• Subject Name : Nursing

Strategies to Address Tropical Child and Adolescents Health Issues

Introduction to Project Sakhi: Menstrual Health and Hygiene

Menarche is the beginning of menses for adolescent females that indicate the arrival of her journey on the way to motherhood. But is this event praised publically? Not in India. It is considered to be a restriction period consequently a teenaged female is viewed to be unclean and cannot allow touching anything in think of it being tainted. Swati Bedeker through the Foundation named Vatsalya situated in Vadodara decided to change this thought process among the people. Through the process of using cinders to filthy garments, females in villages of India set their fitness at extensive threat throughout the time of the month. Swati Bedeker not only develops the knowledge about using hygienic napkins but also give the means to rural women to make an earning out of it. Additionally, she also involved men in this campaign (Shaikh, 2020).

Generally, the women who can spare the price of sanitary napkins, this stage in their lives does not affect them and their work. But the condition alters for uneducated, poor girls repeatedly surround themselves in justifying the taboos in place of looking after their health and protection from infection. By not practising proper menstrual hygiene this can result in various kind of infections such as fungal infection, white discharge, etc. and affecting the living standard of work-loaded women. By chance, Vatsalya Foundation started its campaign concentrating on menstrual sanitation. In the Panchmahal District in Gujarat, the Foundation was allocated an assignment to guide modules of math and science to develop the level of education among students in 500 government schools. The mentors noticed that girls continuously not present for 5 to 6 days every month. This monitoring led the trainers to ask their guardian about the cause. The main point for absenteeism was the monthly periods (Children in Gujarat, 2020).

On doing in-depth research about maintaining hygiene during the days of menstruation, Bedeker discovers about some shocking coping procedures that girls acquire. She observed that the women or teenage girls would make use of leaf with mud which was bind on all side of their waist. Pieces of Synthetic garments, or any other garment which were not even washed, were used (Phatak, 2020). The other major problem was the disposal of these used pieces of cloth. In turn, the teenage girls or women did suffer from various kind of infections which resulted in the loss of employment, and if anyhow they were able to end up at health care centre then the doctor bills were the second major problem (Bindra, 2020).

Swati assured that Foundation should go into this analytical features and help the females in performing right menstrual sanitation. Just providing knowledge was not going to benefit. The teenage girls or women required to embrace hygienic and secure techniques to manage their monthly period's problem. She looks into the design structured by Arunachalam Muruganantham of Coimbatore. He had established a manufacturing department to produce hygienic napkins that were clean and so far minimum cost, utilising pulp of wood to soak up the flow of menstrual blood. She used the existing Self- help groups of Sakhi to establish an organisation female would manufacture sanitary napkins. This would let the females earn and address the problems that are facing by them. The men were also taking interest as the earning was to be made through this. Although, Vatsalya Foundation concentrated on female and their requirements. The female required an option of employment near their homes in the rural area and it is better than relocate to cities to work at establishment sites (Project Sakhi Saheli, 2020).

The tribal department of government given the initial amount of Rs.3 lakh to establish this organisation. The first organisation was constructed at Chottapalli village in Limkheda part of Panchmahal district, Gujarat. A short time ago, after being influenced by the ice bucket challenge Vatsalya Foundation set up the "Hygiene Bucket Challenge". Organisation housing females be they physically or visually challenged, along with housemaids were the target beneficiary. The challenge was to take up one bucket worth Rs.250 which would offer the recipient with a one year supply of hygienic napkins. To receive huge support from the public the foundation using the social media platform like Facebook hence this strategy help them to gain big support (Project Sakhi Saheli, 2020).

Swati's husband is a textile engineer he also given advised into this matter. He has been active in establishing a creative cost-effective incinerator for the safe dumping of used napkins. Utilising mud and pottery methods, he created a dense, modest incinerator for Rs.1500. The incinerator has worthless for vandals and thieves, therefore, will remain safe. Still from the viewpoint of females and management of waste, this incinerator holds a great value and is easy to use the device (Project Sakhi Saheli, 2020).

Swati has been able to make use of the chance to provide a source of income along with an assurance to provide proper menstrual hygiene management for females in rural areas of India by developing a well-established model for society that can be adopted in any part of the world particularly in India. At present, menses is truly a starting to great things for many females.

The objective of the study is to resolve the issues that affect the on-going practices of menstrual cleanliness among the teenaged girls and to explore the conception, beliefs and resource of knowledge related to menses in between the people of India.

Background of Project Sakhi: Menstrual Health and Hygiene

Much has been supposed related to the sanitary napkins utilisation in rural India. The common insight is that sanitary pads are not accessible or affordable by females of rural areas in India. The research was reported by A.C.Neilsen and validated by Plan India in November 2011, which described that only 11% of Indian female utilise sanitary pads and rest of the females are utilising filthy techniques of managing menses. Although, this research named as "Hygienic Protection: Every Female's Health Right" is not accessible on any public area (Agarwal, 2018).

Teenager female comprises an unsafe group, especially in India where teenager female is a neglected one. Menarche is still considered as being filthy or dirty in the culture of India. However, the menstrual cycle is a natural phenomenon, and it is associated with distinct misunderstanding and practices, which once in a while result in poor health conditions. Females having a good understanding of menstrual cleanliness and practising safe methods are less prone to infections of the reproductive tract and its effects. Females comprise half of the Indian population. Still, gender inequality remains a critical problem in India affecting females' education, health, and employment. Data indicates that females are mostly on sameness with boys up to the age of puberty, but with the onset of adolescence, outcomes for females start to manifold and females face many restrictions to their agency and mobility. In India, there are over 255 million menstruating females, but lots of female all around the country still face notable barriers to a comfortable and distinguished awareness with menstrual hygiene management (2020).

Females do not get proper knowledge of menstruation before the start of monthly periods. After menstruation, training programs begin on the biological features of adolescence, with a little concentration on emotional requirements. Training programs are usual but insubstantial to product utilisation, restrained by a feeble coordinator, and infrequently target influencers. In India, the majority of females utilise homemade items to deal with their menses. Commercial napkins are costly for low-earning buyers, and cheaper cost of napkins vary in quality. Societal practices, regularly maintaining hygiene, and society reactions towards menses restrict females’ utilisation of washrooms, especially during menstruation. Present efforts at a national level to advance the culture of hygiene do not line up menstrual hygiene management or impact applicable society standards. Solutions to dispose of used menstrual products are highly unexposed (Bhagwat and Jijina, 2020).

There are instantaneous chances to support the national strength of India to enhance menstruation health, especially for teenagers. Primary concern comprises of reinforcing coordinator ability to carry out awareness program, advancing the product quality of menstruation, and advancing the targeting influencers. Females’ potential to manage their menses is determined by extensive gender unfairness all over India and can be obstructed by the existence of biased community standards. There may be the chance to support menstrual hygiene management as not much attention is to be given on the issues related to reproductive and sexual health topics, for example, the rights of reproductive health and early age pregnancy precautions, and enhance a female's accreditation at a higher level, but research and proper training are still just a beginning (Das, Mallick, Bharati and Biswas, 2020).


In Vadodara, Vatsalya enhances menstrual hygiene by manufacturing cost-effective, nearby developed incinerators of terracotta, Ashudhhinashak, and cost-effective sanitary pads of Sakhi model is easy to access to females all over the country. The foundation normalizing the process of menstruation by imparting knowledge about the menstrual cycle and its management with the help of providing game kit and an information booklet. The booklet contains information about the Ashuddhinashak incinerator and Sakhi napkins. They provide information about the product choice mainly concentrates on the advertisement of the Sakhi napkins as a hygienic and safe in comparison to other unhygienic products such as sand and old rags. They teach about the safe management of menstrual waste by manufacturing the reinforced cement version of an incinerator of terracotta that facilitates the transportation of the model to other places. They generate employment by providing training to an existing group of self-help females, Sakhi manuals and their families to produce Sakhi napkins. They also provide training to the families of the potter in manufacturing terracotta incinerator (2020).

Incinerator features: Having the maximum capacity to manufacture 20-25 pads; Maximum temperature to burns used pads is 200- 250 degree Celsius; Time taken to dispose of is 30 minutes at minimum capacity; Variety of napkins best suitable to incinerate are Compostable pads and Cellulose pads; At the bottom of the chamber is a mesh on which the sanitary napkins burn, and the ash settles down; Weight of Terracotta is 35 kgs; Unit dimensions Height is 2 ½ feet; Cement used in manufacturing Insulation is 70 kgs; It does not run on solar power or electricity; Emission outlet Chimney controls the incinerator can be lined with lime that gives out to absorb some emissions; Ash residue collects in the base chamber and has to be manually cleaned out; Operation manual cleaning, manual firing needs manual cleaning of ash and any residues left inside the burning chamber (Rani and Reddy, 2019).

Settings for use: Schools Communities Cost Cement: INR 4600; Terracotta: INR 3600.The scale of use: The Ashudhhinashak incinerator and Sakhi pads are available in the mentioned states such as Uttar Pradesh, Telangana, Tamil Nadu, Rajasthan, Punjab, Odisha, Maharashtra, Madhya Pradesh, Kerala, Jharkhand, Himachal Pradesh, Gujarat, Chhattisgarh, Assam across the country (Project Sakhi Saheli, 2020).

Total of 5 manufacturing department is manufacturing 1,00,000 sanitary pads every month. Under the Sakhi brand, these napkins are sold. All packet carries 10 menstrual hygienic napkins and is the cost at Rs.20 on each packet. In terms of the break-up, for each packet sold, Rs.12.50 goes to purchase fresh manufacturing material, Rs.5 is given as hard work whereas Rs.2.50 deposited into the bank as reserves. The female members get payment as per the number of napkins they manufacture (Project Sakhi Saheli, 2020).

Reasons for The Success of The Vatsalya Foundation

The main focus of the Vatsalya Foundation is to encourage the people of rural area of India about practising right menstrual hygiene. With the help of Sakhi Mandal network, the foundation set up the Sakhi strategies to educate and teach female members to manufacture and make use of sanitary napkins. The strategies not only gave the females a source of income but also provide an option to access sanitary pads at low cost. Lots of Iraqi and Syrian females residing in refugee shelter of Jordan have no availability to hygienic napkins, and in place of sanitary napkins, they are using rags. They are set to make the best use from an Indian solution to their difficulty of practices unhygienic menstruation. A non-governmental agency of America named as Loving Humanity works in association with the United Nation in conflict relief zones is looking after to make a replica of a cost-effective model of sanitary pads manufacturing unit of Sakhi organisation, established by Swati Bedekar from Vadodara in Gujarat. Amy Peake, an initiator of Loving Humanity, is intended to replicate the success of the Sakhi model in distinct refugee camps of Jordan, assured that it is the solution she was searching for. Currently, she is in Gujarat get ready to transport equipment's, machinery and basic requirements to framed 12 manufacturing modules, and look forward to initiating manufacture the sanitary pads in the camps soon (2020).


The adolescent girls are dealing with several menstrual-related difficulties such as abdominal pain, polymenorrhoea, menorrhagia, etc. Although, only the limited number of females get proper treatment for the same. These untreated difficulties are also answerable for the loss of schooling days. Most of the teenage girls still practising the unhygienic methods such as making use of cloth for soaking the flow of menstrual blood. They are not aware of an appropriate method of throwing out the sanitary napkins or other material used as absorbent, turns into the wrong process of disposal which may develop various contagious infections among themselves as well as in the group. Huge efforts are required to advances the methods of suitable menstrual hygiene among rural women. This can be attained by providing them with appropriate health education and training with the help of family members, teachers, Anganwadi worker or health worker and media. The findings of the research can be utilised for developing the latest policies, organising programs for enhancing the level of information particularly, for villager's teenage girls.

Literature Review to Support the Argument

The Government of India has started a latest, creative plan for the advertising of menstrual sanitation among teenaged girls in villages of the country. The plan of action is focussed at teenage girls living in the countryside to ensure that good quality sanitary pads are provided to them and they are required to understand about the safe disposal practices to make the environment clean. The major target of the programme is to advance the knowledge among teenage girls on menstrual hygiene and enhance availability to and use of good quality sanitary pads by teenage girls or women in villages. In the latest research, 18% of girls reported irregularity in periods. This generality is greater than the earlier research carried out in India by S. B. Salve et al (4%). Although the latest research is comparable to another review performed in the same state, Gujarat by Dr P. B. Verma et al. Current research illustrated that 43.9% of women had periods associated with stomach pain. Even though in contrast results (9.9%) were investigated by the research carried out by Khyrunnisa Begum and Shabnam Omidvar. Other research performed at West Bengal disclosed generality of abdominal pain during monthly periods as more as 80.8%. For the research comparative study of the age group of 18 to 27 years have been done, while current research comprised the teenage group (Haque et al., 2020). As the medicine to get rid of abdominal pain is easily available in the primary health care centres of rural areas, 68.9% of women were taking medicines during periods for getting rid of the pain during menstruation. Only 14.5% were adapting to home treatment while dealing with the same issue. While menstruation 26.7% of women revealed that they faced difficulty in doing daily activities. In distinct research performed by Khyrunnisa and Shabnam Omidvar, could reported that 78.6% of women had problems conducting daily activities while menstruation. Difficulties faced by the girls during menstruation are the main reason for school absenteeism. 71% of women made use of cloth and 29% were using sanitary pads for soaking the flow of menstrual blood. During menstruation the substances used, extended in various parts of the country. Similar research performed in the West Bengal state of India reported that 8% and 92% of women made use of sanitary pads and cloths respectively throughout the menstruation period. Other research of country Lebanon reported that 100% of the women made use of a sanitary napkin. 94% of women were washing the private parts following periods regularly. Various techniques were utilised by the women for washing the private parts. In the latest research 49% females, who make the use of cloth, had the practice of cleaning the cloth for use it again while 20.6% throw it into the dustbin. Teenage girls used sanitary napkins, 52.7% throw it into dustbin followed by throwing it by burning (26.9%). Research performed in the North region of India reported 70.87% of teenage girls in the research were throw the used napkins in the dustbin along with the disposed of by burning (12.63%). Small selected participants and insufficiency to include students of private school because school management did not agree on this so this can be viewed as a limitation of the present research. Although the research can explain the purpose and report the present widespread Menstrual Sanitation Practices in rural region of Gujarat (Malvika Singh et al., 2019).

Conclusion on Project Sakhi: Menstrual Health and Hygiene

Menstrual hygiene must be advanced by carrying out a course on the management of menstrual hygiene. School teachers must be trained and educated to convey information about the management of menstrual hygiene and menarche among students. Electronic and social media also play an essential role to make the females understand about the brand new menstrual products, various new manufacturers, the latest policies of government etc. On menstrual products, subsidies must be provided so that every female can afford them without any trouble. The non-government agency must come forward to teach people of the rural area about the menstrual cycle, management of menstrual hygiene, hand washing, the importance of toilets at homes, infections linked to the reproductive system because of poor hygiene etc. Female should know the consequences of disposing of used sanitary pads in open space or flushing them in toilets. Litter basket with proper lids must be placed in the washrooms. If possible, incinerators should be placed at schools, educational institute, homes, and society levels. This research reported that lack of privacy is the main problem both in schools and household. Also, misbelief, unsafe practices, unawareness, and lack of knowledge about menstruation in females are the main reason for many problems. So, there is a great requirement to help adolescents at educational levels to carry out safe and hygienic behaviour.

References for Project Sakhi: Menstrual Health and Hygiene

Agarwal, A., 2018. India Moves Towards Menstrual Hygiene: A Key Challenge. Biomedical Journal of Scientific & Technical Research, 8(3).

Unicef.org. 2020. [online] Available at: <https://www.unicef.org/wash/files/UNICEF-Guidance-menstrual-health-hygiene-2019.pdf> [Accessed 3 October 2020].

Bhagwat, A. and Jijina, P., 2020. A Psychosocial Lens On An Indigenous Initiative To Address Menstrual Health And Hygiene In Indian Villages.

Bindra, A., 2020. BARRIERS TO ACCESS MENSTRUAL HYGIENE IN RURAL INDIA. International Journal of Advanced Research, 8(7), pp.657-662.

Unicef.org. 2020. Children In Gujarat. [online] Available at: <https://www.unicef.org/india/where-we-work/gujarat> [Accessed 3 October 2020].

Das, S., Mallick, A., Bharati, P. and Biswas, S., 2020. Effects of menstrual characteristics, symptoms and hygiene-related practices on menstrual experience: A comparative study between freeholder and tenant adolescent schoolgirls of North 24 Parganas, West Bengal, India. Anthropologischer Anzeiger, 77(3), pp.183-193.

Haque, S., Rahman, M., Itsuko, K., Mutahara, M. and Sakisaka, K., 2020. The Effect Of A School-Based Educational Intervention On Menstrual Health: An Intervention Study Among Adolescent Girls In Bangladesh.

Malvika Singh et al.,, M., 2019. Menstrual Hygiene Management in India, A Review and Meta-Analysis. International Journal of Communication and Media Studies, 9(3), pp.1-14.

Phatak, A., 2020. Improving Menstrual Hygiene Management in School Going Adolescent Girls: Experience from Charutar Region of Gujarat, India. Indian Journal of Youth & Adolescent Health, 6(3), pp.13-19.

Facebook.com. 2020. Project Sakhi Saheli. [online] Available at: <https://www.facebook.com/projectsakhisaheli/posts/628671967718801> [Accessed 3 October 2020].

Rani, P. and Reddy, R., 2019. Menstrual Knowledge and Hygiene Management of Adolescent Girls. Current Journal of Applied Science and Technology, pp.1-6.

Shaikh, A., 2020. The Practices and Challenges Faced by Girls / Womens of India Regarding Menstrual Hygiene, Management, and Waste Disposal. SSRN Electronic Journal,.

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