Skip to main content

Covid impact on menstrual cycles? Young girls 'relapsing' back to unhygienic old-cloth rags

By Dr Sudeshna Roy* 

Covid-19 pandemic has gripped the world in health and economic shock. Combating this public health crisis has diverted development resources earmarked for adolescents and the youth. India; having world’s second largest population; 1.38 crores as per UN mid-year 2020 estimation, also shelters the largest adolescents and young adult population, which at 243 million constitute 20% of the world’s 1.2 billion adolescent population.
Adolescence is the critical juncture in an individual’s lifespan; marking the transition from childhood to youth conspicuous by physical-psychological changes. It is imperative to delve into the health challenges emerging in the post-Covid-19 world that are affecting this population cohort; which the slated demographic dividend that is envisaged to be realized till year 2055 would tend to implicate. With the debate on Uttar Pradesh Population Control Bill, 2021 simmering, the adolescent girls are suspected to be further marginalized.
The enormity of the physical health needs gaps can be gauged from that Covid-19 led economic shutdown has resulted in accelerated unemployment rates, unbridled pay-cuts and poverty which has severely compromised the dietary and sexual and reproductive health (SRH) needs of the adolescent girls. The unemployment rate in India in 2017-18 was a 45 year high at 6.1%, while in March 2020, it rose to 8.8%.

Sexual and reproductive health (SRH) and nutrition

One of the most neglected facets of public health is the SRH needs among the adolescents in India. Discussion on sexuality and gender identity, bodily changes, menstruation and protected sexual relationship are tabooed subject in Indian society.
There lies a wide gap in the demand for information on these stigmatized discourses and how they are addressed among the adolescents. Furthermore, drop-out and from school consequently also results in inaccessibility to mid-day meals, sanitary napkin distribution and iron and folic acid consumption thus hampering uptake of nutrition and menstrual health needs.
Anemia, malnourishment, underweight and stunting is schools in Delhi-NCR catering to economically weaker section (EWS) children dispense sanitary napkins for free every month, which has seen a setback since the first-wave lockdown. It is a big tradeoff for poor households between buying napkins against food.
With drastic reduction in household income coupled with production shortages and delays in supply logistics of menstrual hygiene products due to lockdown and containment zonation it is feared that young girls have relapsed back using unhygienic old-cloth, saw-dust/ash, rags, leaves, during monthly menstrual cycles; severely putting their reproductive health at high risk; given that anemia, cervical cancer, reproductive tract infections are associated with poor menstrual health management (MHM).
About 71% of adolescent Indian girls are unaware about menstruation until they start bleeding themselves. There is an utter lack of preparedness even on the part of parents who avoid conversations on such topics, culminating into panic and anxiety among the young children. Moreover, spurt in child marriages will have severe health repercussions on adolescents and young girls as they are victims to forced early multiple pregnancies, intimate partner violence (IPV) and premature maternal deaths.
NFHS-4 (2018) estimates reveal that teenage pregnancy situation in India is quiet distressing; 1 in 3 adolescents who are married off become mothers before becoming adults. Almost 27% of these girls have babies by age 17 and 31% by age 18 years; with Goa (64%), Mizoram (61%) and Meghalaya (53%) being the states with highest rates.
Covid-19 has exposed the dearth of healthcare services pertaining to antenatal care (ANC), abortion and family planning among the young married and unmarried people. Regular ANC checkups and in-person consultations being scrapped, have adversely affected the young uninitiated pregnant women.
According to the directives by Adolescent Health Program of India, provision of counselors is mandatory at district and sub-district levels but tighter monitoring and evaluation is required to see how they have coped up during this pandemic. A study from Foundation for Reproductive Health Services (FRHS) reveals that, 2.95 million unintended pregnancies and 1.04 million unsafe abortions could have happened due to lockdown in India.

Mental health

Estimated, 9.8 million adolescents in age-group (13–17) years suffer from serious mental illness, damaging self-esteem and peer relationships, impairing learning, thus reducing their quality of life. Further the problems of poly-cystic ovary syndrome (PCOD) and other hormonal imbalances during teen years are not been addressed with adequate medical care. Studies have substantiated the inter-linkages between mental health issues such as erratic mood swings, restlessness, impulsive disorders and anxiety with hormonal changes.
Adolescent population has higher likelihood of being mired by incidences of eating disorders, body shaming, obesity which they are finding it increasingly difficult to cope up with post-Covid-19. Lack of outdoor sports and exercises, no physical contact with friends, long hours in front of digital screens, confinement and isolation at homes has disturbed sleep schedules and routine living which is bound to impact the health regimes of the adolescent population.
One of the most neglected facets of public health is sexual and reproductive needs of adolescent girls, a tabooed subject in Indian society
According to a report, isolation, lack of interaction, non-connectivity with peers and deprivation in emotional health needs can have long term effects on cognitive development of adolescents. Further the mental illness and mental health issues in India being highly stigmatized and mental healthcare facilities being grossly inadequate and incompetent, aggravates the disease burden of the country.
Many studies have emphasized how family relationship dynamics influence the mental health of adolescents during their growing up years. Thus, participatory approach in positive parenting with trusted and open communication between the parents and children are encouraged especially during the delicate adolescence life course and amidst these uncertain pandemic times. Parents are advised to be present and engage in their wards’ life allowing the latter’s opinion in decision making such as in career choices, family matters.

Domestic violence (DV)

Incidences of DV has witnessed mammoth spike with National Commission of Women (NCW) reporting a 48.2% rise in complaints immediately following first lockdown in 2020. Childline 1098 had also received a flood of complaints (a 50% rise in calls and 30% related to child abuse) from this age group.
But it must be remembered that most adolescent and young adult victims of DV are out of reach from help-seeking owing to inaccessibility, immobility and lack of privacy from their abusers. Intermittent lockdowns have forced vulnerable adolescents to be locked up with their perpetrators and to silently bear the aggression from male household members.
They are blatantly victimized to witness physical abuse to their mothers and women family members. 1 out of 3 women face DV in their lifetime. This will have intense, spiraling and cumulative impact on emotional health of the young adults. Anxiety, fear, stigma and numerous mental health problems will arise from such fragile domestic environment and dysfunctions in familial relationship.
The impact of violence perpetuates throughout the adolescent and adult life by submitting to, normalizing and internalizing the acts. Rates of suicide and self-harm among adolescents in India are thus one of the highest in the world is feared to accentuate.

Policy reforms

Frontline stakeholders (health workers, teachers, activists, institutional functionaries) require to upgrade capacity to tackle issues of MHM, psycho-emotional health and continuation of schooling at community level. Accessibility to robust tele-counseling services and dispersal of educational and healthcare toolkits is essential as pandemic trauma incidences are bound to exacerbate among the adolescents.
Strengthening of WASH and nutrition initiatives, regularizing social auditing of child protection and safeguarding schemes, augmenting governmental departments and NGOs accountability and mobilization of adolescents for participation in interactive peer-led collectives across India as stakeholders and not beneficiaries only, especially among the tribal, religious minorities must be made underway.
---
* Ph.D from JNU, independent researcher, and writes on gender, health, livelihoods and marginalized people

Comments

bernard kohn said…
an excellent but "sad" testimony of a crucial problem where again, women are on the "wrong" side of the necessary respect that they deserve..
lamentable!!!!!

bernard kohn

TRENDING

Tracing roots of Hindutva Zionism: cannon fodder for 'warped' nationalist pretensions

By Shamsul Islam*  Those who believe in a world free of hegemonic ethno-nationalism, racism, religious bigotry and hatred have rightly taken note of Zionism and its ally Christian Zionism, major perpetrators of ethnic cleansing of ‘Others’. However, the civilized world with its core belief in multi-culturalism and peaceful co-existence is oblivious to a no less dangerous threat to the present human civilization: the Hindutva Zionism. As the term reads it is part of the Hindutva world-view which stands for an exclusive Hindu India minus Muslims and Christians. The other religions like Sikhism, Buddhism, and Jainism will have no independent status but treated as part of Hinduism. The Rashtriya Swayamsevak Sangh (RSS; National Volunteer Organization) is the most prominent flag-bearer of the Hindutva politics whose cadres presently rule India, the largest democracy in the world. RSS was founded by Keshav Baliram Hedgewar (1889-1940) in 1925 who was disillusioned with the Indian freedom st

Regional parties, anti-Congress progressives, civil society groups 'joining' Bharat Jodo

By Harshavardhan Purandare, Sandeep Pandey*  The Congress party declared Bharat Chhodo (Quit India) movement against the British regime in 1942. The Congress party has now launched a movement Bharat Jodo (Connecting and Uniting India) against the Modi regime in 2022. Indian people have had a journey of 80 years since Mahatma Gandhi gave that Quit India call to the British and we have to agree that we stand most divided in our modern history when Rahul Gandhi is giving this Bharat Jodo call to the nation. And back then, Congress was a thriving idealistic political movement against the British rulers and now it is an ever weakening political organization electorally defeated several times. However, it is India at stake, not just the Congress party. That is why so many regional political parties, civil society organizations, traditional anti-Congress progressive forces like socialists and communists, intellectuals and civil servants have declared their support and are proactively partici

Shocking? No Covid vaccine trials conducted on pregnant, lactating women: RTI reply

By Rosamma Thomas*  A Right to Information applicant who sought details of safety trials conducted in India on pregnant and lactating women for three Covid vaccines in use in India – Covishield, Covaxin and ZyCov-D -- was shocked to learn from the Central Drugs Standard Control Organization (CDSCO) that Serum Institute, manufacturer of Covishield, and Cadila Healthcare, manufacturer of the ZyCov-D vaccine, had not sought permission for such trials.  Bharat Biotech, manufacturer of Covaxin, had sought permission for trial on pregnant women and later withdrawn its application. This response , provided after the applicant was initially unsatisfied with the response and went in appeal, is from the joint drugs controller, CDSCO. It was dated September 13, 2022. One researcher closely following the vaccine rollout, however, is of the opinion that the lack of a trial on pregnant and lactating women is a blessing; potential trial participants and their unborn babies thus escaped harm. Aruna Ro

'Blatant violation' of law by Central government in making NREGA payments

By Our Representative  In September third week, NREGA workers across the country were mobilised for two day so raise their issues and submit a memorandum to the Prime Minister. Organised the NREGA Sangharsh Morcha (NSM), a collective of groups that work with NREGA labourers across the country, workers from 13 states -- Andhra Pradesh, Bihar, Chhattisgarh, Gujarat, Haryana, Jharkhand, Karnataka, Madhya Pradesh, Odisha, Rajasthan, Telangana, Uttar Pradesh and West Bengal -- carried out Kaam Do Abhiyaan, staging demonstrations and rallies against what they called blatant violation of law by the Central government in making NREGA payments. While NREGA has had very positive impacts, it has lately become fruitless, exploiting labour, even though workers who have put in honest hard work have to wait for their wages endlessly, it was suggested.  In such a situation, there is a need to firm up NREGA implementation and end systematic corruption to ensure that workers get their basic NREGA entit

Grave error? Scholar blames ex-Gujarat babu for anti-Christian riots 'citing fake report'

By Rajiv Shah  A few days back, I received a message from one of the finest former Gujarat government bureaucrats, PG Ramrakhiani, a 1964 batch IAS official, who retired in November 2000. I would often interact with him in 1997-99, even later, after I was sent to Gandhinagar as a Times of India man to cover Sachivalaya. Those were turbulent times. Shankarsinh Vaghela was the Gujarat chief minister, under attack from two sides – from the BJP, which he had left to form a separate breakaway party, Rashtriya Janata Party (RJP), one one hand, and the Congress, which was supporting him from outside, on the other. Ramrakhiani, in his message, referred to the book authored by Ghanshyam Shah and Jan Breman, both top-notch scholars who have known Gujarat in and out. Called “Gujarat, Cradle and Harbinger of Identity Politics: India’s Injurious Frame of Communalism”, I reviewed the book in January 2022.  It claims that Muslims in Gujarat have been turned into “new untouchables”, thanks to the Hin

Rajasthan cops 'halt' Gujarat Dalit women's rally: homage to untouchability victim boy

By Our Representative  In a surprise move, the Rajasthan police stopped a Dalit women's rally from Gujarat on the borders after it crossed Gujarat alleging that it would "disturb peace" in village Surana, Jalore district, where the gruesome incident of death of a Dalit boy took place on August 13 after he was brutally beaten up by his teacher on touching the drinking water pot. Sources said, while the Gujarat government had "no objection" in allowing the rally, which originated from the Dalit Shakti Kendra (DSK), an empowerment-cut-technical institute for teens founded by human rights leader Martin Macwan, on September 24 morning, the Rajasthan police stopped it for two and a half hours before allowing it to proceed to Surana. The decision to take out a women's rally was taken at a DSK meeting on September 5 following a condolence meeting of the NGO Navsarjan Trust, also founded by Macwan, activists committed to work against caste-based discrimination, orga

Excess to cheetah in Kuno to increase 'woes' of local people, 'disturb' wildlife balance

Bharat Dogra*  The release of eight cheetahs into the Kuno National Park ( Madhya Pradesh) by Prime Minister Narendra Modi on September 17, although accompanied by a media blitz, has raised several questions. The animals were flown from Namibia to Gwalior and from there they were taken to the release site in a helicopter. Official sources have stated that this is the first time a large carnivorous species has been moved across continents for establishing a new population. This first release will be followed by others under this project. However, precisely for this reason, it is important to be cautious because if such translocations have been generally avoided in the past, there may have been reasons for this and at the same time we do not have much learning experiences from the past. The Cheetah became extinct in India in 1952, although this very fast moving animal is still remembered in the folklore of many areas. Hence the first impulse is to say that trying to introduce and revive

Introducing non-native cheetahs is 'not equivalent' to restoring pride in the nation

By Bappaditya Mukhopadhyay*  The Cheetahs from the African continent has finally been introduced to India by the Indian Prime Minister on his 72nd birthday. The process had started with the previous Government in 2009. However, the Supreme Court clearance was pending owing to the objection by the National Tiger Conservation Authority (NTCA) plea to reintroduce cheetahs. Finally the clearance was obtained in January 2020 and thereafter Kuno National Park (KNP) was chosen for the reintroduction of first set of Southeast African Cheetahs. In the near future, depending upon the success story of the current reintroduction, more cheetahs from South Africa may also be introduced. This exercise has generated a lot of interest among various stakeholders with opinions on both sides galore. It is important to pose some questions that surround the whole exercise. Let us evaluate some of these arguments. The first set of arguments are quite detached from the issues of conservation as they most

'Military diplomacy': US praises Bangladesh Army for leadership role in UN operations

By Kamal Uddin Mazumder* As the Indo-Pacific region represents the world’s economic and strategic center of gravity, the Indian Ocean today is becoming the centerpiece of all geo-strategic play. Cooperation in the region is crucial to implementing the international community’s global agenda, including achieving the UN’s Sustainable Development Goals. Major powers like the US have enhanced and deepened their strategic engagement and leadership roles with countries in the region. The Indo-Pacific Army Management Seminar, or IPAMS, is a U.S. Army Pacific (USARPAC) initiated conference that is aimed at facilitating and enhancing interactions among the armies of the Indo-Pacific region. This year's 46th Indo-Pacific Armies Management Seminar (IPAMS)-2022, co-hosted by the Bangladesh Army and US Army Pacific (USARPAC), concluded in Dhaka. The objective of IPAMS is to promote peace and stability in the region through mutual understanding, dialogue, and friendship. It is the largest confer

Buddhist shrines were 'massively destroyed' by Brahmanical rulers: Historian DN Jha

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".