Any talk about menstruation in India is often met with hesitation at best anger at worst. It is considered to be a taboo subject and certainly not something that concerns men. Consequently, young girls are unaware of what to expect and how to deal with it. In fact, over 70% of girls in India had no clue about menstruation until they experienced it for the first time.
This has far-reaching consequences — both for women and society. In 2012, 60% of women suffering from reproductive tract infections had poor menstrual hygiene. When it comes to the use of sanitary products, the situation is no better. In 2015, only 57% of women in India used disposal products, like sanitary napkins.
When schools closed during the pandemic, it blocked conduits of information such as teachers, friends, and health curriculums. However, information was widely available elsewhere — on the Internet. In Kolkata, about 66.4% of 13–18-year-old girls are online and 77% of them access the internet through smartphones and tablets.
Though there is a digital divide in India, girls are beating all odds to come online. Quilt.AI studied the digital footprint of adolescent girls across 100 villages and 33 cities in India and found that about 23% of girls from rural areas and 69% of girls from urban areas are active internet users. They see the internet as a source of information and an alternative space where they can exert their autonomy and express themselves on their own terms.
As schools shut down during the pandemic, organizations like Splash, explored alternate approaches to reaching students with critical menstrual health information. Splash is a social enterprise dedicated to designing child-centered water, sanitation, hygiene, and menstrual health solutions for government schools in Addis Ababa and Kolkata.
During the first wave of the pandemic in India, Splash and Quilt.AI partnered to better understand how digital insights can complement on-ground menstrual health programs and reach girls online. We analyzed 2,945 unique keywords and 1.5 million searches across Kolkata along with social media posts from Facebook, Twitter, and YouTube.
We have three key takeaways for other organizations working in schools or around menstrual health.
- Girls are actively searching for solutions around menstrual health and products
Girls searching for information on menstrual health fall into one of the four categories: looking for general information, menstrual health products, sanitary waste disposal, or finding remedies for period pain. Along their search journey, girls mainly searched in English and are met with mixed results:
- Top sites while searching in English are American or British such as Planned Parenthood, National Health Service, KidsHealth.org, HealthLine, and menstruation product brands (e.g. Always).
- There was a low search volume for keywords in the local languages for menstruation.
- For organizations trying to spread awareness on periods, and reach girls — our recommendation is to use English keywords. That will allow girls to find useful resources when they are looking for them.
Girls also searched for period products with the top keywords being “sanitary napkins,” “tampons,” and “how to use tampons/pads.” They were redirected to Indian e-commerce sites (e.g. FlipKart, IndiaMART). However, information on how to use menstrual products led them to both American (e.g. Planned Parenthood, Always.com) and Indian sites (e.g. Menstrupedia, StayFree India).
Of all the searches, there was a higher volume related to discomfort during periods. Top used keywords like “medicine for period pain” and “how to reduce period pains”, led girls to foreign sites. If a Hindi or Bengali keyword was used, girls were redirected to YouTube videos by local health and wellness channels.
2. Normalizing menstrual health and products through education and campaigns
Menstrual health has increasingly become a much-discussed topic — whether it is about period leave or lack of access to sanitary products during a pandemic.
Girls have taken a step forward in an attempt to break this taboo through openly speaking about it — especially menstrual hygiene products. Of the different types of products, searches for sanitary pads grew the most at 70%. Furthermore, there are more searches regarding how to use products(higher intent exploration), beyond simply searching about / where to get the products.
The study also revealed that there was a yearning for positive change in menstrual health management and seeking a supportive environment. Campaigns such as #reddotchallenge and several Kolkata-based organizations (e.g. Paint It Red, Anahand for Change) focus on removing stigma and provide girls with a safe environment to learn about their bodies. Using bite-sized information, they are able to effectively deliver key messages. Furthermore, during COVID-19, distributing sanitary pads and menstruation have garnered more attention in Kolkata as organizations and activists mobilized for distribution and awareness.
Interestingly, the study also found high interest in disposal/waste management. In fact, searches around reusable sanitary products increased by 93%. Citizens launched signature campaigns to urge the government to institute proper protocols and there was a surge in interest in eco-friendly products such as cups.
3. Discourse on menstrual health is advancing, slowly but surely
On social media, women who post about menstrual health face pushback from men who reinforce menstruation as a taboo. This is manifested through their tone and speech, such as trivializing menstrual health or making lewd comments.
However, findings from the last year show that more male voices are surfacing to support girls in the menstrual health narrative. Their main narrative drives home the point that taboos around menstruation emerge from gender inequality.
What does this mean?
Organizations and policymakers can use these findings to improve their menstrual health initiatives, especially in reaching girls online. Based on the digital insights, some recommendations are:
- Meet girls online with the relevant information they are looking for. This includes creating local and visually rich content to appeal to girls and redirecting them to such information. Furthermore, girls’ interest ranges from accessing and using sanitary products to disposing of them. Creating a safe space online (e.g private Facebook group) with targeted information on these interests will equip girls with resources and action steps
- Leverage the growing number of male allies. In order to move the needle on issues that affect girls, it is essential to engage boys and men. If boys are raising their voices against gender inequality and normalize menstrual health, then they must be roped in as champions for campaigns. Adding their presence and voice will not only create a more supportive environment for girls but also pose as role models for men.
- Layer digital insights with on-ground programs to amplify reach and reinforce messaging. Digital insights from this study can inform Splash’s on-ground MH curriculum to focus on what girls are searching for the most online. It can also be used to micro-target girls in Splash’s intervention areas so when they search for related MH information, they are redirected to the right information. The offline and online approach will only reinforce MH messaging for target audiences and nudge them to positive behaviors.
It is imperative to understand girls’ search and social media behaviors especially around taboo topics such as menstrual health. The internet provides an anonymous and confidential platform for them to seek information. By understanding their digital ecosystem and interests in MH, it is then easier to support them — both offline and online — in their journey to learning about their bodies.