CONCEPT NOTE ON MENSTRUAL HYGIENE MANAGEMENT

Background

Menstrual Hygiene is an issue that every girl and woman has to deal with once she enters adolescence
around the age of 12 and until she reaches the menopause somewhere in her 40’s. Overall, a woman
spends approximately 2,100 days menstruating which is equivalent to almost six years of her life.
Adolescent girls constitute a vulnerable group, particularly in India where female child is neglected one.
The gravity of the present scenario can be fathomed from the several studies undertaken by reputed
agencies in the country that shows that:
 Around 300 Million Indian women & girls do not have access to menstrual hygiene products
 More than 23% girls drop out of school when they start menstruating
 Only 60% women change their menstrual cloth once a day
 10% girls think menstruation is a serious illness
 20% women do not use latrines during menstruation due to cultural taboos
 Indian women who lack sanitary products are forced to use materials like old rags, husk, dry
leaves, ash, sand, newspapers etc during their periods

Concerns regarding Menstrual Hygiene are as follows:

 Issues associated with menstruation are never discussed openly and the silence surrounding
menstruation burdens young girls by keeping them ignorant of this biological function. Even after
the attainment of menarche, very little information is given to young girls about the physiological
processes involved and the hygienic practices to be followed.
 Menstruation is still regarded as something unclean or dirty in Indian society. Although
menstruation is a natural process, it is linked with several misconceptions and practices, which
sometimes result into adverse health outcomes.
 Hygiene-related practices of women during menstruation are of considerable importance, as it has
a health impact in terms of increased vulnerability to reproductive tract infections (RTI). The
interplay of socio-economic status, menstrual hygiene practices and RTI are noticeable. Today
millions of women are sufferers of RTI and its complications and often the infection is
transmitted to the offspring of the pregnant mother.
 The onset of puberty results in significant changes in school participation for girls. At school
menstruating girls are faced with poor facilities – inadequate water for washing, lack of soap, no
privacy, non-functioning or inadequate toilets and no disposal facilities.

Why Menstrual Hygiene Management (MHM) is Important

Menstruation is a monthly occurrence that requires access to appropriate materials and facilities, without
which, females suffer from poor menstrual hygiene which restricts their movement and self confidence.
Good menstrual hygiene is therefore crucial for the health, education and dignity of girls and women.
Women having better knowledge regarding menstrual hygiene and safe practices are less vulnerable to
RTI and its consequences. Therefore, increased knowledge about menstruation right from childhood may
escalate safe practices and may help in mitigating the suffering of women. There is a need to change
family and community beliefs in this regard. Secondly, Schools are ideal entry point for any kind of
intervention on MHM. Schools should address the counseling needs of young girls on the physiological
and psychological aspects of MHM. A girl child once sensitized to the need and use of MHM facilities
will also become a catalyst in her family and community. In all, MHM needs to be understood in its
entirety – from the psychological and physical needs of menstruating women right through to the facilities
that would enable proper management and human dignity.

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Project Goal

To improve the reproductive health of adolescent girls and women in target villages by promoting safe
menstrual hygiene practices and providing easy and private access to sanitary napkins and facilitating
their safe disposal.

Key Objectives

• To promote healthy menstrual hygiene practices among adolescent girls.

• To increase awareness about the sanitary napkins and thereby increase their acceptability and
usage among adolescent girls.
• To ensure easy availability of quality sanitary napkins in targeted schools through Sanitary
Vending Machines and Incinerators.
• To facilitate creation of an enabling environment both at the community & school level that
sustains the desired behavior change regarding MHM.

Target Audience

In order to bring about a behavioral change in menstrual hygiene it is necessary to inculcate the habit of
using sanitary napkins at an early stage, preferably at the onset of menstruation. Hence, the primary target
group would be adolescent girls in the age group of 10 -17 years (both school going as well as drop outs).
The secondary target group would be decision makers/ influentials at the household level, community
level, school functionaries and local health service providers.

Components of MHM

Good Menstrual Hygiene Management requires access to (both at school and community level):
 Accurate information
 Affordable hygiene materials
 Adequate water , sanitation and hygiene facilities
 Safe disposal of used sanitary materials

Activities under MHM at School Level

 Efforts would be made to ensure that sanitary napkins are easily available at schools through
installation of sanitary vending machines. In addition, HLFPPT would also train one of the lady
teachers for management of this machine and to ensure that a girl has access to menstrual hygiene
products while at school for change or unexpected start of periods.

Sanitary Napkin Vending Machine (SNVM) is an electrically-operated compact

machine that dispenses a pack of sanitary napkin with the insertion of dispensing
currency which could be either a coin or a token. The machine can be mounted on the
wall or can be installed on the floor. The vending machines supplied to schools will be a
two product selection unit, which can dispense a single pack or a three pack napkin
depending on the value of the token or the coin inserted.

Sanitary Napkins Incinerators: Safe and eco-friendly disposal of sanitary napkins is

important for overall hygiene in a school environment. Thus, as a comprehensive
package with the SNVM, HLFPPT will install incinerators in selected school. The
incinerator burns/incinerates wastes like soiled cloth, cotton waste, sanitary napkins,
paper towels etc in just about few seconds leaving very small quantity of ash and other
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 non-hazardous residues. The incinerator comprises of two chambers, an emission control system
along with a door for firing and removal of ash.

 HLFPPT will organize the logistics for installation of the machines. The machines are provided with
12 months warranty and subsequently, Funding Agency may go for annual maintenance contract at
prescribed charges with the franchisor. The annual maintenance arrangement is required from the
second year of installation only.
 Annual Provision of Sanitary Napkins: With funding agency support, adolescent girls and women of
the village will be provided high quality and free sanitary napkins for 1 year (single and three piece
packs). It is expected that around 48.9 % of population would be covered (as 48.9% constitute women
15-49 years of age, Census 2011). Single piece is ideal for use during the last few days of the
menstrual cycle. Three piece packets will be especially useful during the initial days.
 HLFPPT will ensure the supply of sanitary napkins at the village site through its Project Stockist in
the area. The village Health Committee members will be provided tokens during the commencement
of the project. The Custodian designated by the community members will be responsible for
distributing the tokens to the target beneficiaries in the first week of every month.
 Capacity Building of Community members, School Staff and Model peer Women: HLFPPT would
also train one helper, one community member (preferable female PRI members), Peer group Women
leader and lady teacher for management of this machine and to ensure that the beneficiaries have
access to menstrual hygiene products as per their requirement. In addition, school functionaries would
be sensitized to create awareness regarding various issues of MHM not only at the school level but
also at the community level. The franchisee will also provide training on operating the machines.
 Celebration of Special Event at School& Community Level: HLFPPT would organize special school
& community events in the form of competitions, road shows, marching campaigns etc on Menstrual
Hygiene Day (May 28th) to create awareness about the issue.
 Sensitization programs for School Functionaries would be organized to create awareness regarding
various issues of MGM.
 MHM Counselling facility would also be provided in schools to girl students, with specific focus on
girls who absent themselves regularly on days of menstruation. This would include a confidential talk
on how to manage the menstrual flow during school days and how to use school facilities. This would
in turn increase school attendance and also enable these girls to continue their education.

Activities under MHM at Community Level

 Sensitization of community health workers- Accredited Social Health Activist (ASHA), Auxiliary
Nurse Midwife (ANMs), Aaganwadi Worker (AWW) and Multipurpose Health Workers Female
(MPHW-F)
 Sensitization of Family members (esp. female decision makers at household level))
 Community health education programs to sensitize the village influential’s on issue of menstrual
hygiene:
 Behavior Change Communication (BCC) Activities: A combination of interpersonal communication,
mass media and local media.
 Identification and felicitation of Local Sanitation Champions
 Ensuring easy availability of sanitary napkin at community level through social marketing channel.
 Organization of special community events on Menstrual Hygiene Day (May 28 th) to create awareness
about the issue.

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 Elements of Menstrual Hygiene Management (MHM)

Anexure A: TECHNICAL SPECIFICATIONS

1). Technical Specifications of Sanitary Napkin Vending Machine

No. Features Description
1 Type of Machine Electronically operated with display (LCD) for interactive communication
2 No. of Product Columns Two columns of vertical spiral
3 Dimensions (External) Width – 600 mm, Depth - 150 mm & Height –600 mm
Construction of the Cabinet 1.2 mm thick CRC anti corrosive and powder coated Steel, aesthetically
4 / Door well designed
5 Mounting Method Wall flushed mounting frame with easily removable machine
Vends one product when a coin is inserted and particular selection is
pressed. The Vending is by way of vertical guided spirals. The space of the
vertical columns and spiral design is as per the product dimensions. The
6 Vending mechanism spiral operates through DC Motors controlled electronically. Easy and user
friendly product delivery thru open “V” type delivery bin
7 Product Storage Capacity Hold minimum 40 products in two selections
The machine is fitted with Electronic Coin acceptor which accepts 6 coin
8 Coin Acceptance variants of INR. The coin acceptor is programmable in field for any new
mechanism coins which may be introduced at a later stage
The product pricing is changeable from the machine itself. There is
provision for stock lock out and for recording sales in numbers and value
9 Programming features and is displayed on certain action. The sales data is retrievable through
USB port thereby eliminate errors associated with manual data collection
and easy system for report generation
10 Power Back up The machine is provided with optional power back up for 10 transactions
or two hours. The cost of power back is additional

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2). Technical Specifications of Sanitary Napkin Incinerator Machine
No. Features Description
1. Capacity 200 to 300 Napkins in a day
2. Loading Capacity 20 to 30 Napkins at a time
3. Housing Sheet Metal Housing Powder Coated - rust free.
4. Operation Electrical
5. Automatic Timer Up to 8 programs every day
6. Thermal Protection Provided.
7. Power saver Provided with auto power off
Insulation Provided with high density ceramic fibre insulation to avoid thermal loss &
8.
packed with CERA board
9. Emission outlet Provided to let out the flue Gas
10. Burning Napkins Into sterile ash with less than 1gm ash per napkin
11. Electronic Display Provided to Set/indicate the temperature in the primary chamber.
12. Loading of Napkins Front Loading.
13. Twin Door Provided with two doors viz. one for loading and another for ash Tray.
14. Dimensions 300 x 300 x 640 mm
Electrical 230V +/- 10% / 50Hz / Single phase / 5Amps can be designed for 110V
15.
operation also.
16. Wattage 1.25 KW (1250W)
17. Weight 20 Kg

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