A recent paper by Libbet C. Loughnan, et al., advisor to the World Bank, titled: What can existing data on water and sanitation tell us about menstrual hygiene management, available at www.developmentbookshelf.com/doi/pdf/10.3362/1756-3488.2016.019 gives useful essentials of menstrual hygiene management (MHM). The authors call them critical elements of MHM.

The first critical element is water. Water is a critical definitional element of MHM, and it must be available in sufficient quantities for women and girls to wash themselves at home and, to clean any reusable cloth/materials used in MHM.

The second critical element is soap. Access to soap is also a critical definitional element of MHM. The soap should be available in the premises or at the place of handwashing. The other two critical elements are a private place; and a suitable place for disposal.

If I were to critically examine the MHM scenarios in the rural areas of Sindh, Pakistan, I can also say that the menstrual girls and women are to face a very bumpy road ahead. The critical elements are right away missing. There is a long, long way to go for sensitizing the government functionaries and politicians.

As Libbet C. Loughnan says in her blog (blogs.worldbank.org/water/lack-access-to...dest-especially-when), captioned Lack of access to a toilet and handwashing materials hits women and girls hardest, especially when menstruating, half a billion women globally, or 13 per cent of all women, lack a place to defecate, and likely lack privacy for menstrual hygiene management.

She says: Women and girls are particularly affected by the lack of safe and accessible water, sanitation and hygiene (WASH). They suffer during menstruation and childbirth, and also carry the burden of hours spent collecting water when is it not easily accessible, causing them to miss school and risk rape and harassment.

International agencies have a major role to play, if significant progress is to be achieved. They need to come down to poor developing countries, develop effective strategies, and catalyze the local partners, for improving the life of girls and women, as far as MHM is concerned.

F H Mughal