Insights EDITORIAL ANALYSIS : Meeting family planning goals

Source: The Hindu

• Prelims: Current events of national importance(Different social service Schemes, NFHS, Rights of persons with disabilities act.,2016)
• Mains GS Paper I & II: Social empowerment, development and management of social sectors/services related to Health, menstrual health etc.

ARTICLE HIGHLIGHTS

• A significant progress has been made in India by government and nongovernmental actors with regard to menstrual health and hygiene management (MHHM).
• Increased Awareness about MHHM, enhanced access to female friendly/gender appropriate sanitation facilities and availability of menstrual products, in particular sanitary pads, are some of the visible outcomes of this progress.
• However, certain groups have been overlooked thus far, including girls and women with disabilities, who face an exceptional burden on account of the intersections between gender and disability.

INSIGHTS ON THE ISSUE

Context

Menstrual health:

• Menstruation is a natural and healthy biological process for women, in spite of this, it is still considered a taboo in Indian society.
• Menstrual hygiene continues to be amongst the most challenging developmental issues that women face today, especially in the developing countries like India, the mindsets, customs and institutional biases prevent women from getting the menstrual health care they need.
• The cultural and social influences on people create a major hurdle in ensuring that the adolescent girls are educated about menstrual hygiene.

Reasons for taboo in the society and lack of menstrual hygiene:

• Menstruation being associated with the onset of puberty in girls and many times, it brings with it rules, restrictions, isolation and changed expectations from the girls by society.
• Women are prohibited from participating in day-to-day activities during menstruation. For example prohibiting women from entering the kitchen or a temple.
• Prevalence of hegemonic Patriarchy in Indian society perpetuates the restrictions, which are often reflected in some religious texts or in the restriction on entry of women from the menstruating age group in the religious places like Sabarimala temple.
• Patriarchy normalises the discrimination against women and not only men, even women become the agents to impose the notion of subjugation on other women.
• The main reasons for this taboo still being relevant in the Indian society are the high rate of illiteracy especially in girls, poverty and lack of awareness about menstrual health and hygiene.
• This places the girl at increased risk for infection and has critical health implications and most vulnerable being girls with disabilities.

Women with disabilities:

• Many women in general and those with disabilities in particular have to face poverty, poor health conditions, little or no income, lower education levels and isolation.
• With resources being scarce, women usually get the short end of the stick, more so if they suffer from some form of disability.
• Issues faced during Pandemic times:

1. Access to essential items: Women with locomotor disabilities were not able to visit stores to access food and the virus acted as an impediment to getting delivery of essential services.
2. Access to sanitary pads: Women in general faced problems with reference to access to purchase of sanitary pads, disabled women faced the most.
3. Access to Arogya Setu App: Many with sight disabilities were not able to access the Aarogya Setu app as it does not factor in their requirements.
4. Access to Digital Payments: Many payment apps are not accessible to the visually challenged and many online courses too are not tailored to their needs.
5. Access to Support: Social distancing and fear of the virus has led to many of them losing whatever little physical support they had in the form of attendants. The pandemic has also curtailed the possibilities of many disabled women being able to get physical and psychological support.
6. Vulnerable to Abuse: Trapped at home, they are also vulnerable to abuse and face barriers in being able to register a complaint with the police or bring this to the notice of a civil society organization.

Right of Persons with Disabilities Act 2016:

• Disability has been defined on the basis of evolving and dynamic concepts.
• The types of disabilities have been increased from 7 to 21.
• The act added mental illness, autism, spectrum disorder, cerebral palsy, muscular dystrophy, chronic neurological conditions, speech and language disability, thalassemia, hemophilia, sickle cell disease, multiple disabilities including deaf blindness, acid attack victims and Parkinson’s disease.
• Government has been authorized to notify any other category of specified disability.
• It increases the quantum of reservation for people suffering from disabilities from 3% to 4% in government jobs and from 3% to 5% in higher education institutes.
• Every child with benchmark disability between the age group of 6 and 18 years shall have the right to free education.
• Government funded educational institutions as well as the government recognized institutions will have to provide inclusive education.
• The Chief Commissioner for Persons with Disabilities and the State Commissioners will act as regulatory bodies and Grievance Redressal agencies, monitoring implementation of the Act.
• Separate National and State Fund created to provide financial support to the persons with disabilities.
• Women and children are particularly vulnerable, and certain rights, such as reproductive rights,may be even more neglected or disregarded as compared to others.

Solutions:

• Accessible and adapted Information, education and communication on menstrual health and hygiene for persons with disability based on their differential needs and capacities, and an enabling socio cultural environment.
• For example, while the core messages related to menstruation and menstrual hygiene are the same for all, Tactile models accompanied by audio explanations can help people with visual impairment, whereas the same models accompanied by materials with clear step by step visuals are useful for people with hearing impairments.
• Appropriate and safe menstrual products and hygiene promotion. Fewer than two thirds of girls and women with disabilities aged between 15 to 24 years use hygienic menstrual protection methods (National FamilyHealth Survey 2019-20).
• Persons with intellectual impairments are highly sensitive to materials and may require those that are soft to touch and cause less irritation.
• Persons with mobility restrictions require products that can be worn for longer as changing them frequently poses a challenge.
• Responsive and inclusive water, sanitation and hygiene (WASH) facilities, including disposal solutions in different settings.
• Caregivers, both from within the family and institutions are vital for disability focused interventions and must be included as both participants and partners.

WASH Strategy:

• The WHO vision for WASH is to substantially improve health through the safe management of the water, sanitation and hygiene services in all settings.
• Principles:

1. Prioritize actions with the highest public health benefit in areas where WHO has or can build comparative advantages.
2. Strengthen health sector capacities in promoting safe WASH and taking up its public health oversight role in WASH, including effective outbreak response systems.
3. Align with the SDGs, specifically targets relating to WASH, health, climate change and nutrition, as well as human rights principles.
4. Employ the highest quality science including through collection, review and use of evidence about WASH impacts on health and a full range of practical experiences when developing norms and good practice procedures.
5. Promote a contextual, incremental improvement approach when supporting countries to set national WASH standards and ambitious but achievable national targets.
6. Capitalize on existing regional policy frameworks that promote WASH and stipulate national target setting.
7. Stimulate sustainable change by strengthening government institutions and systems charged with implementation, oversight and regulation of WASH service delivery.
8. Engage with partners and positively influence partnerships to ensure health issues are considered and addressed by the WASH sector and to also ensure that WASH issues, notably in health care facilities.

Sustainable Development Goals:

• The United Nations (UN) launched the 2030 Agenda for Sustainable Development.
• There are 17 goals and 169 specific targets to be achieved by 2030.
• SDGs are not legally binding.

Way Forward

• Leveraging grassroots system: Government could use its robust grassroots systems with its health workers to create awareness in families about the need to not compromise on health and education for women with disabilities.
• A one-size-fits-all approach is unhelpful for disabled persons. There needs to be a shift from a charity-based approach to a rights-based approach.
• Representation of persons with disabilities in all ministries, commissions and committees to advise and ensure inclusion in all policies, programmes and development.
• Guidelines for Gender Issues in Sanitation (2017) have been evolved by the Ministry of Drinking Water and Sanitation(MDWS) to ensure gender equality and empowerment of women and girls with respect to sanitation.
• There is a need to incorporate a disability inclusive approach within the menstrual health and hygiene work in the country and to implement specific disability focused interventions to facilitate inclusion.

QUESTION FOR PRACTICE

There is a need to incorporate a disability inclusive approach within menstrual health and hygiene. In the light of this statement, discuss the issues faced by women with disabilities and give solutions. (200 WORDS, 10 MARKS)