using old cloths or rugs instead of a sanitary napkin was the predominant menstruation management material for nearly 89percent  of menstruating girls and women.

Who suffers the most?

Starting from the raw materials to a finished product, a number of taxes are imposed on a commodity, including supplementary duty, custom duty, ATV, regulatory duty and value added tax. By the time the product reaches the customers, it costs Tk120 to 160, which may seem reasonably priced to well-off families, but the scenario isn’t exactly the same for lower income people.

It is difficult for Amina Khatun to provide these sanitary pads for her daughter. The mother of three said, “my husband is a security guard and I work as a cleaner. Our earning doesn’t allow us to afford such products for our daughters. And during those days, they often remain absent at school.”

According to a cross-sectional survey named ‘Menstrual hygiene management among Bangladeshi adolescent school girls and risk factors affecting school absence,’ 41percent  of school girls who have reached menarche were reported to miss school, with an average of 2.8 missed days per menstrual cycle.

Addressing the initiative of exempting VAT and SD as a fruitful initiative, Nazneen said, “If the price increases by even Tk1 because of VAT, many women from lower income families would stop using it and go back to their old practice. From that perspective, exempting VAT and SD on such products is something that I believe would be beneficial.”

Shefali, who’s working at a garment factory in Rampura as an operator for nearly four years now, is the only earning member of her family. “I have to produce at least 100 to 150 pieces of products every day. Apart from lunch break, I hardly get time to move from my seat.” The mother of an 11 year old has attended various sessions on menstrual hygiene management but still prefers to use a cloth. “I know using a cloth isn’t hygienic, but I have no other option but to use it,” she says. According to Baseline study of RMG workers, 2015, WwW project, Disposable pads or sanitary napkins were used by about 41percent  of RMG workers.

Jamal Uddin, Inclusive Business Advisor at the Working with Women project, shared the current scenario of workers at the RMG sector. At present, 90percent  of the female workers are aware about menstrual hygiene and 70percent  of them use sanitary pads. “Many garment industries, for example Ecotec, Renaissance Garments Limited and AKH group are subsidizing their workers, with the amounts ranging from Tk10 to Tk36.” The inclusive business advisor believes, a minimum increase in the price of sanitary products may cause threat to people earning within the borderline, and discourage new users. It may also generate additional costing load for the organization.

Why are subsidies important?

“Maintaining menstrual hygiene plays an integral role in achieving the SGD goal of Sexual and Reproductive Health. Moreover, as the government is working actively on women empowerment for all economic classes, incentives are required to accelerate this growth in order to achieve bigger impact,” said Jamal Uddin. The issue is being looked after by the government, along with the National Board of Revenue (NBR)’s prompt action, and he believes this will have a good impact in the long run.

Another Bangladesh National Hygiene baseline report also states that 40percent  of school girls are reported to miss school during menstruation for around three days a month. “Looking at the statistics, it is quite clear why school girls and working women at the lower level in the society need the government’s support the most,” mentioned Ariful Forquan, initiator of Sokhipad, a social business venture with a vision to facilitate affordable and quality sanitary napkins among school girls and lower income working women.

Discussing the topic of stipend for female students, Ariful, who is the chief operating officer, said, “many school students cannot afford sanitary napkins. Furthermore, there is an issue of inadequate school facilities contributing to the absence of these girls during menstruation. In my opinion, female students should be provided with a packet of sanitary napkins, along with the stipend to ensure no abruption from education and a healthy life.”

Of price tags

Sanitary pads are not a luxury product. The market should consider the issue keeping their social responsibilities in mind, instead of having the tendency to generate more profit.

Referring to a report by the Dhaka tribune, the annual market size of sanitary napkins is about Tk400 crores, which is growing at 20percent  per year, according to the industry officials.

The decision to exempt the supplementary duty was taken in an effort to give local manufacturers an opportunity to expand and meet the demands of local consumption at an affordable price.

Terming it as a classified item, Nazneen said, “it is crucial to make sanitary pads available for every woman. However, making such products available and affordable depends on strong supervision of the market so that the prices cannot go beyond the ability of people earning within the border or lower than that.”

It is an essential product for women and the market need of it requires proper scrutinization by the government. Preferred to be anonymous, the spokesperson of a local manufacturer said, “if life saving items like saline and condoms can be sold under subsidy and strict price range under the surveillance of the government, then why not sanitary napkins? A fair price tag needs to be introduced by the government, and it should be mandatory for every local manufacturer to follow it.”

Representation of health experts in policy making

Urging the government to look for new avenues in order to make sanitary pads available for women at every level of the society, Nazneen, a Public Health and Policy Planning expert, believes, experts from medical backgrounds need to be involved in policy making. “Representation from public health experts can illustrate the medical information and sensitize the respectable authority.”

It is expected that the price of sanitary pads can be lowered by 40percent  if this exemption is factored in manufacturing sanitary napkins. Thus, it is time for the citizens to wait and aspire that this decision would bring change to the price.

The concept of keeping everything about menstruation behind the doors still exists in Bangladesh. The recent concern among citizens by being vocal on social media and arranging events by students is certainly an indication of the fact that the level of awareness is increasing slowly, but surely.

Source: Dhaka Tribune