ROLE OF SOCIO-ECONOMIC FACTORS, WOMEN EMPOWERMENT, AND GOVERNANCE IN MENSTRUAL HYGIENE MANAGEMENT IN EAG STATES, INDIA

Objective: The study aims to examine the progress in menstrual hygiene management in the Empowered Action Group (EAG) states, India between 2015-16 and 2019-21 and identify its correlates in terms of household characteristics, women’s characteristics, and quality of governance at the state level. Methods: The National Family Health Survey (NFHS) is the primary data source for state-wise data on hygienic methods of menstrual protection (HMMP) and its potential correlates, namely household-level and women-specific characteristics. To assess the role of the quality of governance in the adoption of HMMP practices, the Governance Index is constructed using data on eleven variables from various secondary sources. The method of principal component analysis is used to construct the Women Empowerment Index and the Governance Index. The statistical methods also include computation of Karl Pearson’s bivariate correlation coefficients between the percent of women adopting HMMP practices and the covariates namely, household and women’s characteristics and the governance index as well as testing the statistical significance of the estimated correlation coefficients. Results: The study finds that the use of HMMP is positively correlated with household characteristics namely household wealth and general caste; women’s characteristics namely women’s education, empowerment, and exposure to the internet; and governance factors at the state-level. The study, however, does not find religion and exposure to mass media as exhibiting a statistically significant relationship with menstrual hygiene practices. Among the EAG states, Bihar and Madhya Pradesh exhibit the worst performance in HMMP, while Uttarakhand is the best performer and is an outlier with its exemplary performance in HMMP as well as in socio-economic indicators. Odisha and Rajasthan, despite mediocre performance in some of the socio-economic characteristics, show considerable improvements in menstrual hygiene largely due to successful government initiatives. Conclusion: The interplay of household, women’s characteristics and governance contributes to the poor performance of EAG states of Uttar Pradesh, Madhya Pradesh, Bihar and Chhattisgarh as compared to other states. The experience of EAG states highlights the importance of targeted state interventions and governance along with a supportive socio-economic environment in achieving the menstrual health of women. In addition to ensuring adequate income support, reducing social disparities, dispelling myths and taboos regarding menstrual health, and empowering women; the allocation of adequate funds and trained personnel can contribute significantly to the effective implementation of government schemes for improvements in menstrual hygiene. Keywords: Menstrual hygiene, Socio-economic factors, Women empowerment, Governance, EAG states, India