The conversation on menstrual leave

This article is authored by Indira Behara, vice president, Global Health Strategies and public health specialist, New Delhi.

Whichever side one may be on regarding the debate on the need for menstrual leave, the somewhat sensational headlines we saw today is a wonderful sign that we are talking about this issue more openly than ever before.

Menstruation(Twitter/Panacea_Eva)

Over the past few days, there have been a couple of discussions in our Parliament on the need for menstrual leaves and whether or not there will be any kind of policy mandating this; at the moment, there doesn’t seem to be such a regulation on the cards. But, what we do know is that the ministry of health and family welfare (MoHFW) has recently released a draft Menstrual Hygiene Policy 2023; it makes some strong suggestions on a well-rounded approach to menstrual health, recommending the integration of menstrual hygiene-focused information and principles in to existing health and related programmes, promoting cross-sectoral collaboration and safe spaces for girls and women at educational institutions and workplaces to support their menstrual needs. It also suggests that workplaces and educational institutions should look at how to extend flexibility to women workers and women or girl students during menstruation, so that they can deal with their health needs during this time, emphasising “such arrangements should be available to all, to prevent perpetuating stigmas or assumptions about productivity based on menstrual cycles.”

Recently the ministry of personnel and the related Parliamentary Standing Committee on Personnel, Public Grievances, Law and Justice have also been discussing menstrual health and exploring ways to address women’s needs while ensuring equality.

But before we get to the part about leave, it is worth looking at the importance of focusing on the broader topic of menstrual health and hygiene. Numerous studies have presented the relationship between absenteeism amongst schoolgirls due to challenges related to their menstrual cycles. Menstrual symptoms, encompassing issues like cramps, fatigue, and general discomfort, have been identified as significant contributors to a notable loss of productivity, amounting to almost nine days of a woman’s work life in a year.

So, beyond the popular home remedies that many women and girls were proffered from hot water bottles to ibuprofen, what do we need to do to ensure that we address menstrual health and hygiene comprehensively; so that girls stay in school and women can be their most productive?

A great starting point would be building awareness and educating girls and boys, through schools, through community health workers or providers (formal and informal), about menstruation, what menstrual health and hygienic practices entail, and where to access stigma-free care (including providing easy to access menstrual health products at school).

Ensuring access to care (and actively promoting it) for the lifecycle of women’s menstrual health - from menarche to menopause is just as important. While the public health system across the country has started to make low-cost sanitary pads available, it is extremely important that as a society we focus on speeding up access to and utilisation of affordable but high-quality menstrual hygiene products across both urban and rural markets (at some point, we have to talk about environmentally-friendly solutions, but that’s a conversation for another day). Medication and formal care to address dysmenorrhea and menorrhagia (i.e. extremely painful periods or excessive bleeding) must be made far more widely available than they are; later in every woman’s life, menopause (definitely needs an article of its own) which presents as a spectrum of issues and finds very little time and space in the public health narrative, needs much more attention.

Social stigma, myths and misconceptions around menstruation continue to be one of the many social barriers that girls and women face to equality and advancement. We must work with community leaders and social influencers to actively, even if slowly but steadily, destigmatise menstruation, and so that women of all age groups and men are able to accept it as a normal physiological function, which every month can be a painful inconvenience to some of us.

I think the MoHFW’s policy is hitting some of the right notes. We do live in a world where in order to level the playing field, we need mechanisms that provide a leg-up to those who face barriers to their ability to flourish and thrive. Female and male bodies are different, and 12 additional days in a year of leave (with no labels) may provide a small boost. Educational institutions face no cost to acknowledging that difference amongst their students – arguably employers do. Could we consider incentivising, instead of mandating employers, to extend some minor additional benefits or flexibilities to menstruating women so that we are being inclusive without impeding economic opportunities for women?

At the end of the day, the menstrual cycle whether it starts or it ends, impacts most women. Whatever one’s take on the matter – at least we are seeing this conversation front and centre in the public narrative. For me, that’s a step forward. Period.

This article is authored by Indira Behara, vice president, Global Health Strategies and public health specialist, New Delhi.