Menstrual health education: a key to nurturing confident girls

May 26, 2016 by Sushmita Malaviya

In this still from a locally made Projecting Health educational video, rural Indian village girls learn about menstruation from a trained volunteer.

In this still from a locally made Projecting Health educational video, rural Indian village girls learn about menstruation from a trained volunteer.

One young woman's story explains why menstrual health education isn't just useful— it's necessary.

Anshu, a teenager who lives in a village in Raebareli District of Uttar Pradesh, India, was a friendly and lively girl. But when she reached puberty, she had very little information about how to manage her menstruation, and she began to lose her confidence. During those days each month she did not venture out from her house, and she avoided going to school.

But in Anshu’s village, a program, implemented by PATH and called Projecting Health, uses an innovative methodology to involve the local Accredited Social Health Activists (ASHAs) in educating both women and girls about a variety of health topics. The ASHAs facilitate community-based learning using a participatory process to create simple, locally made videos and share them in local sessions using low-cost projectors.

At one of the adolescent girls’ meetings, the local ASHA screened a video on menstrual hygiene and the use of sanitary napkins. This video featured familiar settings because it had been produced in the same district, in the nearby village of Khiro, using local girls and real ASHAs as the onscreen actors.

After watching the video, Anshu understood that many improvised solutions to manage menstruation were not hygienic and she had many questions. From the video she learned that using a cloth during menstrual cycle would not be hygienic if it was not washed and dried properly. While discussing the issue with her friends, she learned they also had many questions.

Learn about PATH’s work in menstrual health at ShesJustGettingStarted.org

That was when the ASHA introduced them to sanitary napkins and explained how to use them. Initially, Anshu was not sure of the sanitary pads, saying they were “very thin.” Anshu thought a pad would not stop her clothes from getting stained. Out of curiosity though, Anshu took the pads and used them. Soon, she shared her new experience with her friends and encouraged them to use sanitary pads as well. Anshu’s confidence in her school routine was quickly restored.

Saroj, the ASHA of Anshu’s village, said that before the video it was very difficult to convince the parents and their adolescent girls to use sanitary napkins. After seeing the Projecting Health video the girls themselves came to her demanding napkins. Now, many of the girls feel that the pads are much more comfortable compared to using cloth.

Indian woman handing a teenaged girl a package of sanitary pads.

Local ASHAs sell low-cost sanitary napkins in the community, making them available to girls who need them while earning a very small commission that motivates them to provide the service. Photo: PATH.

Using customized educational videos developed and produced by local communities to effectively improve health knowledge and behaviors, PATH successfully integrated the Projecting Health model into an existing community program in India through local nonprofit partners Gramin Vikas Sansthan and Nehru Yuva Sangathan Tisi. There was a real demand from the girls and community for this information and the video format.

And the ASHAs make sanitary napkins available at below-market cost directly to the village girls, earning 1 rupee for each packet sold. ASHA Sanoj explained, “Even if I do not get this amount in future, I will still continue to help girls in my community.”

Like Anshu, 14-year-old Alka’s mother initially told her to use cloth. The cloth was both difficult and very uncomfortable for Alka, and she was always worried about leakage. She did not like to go out of the house or to school during her periods. She was also not able to sleep and was afraid of stains and the ensuing embarrassment. All this stress left her feeling very irritated most of the time.

After watching the video on menstrual health and hygiene, Alka learned a lot of things. “I suffered for a year because I did not know the proper method of disposing of the napkins. Now I have learned the importance of using proper sanitary napkins and how to dispose of them,” she says. She adds that once she started using the napkins during her periods, she felt very relieved and was comfortable and confident to go out of the house. She was not afraid of stains and therefore enjoyed her daily activities and stayed happy all through the day.

Says Anil Mishra, field manager for the Projecting Health Project, “The menstrual hygiene video is still being shown in the community among adolescent girls. These videos have become very popular among the adolescent girls in our implementation areas. We get regular requests from the girls, their mothers, ASHAs, and AWWs [Anganwadi health workers] for repeated screenings as and when required.”

“ Having girls see menstruation normalized in the Projecting Health videos takes this topic out of the shadows and brings it into the open where girls can ask questions and get informed answers. ”
— Nancy Muller

The community health workers feel that these videos have made their job easy in order to orient the adolescent girls along with their mothers on the issue of menstrual hygiene. The screening of these videos has increased the demand for the sanitary napkins from adolescent girls, too.

Nancy Muller, who leads PATH’s global work on menstrual health says, “Having girls see menstruation normalized in the Projecting Health videos takes this topic out of the shadows and brings it into the open where girls can ask questions and get informed answers. The added power of having the video ‘stars’ be community members who look and sound like the girls themselves allows for girls to immediately relate, as if talking to a friend. It’s another way of recognizing menstruation as a very normal subject.”

As Anshu says, “Those few days used to be the most dreaded. Now it is a new beginning. The videos helped me handle my periods in a hygienic way.” A happy, confident young woman now helps and encourages other girls in participating projecting health project activities.

Watch the full video used locally in the Projecting Health project: