Navigating through menstrual health experiences of educated urban individuals who menstruate during the COVID-19 lockdown: a study from India.

Literature on the challenges faced by those who menstruate to maintain menstrual health and hygiene during a crisis like COVID-19 is still developing. To address this gap, we conducted an online survey to understand the experiences of those who menstruate during India's COVID-19 national lockdown in 2020. We conducted a secondary analysis of qualitative data from a sub-sample of the 683 Indians who menstruate aged 18 to 49 years. The survey utilised one open-ended survey question. Data analysis was conducted using thematic analysis. Over 140 individuals aged 18 to 49 were included in the analysis. The survey findings point to six themes: (a) poor menstrual health; (b) limited access to sanitary items and water, and sanitation and hygiene facilities; (c) high price of sanitary items; (d) continuing stigma surrounding menstruation; (e) lack of alternatives to sanitary items; (f) poor availability of time to rest, think and adjust. Based on the findings, we propose that government and policymakers should aim to (a) conduct workshops for those who menstruate to teach them best practices for managing their menstrual health and bring conversations around these issues to the fore; (b) improve water, sanitation and hygiene facilities; and (c) strengthen distribution mechanisms for the sanitary items via government schemes.

Unlocking the Role of Social Norms: How They Shape Women's Public Toilet Usage in India.

Poor access to toilets has significant impacts on hygiene, health, safety, and well-being. Women in resource-poor areas may not use public toilets because of concerns about personal safety and the disapproval of others. This study examines social beliefs about women's use of public toilets in India, using data from 5,052 households in rural, semi-urban, and urban slum areas of Bihar and Tamil Nadu in 2018. We asked respondents about their beliefs regarding the prevalence of young women aged 16 to 30 years using public toilets alone and whether this behavior was approved of in their community. We also asked about their personal beliefs on this issue. We used hypothetical vignettes to assess perceptions of a young woman's behavior in different settings regarding public toilet usage by women. Our results show that people who believe many women in their community use public toilets alone and approve of it are more likely to have positive beliefs about this behavior. The experimental vignettes suggest a potential causal link between the prevalence and approval of public toilet usage among young women and their likelihood of using it. These findings are consistent across Bihar and Tamil Nadu and the three administrative regions, indicating that interventions aimed at changing social expectations about women's use of public toilets should focus on highlighting community members' usage and approval. Efforts to encourage woman's access to public toilets and services should target shifting beliefs about public toilet usage among women without disapproval from others.

What socio-demographic factors support disposable vs. sustainable menstrual choices? Evidence from India's National Family Health Survey-5.

For over a decade, improving menstrual hygiene among poor girls and women in low-and-middle-income-countries has been a prominent global goal. Towards this, governments in the Global South have worked to promote the uptake of disposable sanitary pads. Despite this, we continue to see a high prevalence of period poverty mainly because disposable pads require monthly purchasing that may be burdensome for many women. Not only are pads financially unsustainable but also represent a heavy environmental burden which has kindled an interest in re-usable innovations like menstrual cups that present a sustainable solution. However, there is little understanding of factors that promote the take-up of disposable vs. sustainable products at population levels. In this paper, we draw on India's National Family Health Survey-5 to understand the socio-demographic determinants of period product usage among girls and women, differentiated by their sustainability quotient. Our findings suggest that awareness of sustainable products and cultural factors are the key driver to promote their use. Women with exposure to menstrual cups either via education or mass media were more likely to use them. Belonging to urban areas and to disadvantaged social categories are other driving factors, at least partly because taboos of vaginal insertion are less of a concern among these groups. These findings suggest that improving the uptake of menstrual cups requires a paradigm shift in menstrual health policies from the promotion of disposable pads alone to spreading awareness of sustainable period choices among women via innovative use of mass media and community networks. Some micro-level evidence of change supports our conclusions.

How COVID-19 lockdown has impacted the sanitary pads distribution among adolescent girls and women in India.

This paper empirically explores the impact of COVID-19 pandemic and its accompanying lockdown on adolescent girls' and women's access to sanitary pads in India. We have used the National Health Mission's Health Management Information System (NHM-HMIS) data for the study, which provides data on pads' distribution on a district level. The empirical strategy used in the study exploits the variation of districts into red, orange, and green zones as announced by the Indian Government. To understand how lockdown severity impacts access to sanitary pads, we used a difference-in-difference (DID) empirical strategy to study sanitary pads' access in red and orange zones compared to green zones. We find clear evidence of the impact of lockdown intensity on the provision of sanitary pads, with districts with the strictest lockdown restrictions suffering the most. Our study highlights how sanitary pads distribution was overlooked during the pandemic, leaving girls and women vulnerable to managing their menstrual needs. Thus, there is a requirement for strong policy to focus on the need to keep sanitary pads as part of the essential goods to ensure the needs of the girls and women are met even in the midst of a pandemic, central to an inclusive response.

Empowered but abused? A moderated mediation analysis to explore the relationship between wife's relative resources, relational empowerment and physical abuse.

There is a growing body of literature focusing on the direct relationship between women's relative resources (WRR) and intimate partner violence (IPV). However, the underlying mechanism remains largely unexplored. Grounded in the popular sociological theories, Relative Resource Theory (RRT) and Gendered Resource Theory (GRT), this study addresses the research gap by proposing a moderated-mediation model to i) understand the process through which WRR influences the relational empowerment and violence victimization, and, ii) explain the role of husband's patriarchal attitude in the proposed linkages. We posit that the relationship between WRR and IPV is mediated by relational empowerment, and husband's patriarchal attitude moderates the relationship between relational empowerment and physical abuse. The proposed model is tested in the Indian context using secondary data collected from 47,514 married couples. As our variables of interest were latent constructs, we first used factor analysis in AMOS v.22. Then, using the Structural Equation Modelling (SEM) technique, the proposed model is tested in SPSS v.22 using the bootstrap Confidence Interval (C.I.) method. In our study sample, about 28% of ever-married women reported experiencing spousal violence in the last 12 months. The study finds that WRR is a significant predictor of relational empowerment (ß = 0.21, p < 0.01), and relational empowerment is negatively associated (ß = -0.06; p < 0.01) with violence victimization, thus supporting mediating role of relational empowerment in WRR-Abuse linkage. The interaction of the husband's patriarchal attitude with relational empowerment significantly predicts violence victimization. Our study results indicate the critical role of socio-cultural norms, rooted in patriarchy, in understanding IPV. The study findings suggest that the potential of women empowerment initiatives against IPV is conditional on men's progressive attitude. The study findings call for acknowledging the complexity of the interaction between patriarchal attitude and IPV on the one hand, and women's position in society, in any attempt at empowerment.