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How to design for taboos? A design intervention to overcome the taboo of menstruation in India

Authors:

Abstract and Figures

Taboos are like ''open public secrets'' and often dealing with these topics can be challenging due to the negative societal view. However, taboos can have a strong impact on the well-being of people, therefore, addressing these subjects is of high importance. In this paper seven building blocks to design for taboos are presented. These blocks were identified during our desk and field research project on the taboo of menstruation in India. Menstruation is a taboo that is prevalent worldwide, but in the low and middle income countries such as India, it has an even stronger negative impact on the lives of women. It is a subject that women deal with in secrecy and shame, often without involving men into the subject. However, India is a patriarchal country where men have a direct impact on the lives of women and the way women conduct their periods. Though efforts do exist to deal with the issue of menstruation, none so far have a focus on the stigma and shame that prevent from dealing with the subject openly. This paper presents the approach of gamification and humor in order to create a positive atmosphere for a discussion on the topic of menstruation inside the family house with all family members as a first step towards dealing with the subject.
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Track: Design for DiVersiTY anD incLUsionsenses & sensibiLiTY '19: LosT in (g)LocaLizaTion




a
a
a 

Abstract





           
      


     





Track: Design for DiVersiTY anD incLUsionsenses & sensibiLiTY '19: LosT in (g)LocaLizaTion


Discussion about taboos bring strong discomfort


taboo topics are related to global issues such as

therefore addressing these issues is of paramount








presents building blocks to design for taboos


























to stronger ones, such as avoiding physical contact
















Track: Design for DiVersiTY anD incLUsionsenses & sensibiLiTY '19: LosT in (g)LocaLizaTion







its structure, history, values and interpersonal



has been created in the society for centuries





that have an impact on the current image of









have been distorted through the years by

meaning behind them, and today they hold strong





vary through families and regions, and can vary






risks due to various aspects like unsafe usage






Cultural taboos can restrict youngsters from














lesser developed Asian countries such as





and to accept that they are not supposed to get



Track: Design for DiVersiTY anD incLUsionsenses & sensibiLiTY '19: LosT in (g)LocaLizaTion



in a nuclear family, the importance of kinships


uncomfortable to assert their needs and therefore
















In the recent years, the Indian government has















have open and free of shame discussions around

involve men and boys for the changes to appear









include all family members into the discussion,

























Track: Design for DiVersiTY anD incLUsionsenses & sensibiLiTY '19: LosT in (g)LocaLizaTion










directly include male members of the family












































and puberty, and portrayed the changes that















Track: Design for DiVersiTY anD incLUsionsenses & sensibiLiTY '19: LosT in (g)LocaLizaTion

















In order to have a deeper understanding of the






















Tailoring these aspects carefully can ensure



the design should be customized to the culture













When designing for taboos, it is important for the
design to undergo a series of tests to check the






















Track: Design for DiVersiTY anD incLUsionsenses & sensibiLiTY '19: LosT in (g)LocaLizaTion



but not going through the cons of having the









playing more entertaining, and even surprising



















removed discomfort of involvement in such a

most male members as it presented the topic of





It is necessary to tackle these issues since not












through centuries and is hard to change but the
Track: Design for DiVersiTY anD incLUsionsenses & sensibiLiTY '19: LosT in (g)LocaLizaTion


order to bring the topic out of the darkness of






humorous aspects of the design, the usually the



The presented building blocks can serve as a



further addressing to be made on the societal


intricate aspects of the culture such as gender and


Track: Design for DiVersiTY anD incLUsionsenses & sensibiLiTY '19: LosT in (g)LocaLizaTion



ournal of Family Issues


Swachh Bharat Mission Hasn’t ‘Met’ Sustainable Menstruaon


The Journal of Design,
Economics, and Innovaon

BMJ Open 2016

Ideo: How to Turn Social Taboos Into Innovave Products,


 Menstrual Health in India | Country Landscape Analysis

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The Internet
Journal of World Health and Societal Polics.
Indian Society and Ways of Living


Indian Journal of Community Health
Tips for Exploring Taboo Topics Through Play

Naonal Family
Health Survey (NFHS-3)

Track: Design for DiVersiTY anD incLUsionsenses & sensibiLiTY '19: LosT in (g)LocaLizaTion

Menstrual health, while excluded from SDGs, gains spotlight at UN polical
forum


Waterlines

 The Tribune



The Naonal medical journal of India

Internaonal Journal of Collaborave Research on Internal
Medicine & Public Health
Sidestepping the Elephant in the
Classroom: Using Culturally Localized Technology To Teach Around Taboos
Views of Menstruaon in Religions and Cultures around the world,

The Encyclopedia of Human-Computer
Interacon

Humour is necessary to overcome sgma

Periods Gone Public: Taking a Stand for Menstrual Equity
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... In order to encourage users to adhere to long-term diet management, a game metaphor that remind people of "diet helps make life better" is designed. The inherent appeal of gamification is also often used by designers to deal with subtle, careful, serious, and boring issues to make them widely accepted and noticed [13]. In "Happy-eating Garden", whenever the user completes the diet goal of a day, a plant will "grow" in the empty garden shown on the interface, symbolizing the bright garden of life. ...
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Diet management has become a common concern in daily life. Most of the current related designs provide accurate calorie estimates and personalized diet recommendations, which does not touch the core of management – how to make this behavior active and sustainable. This study introduces the concept of Positive Design, constructs a three-step design path which is applied in practice, aiming to give long-term happiness to diet management and promote users’ active adherence. The vital step is to invite target users and designers to join in collaborative work, identify and filter eight conflict dilemmas which are worthy of study. Positive design is a new theoretical perspective based on positive psychology. The final scheme produced in this paper aims to explore the application of this method in diet management design, and also provide a certain reference for subsequent research.
... Although not in abundance, literature provides some examples of design projects which have explicitly addressed taboo and shame. One recurrent topic is that of female intimate care; various papers present design-led approaches to engage participants in addressing menstrual taboos or female pelvic fitness [4][5][6][7]. Other taboos concerning embarrassment and bodily fluids have also been investigated. ...
... De acuerdo con un estudio sobre el tabú de la menstruación en las mujeres de la India (Salarić & Diehl, 2019), el tabú afecta a la salud, la educación, las posibilidades económicas, las relaciones y el bienestar general de las mujeres. Es decir, estos tabús tienen un fuerte impacto en el bienestar de las personas, y ese bienestar tiene, a su vez, un fuerte impacto en la estética de las personas (Paoli & Procacci, 2019). ...
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This document contains an analysis of the taboo in our society, and how it affects the aesthetic perception we have, first of all, of our bodies, following by the human nude and taking it to other areas. In this work we start by considering what the taboo is, its origin and the main fields in which it develops, to take it to philosophical aesthetics, to our cultural sense of 'beautiful', and to our perception of identity and beauty. Taboo has a strong socio-cultural component, as an agent and product of culture. Aesthetics, in turn, is closely linked to culture, and therefore, to taboo, and cannot be analyzed, in a holistic way, without taking into account the context that sustains that perception.
Conference Paper
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Article
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This document contains an analysis of the taboo in our society, and how it affects the aesthetic perception we have, first of all, of our bodies, following by the human nude and taking it to other areas. In this work we start by considering what the taboo is, its origin and the main fields in which it develops, to take it to philosophical aesthetics, to our cultural sense of the 'beautiful', and to our perception of identity and beauty. Taboo has a strong socio-cultural component, as an agent and product of culture. Aesthetics, in turn, is closely linked to culture, and therefore, to taboo, and cannot be analyzed, in a holistic way, without taking into account the context that sustains that perception.
Article
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Objectives To assess the status of menstrual hygiene management (MHM) among adolescent girls in India to determine unmet needs. Design Systematic review and meta-analysis. We searched PubMed, The Global Health Database, Google Scholar and references for studies published from 2000 to September 2015 on girls’ MHM. Setting India. Participants Adolescent girls. Outcome measures Information on menarche awareness, type of absorbent used, disposal, hygiene, restrictions and school absenteeism was extracted from eligible materials; a quality score was applied. Meta-analysis was used to estimate pooled prevalence (PP), and meta-regression to examine the effect of setting, region and time. Results Data from 138 studies involving 193 subpopulations and 97 070 girls were extracted. In 88 studies, half of the girls reported being informed prior to menarche (PP 48%, 95% CI 43% to 53%, I2 98.6%). Commercial pad use was more common among urban (PP 67%, 57% to 76%, I2 99.3%, n=38) than rural girls (PP 32%, 25% to 38%, I2 98.6%, n=56, p<0.0001), with use increasing over time (p<0.0001). Inappropriate disposal was common (PP 23%, 16% to 31%, I2 99.0%, n=34). Menstruating girls experienced many restrictions, especially for religious activities (PP 0.77, 0.71 to 0.83, I2 99.1%, n=67). A quarter (PP 24%, 19% to 30%, I2 98.5%, n=64) reported missing school during periods. A lower prevalence of absenteeism was associated with higher commercial pad use in univariate (p=0.023) but not in multivariate analysis when adjusted for region (p=0.232, n=53). Approximately a third of girls changed their absorbents in school facilities (PP 37%, 29% to 46%, I2 97.8%, n=17). Half of the girls’ homes had a toilet (PP 51%, 36% to 67%, I2 99.4%, n=21). The quality of studies imposed limitations on analyses and the interpretation of results (mean score 3 on a scale of 0–7). Conclusions Strengthening of MHM programmes in India is needed. Education on awareness, access to hygienic absorbents and disposal of MHM items need to be addressed. Trial registration number CRD42015019197.
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Design-trained people have access to a very broad range of professions. Yet there is something paradoxical about this development: ostensibly, many of these highly successful people have moved out of the field of “design.” This phenomenon deserves deeper consideration: how do design practices spread across society? What key design practices are particularly relevant to the problems of today’s society? Should what these people do still be considered design? To answer these questions, first we need to understand various ways that practices can be adopted and adapted from one discipline to the other. Problem framing emerges as a key design practice that can be adopted and adapted to other fields, and one which provides a valuable alternative to conventional types of problem solving. An example will illustrate how this frame creation allows practitioners to approach today’s open, complex, dynamic, networked problems in new and fruitful ways. The paper goes on to argue that the practice of frame creation is still part and parcel of the domain of design, and explores how design can develop into an expanded field of practice.
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Context: Adolescence in girls signifies the transition from girlhood to womanhood. Good menstrual hygiene is crucial for the health, education, and dignity of girls and women. This is an important sanitation issue which has long been in the closet and still there is a long standing need to openly discuss it. Aims: 1. To elicit the knowledge and source of information regarding menstruation among the adolescent girl students. 2. To find out the practices of menstrual hygiene among them. Settings and Design: Cross-Sectional study conducted in two randomly selected Inter colleges (one rural and one urban) of district Dehradun of Uttarakhand state. Methods and Material: 453 girls studying in 9th to 12th grades were interviewed by using a prestructured and pretested questionnaire. Statistical analysis used: percentages and Chi-square test Results: 64.5 % girls (71.1% Rural and 57% Urban) were aware about menstruation prior to the attainment of menarche. Awareness among rural girls was significantly more as compared to urban girls. Friends were the first informant in about 31.8 % girls. But the correct reason and source of bleeding during menstruation was not known to most of the respondents. Overall 38.4 % adolescent girls (48.1% Rural and 27.6% Urban) were using sanitary napkins as menstrual absorbent, while 30 % were using a new clothlrag every time. Conclusions: There is a need to educate the girls about menstruation, its importance and hygiene maintenance; so as to enable them to lead a healthy reproductive life in future.
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Background: Hygiene-related practices of women during menstruation are of paramount importance. There is a lack of sizeable literature on menstrual practices from northern India. We documented the menstrual hygiene practices of rural women and assessed their willingness to pay for sanitary napkins. Methods: A cross-sectional study was done in villages under the Comprehensive Rural Health Services Project (CRHSP), situated in Ballabgarh, Haryana. The study participants were women in the age group of 15-45 years. Nine villages were selected randomly while the number of respondents in each selected village was decided through the probability propor-tionate to size sampling method. The households were selected using systematic sampling. One woman was interviewed in each household using a pre-tested questionnaire. Results: A total of 995 women were interviewed. A majority of them (62%) were unaware of the reason(s) for menstruation. The role of the health sector in providing information regarding menstruation was low as only a few women (1.5%) had got information from the auxiliary nurse midwife (ANM)/health worker (HW). For the majority of women, besides religious activities, other routine activities did not suffer during menstruation. Only 28.8% of women were using sanitary napkins and of those who did not use napkins, only one-fourth (25.3%) were willing to buy them. The mean (SD) price per napkin that these women were ready to pay was Rs. 0.54 (0.43), equivalent to US$ 0.01. Conclusion: Women in the reproductive age group should be provided with appropriate information about menstruation, and they should be told about the advantages of using sanitary napkins. Health sector functionaries should play a proactive role in the delivery of such information.
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Background: Menstruation is a natural phenomenon among matured females who experience shedding of blood for 1-7 days every month from the age of maturity until menopause. Menstrual hygiene and management is an issue that is insufficiently acknowledged and has not received adequate attention.Aims and Objectives: This study seeks to assess hygienic behavior of unmarried females aged 15 to 22 years and factors affecting their behaviors.Study Design: A cross-sectional study was conducted during 2009-10 on 350 students. They were recruited from educational institutions from a major city in South India. Demographic and menstrual history and hygiene questionnaires were used for obtaining required information. Statistical Packages for the Social Sciences (SPSS) for Windows version 16 was used. Descriptive statistics, Chi-sq and Fisher’s exact tests were used for analysis.Results: Mean age of menarche was 13.4±1.2 years; disposable pads were used by two-thirds of the selected girls (68.9%) regardless of age while 45.1% reported to use both disposable and non disposable materials. Frequency of changing pads was 2-3 times a day by 78.3% girls. Socioeconomic Status (SES) of the selected girls and their age influenced choice of napkin/pads and other practices such as storage place of napkins; change during night and during school or college hours and personal hygiene. Older girls had better hygienic practices than the younger ones. Seventy six percent of the participants desired for more information regarding menstruation and hygienic practices.Conclusion: A variety of factors are known to affect menstrual behaviors most influential being age and SES. Awareness regarding the need for information about healthy menstrual practices is on rise among young women. It is probable that a mechanism be introduced to provide knowledge about menstrual health and self maintenance among women.
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Parents, peers, schools, and the media are the primary contexts for educating young people about sexuality. Yet girls receive more sex education than boys, particularly in terms of menstruation. Lack of attention to how and what boys learn about menstruation has consequences for their private understanding about the biology of reproduction and also for social and cultural ideologies of gendered relationships. In this qualitative study, 23 written narratives from male undergraduates (aged 18-24 years) were analyzed using grounded theory methodology to explore how young men perceive their past and present learning about this uniquely female experience. Findings suggest that most boys first learned about menstruation in their families, primarily through their sisters’ menarche; menstruation is experienced—in boyhood at least—as a gender wedge; and most men described a developmental process of moving from a childish attitude of menstruation as “gross” to seeing themselves as maturing through the experience of an intimate relationship.
Conference Paper
Cultural taboos can restrict student learning on topics of critical importance. In India, such taboos have led multiple states to ban materials intended to educate youth about HIV, putting millions at risk. We present the design of TeachAIDS, a software application that leverages cultural insights, learning science, and affordances of technology to provide comprehensive HIV education while circumventing taboos. Using a mixed-methods evaluation, we demonstrate that this software leaves students with significantly increased knowledge about HIV and reduced stigma toward individuals infected with the virus. Validating the effectiveness of TeachAIDS in circumventing taboos, students report comfort in learning from the software, and it has since been deployed in tens of thousands of schools throughout India. The methodology presented here has broader implications for the design and implementation of interactive technologies for providing education on sensitive topics in health and other areas.
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Scholars traditionally argued that industrialization, urbanization, and educational expansion lead to a decline in extended families and complementary rise in nuclear families. Some have suggested that such transitions are good for young married women because living in nuclear families benefits their health. However, extended families may also present advantages for young women's health that outweigh any disadvantages. Using the Indian National Family Health Survey, this article examines whether young married women living in nuclear families have better health than those in patrilocal extended families. It also examines whether young married women's living arrangements are changing over time and, if so, how such changes will affect their health. Results show that young married women living in nuclear families do not have better health than those in patrilocal extended families. Of eight health outcomes examined, only five differ significantly by family structure. Further, of the five outcomes that differ, four are patrilocal extended-family advantages and only one is a nuclear-family advantage. From 1992 to 2006, the percentage of young married women residing in nuclear families increased, although the majority remained in patrilocal extended families. This trend toward nuclear families will not benefit young women's health.
Swachh Bharat Mission Hasn't 'Met' Sustainable Menstruation. And That's A Disaster | #ThePadEffect
  • M Bhattacharjee
Bhattacharjee, M. (2017). Swachh Bharat Mission Hasn't 'Met' Sustainable Menstruation. And That's A Disaster | #ThePadEffect, retrieved from: https://feminisminindia.com/2017/05/28/swachhbharat-mission-sustainable-menstruation/
Ideo: How to Turn Social Taboos Into Innovative Products
  • B Fields
  • R Sinclair
  • A Valdes
Fields, B., Sinclair, R., Valdes, A. (2010). Ideo: How to Turn Social Taboos Into Innovative Products, retrieved from: https://www.fastcompany.com/1662478/ideo-how-to-turn-social-taboos-intoinnovative-products