EXPLORING MENSTRUAL HYGIENE PRACTICES, KNOWLEDGE, AND CULTURAL INFLUENCES AMONG TRANSITIONED-AGED YOUNG WOMEN IN THE SIDDI TRIBAL COMMUNITY: A QUALITATIVE ANALYSIS

Addressing menstrual hygiene behaviours necessitates a nuanced understanding of menstrual knowledge and awareness. Our study uncovered a significant deficiency in menstrual knowledge within the Siddi Tribal Community. Our data indicated that while the majority of women reported normal menstrual cycles, some experienced irregularities, specifically longer-than-usual gaps, which may suggest underlying medical concerns. None of the participants had a comprehensive understanding of menstruation prior to its onset, with many perceiving it as the body’s method of expelling “dirty blood” to prevent infections. A substantial proportion of the women were unaware of menstruation before their first period, with friends being the primary source of information. Other sources included mothers and close relatives, while online programs or advertisements were not cited, likely due to the limited availability of electricity in Siddi villages. Dhingra et al. (2009) found similar results and reported that menstruation, known locally as “Kapadaanna” or “Mahavari,” was not fully understood by young adolescents before its onset. The girls viewed it as essential for removing “dirty blood” to prevent infections or diseases. These challenges reinforce the observations and calls for enhanced efforts to address the barriers to menstrual hygiene product availability. Our findings show culture and social stigma are associated with menstruation. These findings align with Garg and Anand (2015), showing that cultural beliefs associating menstruation with impurity lead to various restrictions for girls and women. Women are often barred from the “puja” room and face kitchen restrictions. Menstruating women are also prevented from offering prayers or touching holy books due to beliefs about contamination. Kumar and Srivastava (2011) noted the unfounded belief that menstruation emits a smell or ray that spoils preserved food. Traditional taboos linking menstruation to evil spirits and practices like burying menstrual cloths persist in some cultures, including parts of Asia, despite lacking scientific basis. Maintaining privacy during menstruation is a significant challenge in the Siddi community. These results align with Mudi et al. (2023), who found that privacy concerns during menstruation in tribal communities are deeply tied to cultural practices. Menstrual cloths are often concealed under other laundry, reflecting shame and stigma. The reuse of the same cloth and poor drying methods increase infection risks. Traditional beliefs, such as avoiding baths or handling food during menstruation, further complicate menstrual hygiene, exacerbated by limited knowledge and the perception of menstruation as a divine curse. Such restrictions and stigma contribute to increased anxiety, depression, reduced self-esteem and overall psychological wellbeing among women. Our study found minimal use of disposable absorbents or pads among disadvantaged groups in the Siddi Tribe, consistent with Ram et al. (2020). This disparity underscores systemic challenges that limit access to essential menstrual hygiene products. Low usage among marginalized communities is driven by restricted access, financial constraints, and cultural norms, compounded by a lack of menstrual health education. The preference for reusable old clothes over sanitary pads among tribal women is driven by cost, availability, and disposal concerns. According to Kumari et al. (2021), while child marriage has a long history in India, it is not prevalent across all social groups, particularly among tribal populations. In these tribes, marrying biologically immature girls is uncommon, as marriage is intended to fulfill the couple’s sexual needs. Puberty serves as a significant milestone, with marriage typically occurring within 2–6 years after menarche. Consequently, early menarche may result in early marriage (Kumari et al., 2021). However, within the Siddi tribe, marriages often take place at peak youth age, between 20 to 25 years, with a minimal gap between menarche and marriage. Literature indicates low usage of disposable absorbents, especially among socioeconomically disadvantaged groups, highlighting an urgent need for targeted interventions. Strategies should focus on raising awareness and improving access to affordable disposable pads. Educating women about the health risks of non-disposable products is vital, and integrating menstrual hygiene discussions into routine health worker visits is necessary to increase usage. The impact of media in promoting disposable absorbents is evident, as those with limited media exposure use them less. Strengthening outreach and developing targeted programs for disadvantaged groups, along with supporting campaigns like “18 to 82” (which seeks to bridge the gap between the 18% who use sanitary napkins and the 82% who engage in unhygienic practices) and Run4Nine (which strives to ensure no woman or girl is disadvantaged due to her biology), are essential. Expanding initiatives such as Menstrual Hygiene Day induce promoting menstrual hygiene awareness with support from celebrities. Social marketing approaches similar to those in reproductive health could boost disposable absorbent use. Platforms like Rashtriya Kishor Swasthya Karyakram should integrate menstrual hygiene with adolescent health initiatives (MoHFW, 2014). Increasing the availability of affordable products is also crucial, as shown by Uttar Pradesh’s low availability and high prices. Directing health workers to distribute subsidised pads and expanding school-based programs could significantly improve access.