The Quantum Hub

Author: Deepro Guha

Published: October 5, 2023 in The Economic Times.

Meta recently made a groundbreaking announcement for its European users, offering them the option to opt out of its recommendation algorithm. This move signals a potentially pivotal shift in how social media services are offered in Europe and was necessitated by the implementation of the Digital Service Act (DSA) in EU, which mandates algorithmic transparency by digital intermediaries. In this article, I aim to delve deeper into the concept of algorithmic transparency and explore other avenues of algorithmic regulation.

Ubiquity of algorithms

But let’s start with a simple question: Have you ever found yourself endlessly scrolling through social media, wondering why you can’t seem to stop? The answer likely lies in the algorithm that powers your social media feed. These algorithms have the remarkable ability to curate content that keeps you hooked on the platform. Not only do algorithms decide content shown on social media feeds, they also influence consumer choice by controlling suggestions on e-commerce websites, and are even used by governments to process data for the provision of citizens benefits. In essence, algorithms, which are fundamental instructions governing how specific sets of information are treated, have become potent tools for shaping society.

However, these powerful tools also create a host of complex issues that need careful consideration and perhaps even regulation. First, algorithms employed by digital intermediaries are often so complex that they are inscrutable to the average person and sometimes even to regulators. This creates a stark information asymmetry problem. Moreover, certain algorithms, such as those used to train generative AI, are adaptive, offering little control over the models they create, even to their own creators.  An example of problems created by such models was highlighted in the recent episode of Microsoft’s AI software professing love to a New York Times journalist, and also attempting to convince him to leave his wife. Microsoft in response admitted that it may not know the exact reason behind the AI software’s erratic behaviour.

Second, there is a constant risk of bias creeping into algorithmic decision-making, especially when algorithms are used for targeting or identifying specific individuals. If left unaddressed, this can exacerbate socioeconomic inequalities. For instance, Meta recently settled with U.S. authorities in a case where its algorithms displayed bias against certain communities when showing housing ads for specific localities.

Third, when bias-related problems emerge, there should ideally be a human point of contact for grievance redressal. However, many companies employing algorithms offer limited recourse in such instances. For example, recent reports shed light on how Instagram’s algorithms often flag content posted by influencers as “violating community guidelines,” limiting their ability to monetize such content, without offering a robust grievance redressal system or even an explanation of which specific community guideline has been violated.

Global movement towards algorithmic regulation

As these issues gain global attention, there is a growing movement towards preparing for a future regime of algorithmic regulation. In the United Kingdom, digital regulators have outlined a vision document for the future of algorithmic regulation. The European Union has established the European Centre for Algorithmic Transparency (ECAT). Even in India, the earlier draft of the Data Protection Bill (2022) proposed algorithmic transparency in the treatment of personal data.

Challenges in Mandating Transparency

However, while the need to regulate algorithmic decision-making is urgent, the effectiveness of mandating algorithmic transparency remains questionable. Firstly, there is the issue of proprietary concerns. Companies may be hesitant to share such information because these algorithms often form the foundation of their business, as argued by Google when asked for more information about its algorithms by its own shareholders. Secondly, as Microsoft argued before the European Parliament, knowing how an algorithm is coded can be useless without knowledge of the data fed into it. This was also highlighted in Twitter’s recent move to make its source code public, with experts pointing out that while Twitter’s source code reveals the underlying logic of its algorithmic system, it tells us almost nothing about how the system will perform in real-time.

Alternative Approaches

Given these challenges with mandating algorithmic transparency, experts have suggested some alternative solutions that could alleviate the problems with algorithmic decision making. For instance, stakeholders can collaborate to create algorithmic standards, with the objective of mitigating adverse consequences of algorithmic decision making.  For example, ALGO-CARE, a standard created in the UK, sets out a model of algorithmic accountability in predictive policing. This standard ensures measures like including other decision making mechanisms to supplement the algorithm, creating additional oversight to identify bias etc.

Additionally, there is a growing movement toward mandating algorithmic choice. This could involve companies offering users the option to choose which algorithms are used to provide services (similar to Meta’s move in Europe). Alternatively, third-party algorithm services could give users more options in terms of the information they receive. For instance, consumers could select services that adjust their e-commerce search results to favour domestic production or refine their Instagram feed to focus only on specific topics of interest.

While these interventions may create their own complications and need substantial capacity building, they are undoubtedly worth exploring. Therefore, as the Indian government works on the Digital India Bill, it would be prudent to keep a focus on algorithms and create capacity to allow for future regulation.

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Deepro is Senior Manager at The Quantum Hub (TQH Consulting), a public policy firm in Delhi

Authors: Rhydhi Gupta and Sidharth Deb

Published: September 26, 2023 in The Hindu

The Indian Government is poised to host a Global Summit on Artificial Intelligence (AI) this October. Additionally as the Chair of the Global Partnership for Artificial Intelligence (GPAI), Delhi will also be hosting the GPAI global summit this coming December. These events suggest the strategic importance of AI, as it is projected to add $500 billion to India’s economy by 2025, accounting for 10 percent of the country’s target GDP.

Against this backdrop, PM Modi recently called for a global framework on the ethical expansion of AI. Given the sheer volume of data that India can generate, it has an opportunity to set a policy example for the Global South. Observers and practitioners will track closely India’s approach to regulation and how it balances AI’s developmental potential against its concomitant risks.

One area where India can assume leadership is how regulators address children and adolescents who are a critical – yet less understood – demographic in this context. The nature of digital services means that many cutting edge AI deployments are not designed specifically for children but are nevertheless accessed by them.

The Governance Challenge

Regulation will have to align incentives to reduce issues of addiction, mental health, and overall safety. In absence of that, data hungry AI-based digital services can readily deploy opaque algorithms and dark patterns to exploit impressionable young people. Among other things this can lead to tech-based distortions of ideal physical appearance(s) which can trigger body image issues. Other malicious threats emerging from AI include misinformation, radicalisation, cyberbullying, sexual grooming, and doxxing.

The next generation of digital nagriks must also grapple with the indirect effects of their families’ online activities. Enthusiastic ‘sharents’ regularly post photos and videos about their children online to document their journeys through parenthood. While moving into adolescence we must equip young people with tools to manage the unintended consequences. For instance, AI-powered deep fake capabilities can be misused to target young people wherein bad actors create morphed sexually explicit depictions and distribute them online.

Beyond this, India is a melting pot of intersectional identities across gender, caste, tribal identity, religion, linguistic heritage, etc. Internationally AI is known to transpose real world biases and inequities into the digital world. Such issues of bias and discrimination can impact children and adolescents who belong to marginalised communities.

Alleviate the Burden On Parents

AI regulation must improve upon India’s approach to children under India’s newly minted data protection law. The data protection framework’s current approach to children is misaligned with India’s digital realities. It transfers an inordinate burden on parents to protect their children’s interests and does not facilitate safe platform operations and/or platform design. Confusingly it inverts the well known dynamic where a significant percentage of parents rely on the assistance of their children to navigate otherwise inaccessible UI/UX interfaces online. It also bans tracking of children’s data by default, which can potentially cut them away from the benefits of personalisation that we experience online. So how can the upcoming Digital India Act (DIA) better protect children’s interests when interacting with AI?

Shift the Emphasis to Platform Design, Evidence Collection, and Better Institutions

International best practices can assist Indian regulators in identifying standards and principles that facilitate safer AI deployments. UNICEF’s guidance for policymakers on AI and children identifies nine requirements for child-centred AI which draws on the UN Convention on the Rights of the Child– to which India is a signatory. The Guidance aims to create an enabling environment which promotes children’s well being, inclusion, fairness, non-discrimination, safety, transparency, explainability and accountability.

Another key feature of successful regulation will be the ability to adapt to the varying developmental stages of children from different age groups. California’s Age Appropriate Design Code serves as an interesting template. The Californian code pushes for transparency to ensure that digital services configure default privacy settings; assess whether algorithms, data collection, or targeted advertising systems harm children; and use clear, age-appropriate language for user-facing information. Indian authorities should encourage research which collects evidence on the benefits and risks of AI for India’s children and adolescents. This should serve as a baseline to work towards an Indian Age Appropriate Design Code for AI.

Lastly, better institutions will help shift regulation away from top-down safety protocols which place undue burdens on parents. Mechanisms of regular dialogue with children will help incorporate their inputs on the benefits and the threats they face when interacting with AI-based digital services. An institution similar to Australia’s Online Safety Youth Advisory Council which comprises people between the ages of 13-24 could be an interesting approach. Such institutions will assist regulation to become more responsive to the threats young people face when interacting with AI systems, whilst preserving the benefits that they derive from digital services.

The fast evolving nature of AI means that regulation should avoid prescriptions and instead embrace standards, strong institutions, and best practices which imbue openness, trust, and accountability. As we move towards a new law to regulate harms on the internet, and look to establish our thought leadership on global AI regulation, the interest of our young citizens must be front and centre.

Rhydhi and Sidharth are, respectively, Analyst & Manager, Public Policy at The Quantum Hub (TQH Consulting)

Children can use platforms with parental consent but child users cannot be tracked, making safety measures hard to apply, even as the law’s exemptions could have unintended adverse effects.

Author: Nikhil Iyer
Published: August 24, 2023 in Livemint

After nearly a decade of discourse around a data protection law for India, a requirement that was given urgency by a landmark Supreme Court judgement in 2017 on the fundamental right to privacy, the Indian Parliament has finally passed the Digital Personal Data Protection Bill, 2023. This is the third version; previous drafts of the Bill were circulated in 2019 and 2022. However, in each draft, the law’s approach to protecting children’s privacy has remained hazy.

To recap, the current law sets the age of consent to use online services at 18 years. If you are younger than 18, then the online platform has to obtain “verifiable parental consent,” failing which the platform can incur massive penalties up to ₹200 crore. While a child can use an internet platform once a parent provides consent, the platform is completely prohibited from tracking and monitoring the behaviour of child users, irrespective of the purpose for which such data processing is to be conducted.

This is where this approach becomes problematic. How can online platforms prevent a child from being exposed to harmful, risky or illegal content, interactions and experiences without tracking or monitoring their behaviour? How are they expected to take precautionary measures, such as alerting parents or law enforcement agencies, if the child is getting drawn towards self-harm, bullying, harassment, hate speech or other dangers? While other jurisdictions have chosen to place high responsibility on platforms for keeping children safer, the Indian law takes a diametrically opposite approach.

The law looks at “verifiable parental consent” as an end-all solution. This is in a country where less than 40% Indians are digitally literate, as per the National Sample Survey’s 78th Round (2020-21) data, with the distinct possibility of children gaming the system by using their parents’ phones/email IDs to provide consent without their knowledge. The mere fact of parental consent is presumed to take care of any harm or risk which may befall children after they begin using the platform.

To add to this, the law is willing to provide exemptions from parental consent requirements for certain platforms that will be certified as being “verifiably safe,” allowing them to process data of children above a certain age (16 years) without parental consent. As per an interview of the IT minister of state, this certification could be reserved for platforms that ensure “100% KYC,” through identity-proofs such as government ID cards. The exemption may be available to specific entities such as “education, skilling, some vocational music websites where children are learning music and they [platforms, i.e.] take all kinds of precautions” and “certainly not social media.”

This exemption carrot is riddled with issues as well. One, it is prima facie in conflict with the data minimization principle: platforms should only collect data necessary for achieving specific purposes. It is unclear how collecting parents’ IDs will help in keeping children safe while using the platform. Two, by laying down a white-listing process, where platforms have to apply for ‘verifiably safe’ certification, the law will increase bureaucratic entanglement in a dynamic digital economy. It is unclear if entities will have to apply to a government authority for every incremental change by which they seek to create more value for children using their products or services.

Further, the rationale for singling out certain categories of platforms is not immediately clear. Today, the lines between a platform’s purpose are blurred. For instance, YouTube is perhaps the world’s biggest ed-tech platform, with its invaluable and democratized repository of knowledge on everything from exam preparation to art and music lessons and personal development; but the government may categorize it as a social media or a streaming platform. Through this certification, the law would end up discriminating among entities that may be offering equally strong protections while processing children’s data, but may either be shut out at the door itself or not have applied for ‘verifiably safe’ certification for other reasons. This may also reduce the incentive of online platforms to innovate for children, as they may want to avoid an over-regulated market segment. India’s young netizens would then be at a disadvantage vis-a-vis their global peers in all these situations.

An alternative approach could have been to uphold ‘best interests of the child’ obligations under an internationally recognized standard of the UN convention on child rights, to which India is a signatory. In practice, the design of platforms would have to uphold this standard in terms of default settings, nudges, location tracking, publishing regular risk self-assessments, issuing prescriptions against detrimental use of data and so on. Beyond this, the government could blacklist any platform found to be violating the rules and stop it from processing children’s data. This will push all platforms to adhere to high data protection standards based on associated risk, while children would be able to freely access the internet based on varying levels of maturity.

How to protect children online is a global debate and there are no easy answers. However, the approach that we have taken to this issue suits neither the realities of India nor the challenges of cyberspace.

Nikhil Iyer is Senior Analyst, Public Policy at The Quantum Hub.

Tackling the root causes of deprivation, investing in education, improving nutrition and food security, and accelerating access to clean energy can help transform the lives of millions.

Authors: Mayank Mishra and Swathi Rao
Published: July 11, 2023 in Outlook

As the world commemorates World Population Day today, it is important to look at the most pressing issue faced by millions in India: poverty. While poverty is often used to describe monetary poverty, this definition is often too simplistic. Therefore, the United Nations recommends a different measure of poverty – the multidimensional poverty index (MPI), which is a measure of deprivation that encompasses a web of interconnected disadvantages, including limited access to basic infrastructure, education, healthcare, housing, and more. In fact, the Sustainable Development Goals (SDGs) aim to address precisely this complex nature of poverty.

In simple terms, MPI measures deprivation of three important aspects of a person’s life – their health, education, and living standards – each with specific indicators (10 in total) and having the same weightage. If a person is multidimensionally poor, it means that s/he is deprived in at least three indicators.

Globally, over a billion people are reported to be multidimensionally poor. In the context of India, a country with a diverse population and varying socio-economic landscapes, measuring and addressing multidimensional poverty takes on even greater significance. It necessitates an understanding of the nuanced challenges faced by individuals and communities in different regions.

The story of India’s poverty alleviation in the decade between 2005-06 and 2015-16 is nothing short of extraordinary. Over the last 15 years, the number of multidimensionally poor people in India has fallen by more than 415 million. According to the SDG Tracker developed by the India Policy Insights (IPI) initiative at Harvard University, a significant majority of districts (52 per cent) have achieved their SDG targets, demonstrating commendable efforts in alleviating multidimensional poverty. Encouragingly, 41 per cent of the districts are on track to meet these targets by 2030, indicating positive momentum towards sustainable development. However, despite notable progress, there are still areas that demand urgent attention.

Data on MPI from the UN reveals that nutrition, years of schooling, and cooking fuel, in particular, are areas of high deprivation in India, compared to other indicators, implying that a considerable number of people are undernourished, have not completed six years of schooling, and still use dung, agricultural crops, shrubs, wood, charcoal or coal as primary sources of cooking fuel.

While comprising only 6 per cent of the total number of districts in India, there are still 43 districts in the north, eastern, and north-eastern parts of India that are lagging in the pursuit of poverty alleviation. Although a relatively small proportion, when looked at in terms of population, this represents a substantial number of communities grappling with multidimensional poverty, and calls for immediate attention and investigation.

MPI considers undernourishment, based on age-specific BMI, weight-for-age, and stunting (for children 5 years and under), in any member of a household, as nutritional deprivation. According to the IPI Districts Tracker, the aforementioned 43 districts have some of the country’s highest prevalence of stunting and underweight women. Additionally, over 62 per cent districts in the country are not on track to meeting the SDG target for nutrition, serving as a grim reminder of the burden of undernutrition and highlighting the urgent need to address the nutritional crisis that continues to plague India.

According to the latest National Family Health Survey (NFHS-5) data, the number of years of schooling among urban and rural areas was 7.5 years versus 4.0 years among women, and 8.8 years versus 6.5 years among men. While this is a remarkable improvement from the previous NFHS round (2015-2016), it is also important to note that men consistently have a higher average number of years of schooling compared to women. Further, 27 of the 43 districts falling behind have female attendance rates below the national average (71.76 per cent). This disparity not only perpetuates inequality but also hampers the nation’s progress in achieving sustainable development.

In terms of access to clean cooking fuel, although India has made significant progress through schemes like the Pradhan Mantri Ujjwala Yojana (PMUY), nearly 68 per cent districts in the country are still unlikely to meet the SDG target for clean cooking fuel. At the current rate of progress, most districts in central, northern, and north eastern India are unlikely to have 100 per cent access to clean fuel by 2030. This means that a significant portion of the population may continue to rely on primitive cooking methods, exposing them to hazardous fumes and compromising their health.

Amidst these concerning statistics, it is also worth noting that Indian districts have shown exceptional performance on living standard indicators like sanitation and electricity; while 43 per cent districts have already met the SDG target for electricity, 78 per cent districts are on-target to meet the SDG target for sanitation and an additional 47 per cent for electricity.

The year 2023 is an important year for India. It not only signifies the halfway point to the 2030 Sustainable Development Agenda but also marks a significant demographic shift, with India surpassing China as the world’s most populous country. In light of these developments, it becomes imperative for us to take stock of our development goals and course-correct. India’s journey towards inclusive and sustainable development hinges on our ability to address the multidimensional nature of poverty. By tackling the root causes of deprivation, investing in education, improving nutrition and food security, and accelerating access to clean energy, we can transform the lives of millions.

Swathi Rao and Mayank Mishra are with The Quantum Hub (TQH).

Authentic reviews, whether positive or negative, serve as a valuable resource by sharing genuine experiences. In contrast, fake reviews distort the marketplace by depriving consumers of accurate information and swaying their decisions with misleading endorsements.

Authors: Mayank Mishra and Salil Ahuja
Published: July 27, 2023 in Hindustan Times

While there have been several discussions on how this may impact our society, we specifically examine the challenges that may emerge in digital commerce. Within a few months of generative AI’s rollout for common use, we’re witnessing the early signs of AI tools, like ChatGPT, being misused to power bots, generate fake reviews, and saturate the web with subpar content. The products and services listed on online marketplaces are already witnessing reviews that begin with the telltale words, “As an AI language model…”, which clearly implies that these reviews have been written with the help of generative AI.

This is a significant threat to trust in digital platforms because when it comes to making purchasing decisions, the opinions of consumers, who have used a particular product, hold significant sway. According to a survey by an SEO platform, a staggering 76% of consumers regularly consider reviews before making a product choice. Furthermore, nearly 75% admit that a positive review is the key factor influencing their perception of the product. However, the proliferation of fake reviews jeopardises consumer trust in online reviews as a whole. Authentic reviews, whether positive or negative, serve as a valuable resource by sharing genuine experiences. In contrast, fake reviews distort the marketplace by depriving consumers of accurate information and swaying their decisions with misleading endorsements. Fake reviews also hold the power to either damage or bolster a business’s reputation, with far-reaching consequences. Research conducted by Harvard Professor Michael Luca suggests that a mere one-star change in a company’s Yelp rating can substantially impact its revenue by 5-9%.

In the early days of digital commerce, there wasn’t significant recognition of the need to regulate platforms to ensure genuineness of reviews. Unfortunately, this led to the rise of paid-review farms, which exploit businesses seeking to artificially boost their ratings on review platforms. A different study by Luca highlighted that in 2015, fake reviews could be brought for as little as 25 cents per review, indicating that the cost of posting fake reviews was much lower than the benefit one could reap out of them.

Recognising the severity of the problem, the European Commission (EU) and national consumer protection authorities conducted an extensive EU-wide website screening to assess the credibility of consumer reviews. The results revealed deep doubts about the authenticity of reviews on the majority of the analysed websites. In India, the proliferation of fake and misleading reviews also violates consumers’ right to be informed, as enshrined in the Consumer Protection Act, 2019. The Department of Consumer Affairs therefore took notice after the release of the EU report and promptly invited key stakeholders to address the issue.

As a result of these discussions, the Department in collaboration with the Bureau of Indian Standards (BIS), introduced voluntary standards for online reviews in November 2022. However, when these standards were created, they did not proactively account for the generative abilities of AI. It is now crucial to consider the ongoing AI boom and its implications on the industry.

AI is a dynamic field, and regulating fake reviews online requires the support and collaboration of industry stakeholders. The government must encourage innovation by the private sector in collaboration with experts and consumer groups to address this problem at scale as proliferation of fake reviews is likely to increase given the short time required to generate new content. Online marketplaces also have market incentives to address this problem, as they are well aware that fake reviews undermine trust and credibility, leading to decreased user engagement and ultimately people’s reluctance to use their platforms. We must therefore also build systems so that platforms collaborate with each other to identify common bad actors who are operating across online marketplaces.

Further, in India, initiatives such as the Open Network for Digital Commerce (ONDC) which are encouraging interoperability could also play a potential role in building systems of cooperation to check fake reviews. Fixing accountability of fake reviews and law enforcement mechanisms may also need to be revisited as AI’s impact on this aspect becomes clearer.

As the AI revolution unfolds, our ability to preserve the integrity of digital commerce becomes paramount to ensure continued trust in digital markets. We should take proactive steps to regulate and combat the proliferation of fake reviews to enable informed decision-making and protect online commerce from AI-powered manipulative practices.

Mayank Mishra is Manager, Public Policy and Salil Ahuja is Associate, Public Policy at TQH Consulting.

We need a policy that views senior citizens not just as passive recipients of welfare schemes but as valuable assets who can contribute significantly to society.

Authors: Srijan Rai and Aparajita Bharti
Published: July 24, 2023 in Livemint

The wellbeing of the elderly is mandated by the Constitution, specifically the Directive Principles of State Policy. However, the fact that the existing policy on older people was introduced in 1999 reflects the lack of policy focus on this issue. According to a report by the Parliamentary Committee on Government Assurances, the Ministry of Social Justice and Empowerment has given 11 assurances in Parliament since 2011 about bringing in a new policy. However, a draft of the National Policy for Senior Citizens from 2016 is yet to be finalised.

As we set our sights towards the India of 2047, this lack of attention to the country’s elderly population needs to change. The National Family Health Survey (NFHS) provides valuable insights into the changing needs and dynamics of senior citizens. The survey reveals that the number of senior citizens living with chronic illness is rising every year. It showed that about a quarter of those aged 40-49 already have hypertension and that its prevalence increases sharply with age. The findings show a similar pattern for diabetes. These health challenges demand a well-structured policy that integrates healthcare services, promotes preventive measures, and ensures that all elderly citizens have access to quality medical care.

The NFHS data also shows that a significant proportion of the elderly population faces financial hardships and social isolation. Many are dependent on their families or meager pensions. For instance, the National Social Assistance Programme provides a pension of ₹500 rupees a month and the Atal Pension Yojana (available to a small proportion of elderly) offers ₹1,000-6,000 a month . These sums are insufficient to cover even basic needs.

Several other changes – such as a rise in the number of nuclear families, a decline in family size, and migration to urban areas and abroad – are also displacing the existing system of elderly care within families. India’s average family size decreased from 4.67 members in 2001 to 4.45 members in 2011 and is likely to drop further with fertility rates falling. The Maintenance and Welfare of Parents and Senior Citizens Act, 2007 – the law that allows the elderly to take legal action against their children if they fail to provide for them – is also insufficient. It does not take into account the reality of shame and social pressure that prevents many elders from taking legal recourse even if they are aware of their rights under this act. It is also silent on the government’s responsibilities towards elderly Indians.

Another aspect of India’s aging population is that the share of women in this group is increasing. In line with global trends, Indian women’s life expectancy is already more than men’s and this gap is only expected to increase, according to the UN Population Division.This means the issue must also be seen through the lens of gender. Older women are at more risk of neglect, abuse and ill-treatment due to their higher financial dependence and lack of agency. Apart from women, we also need to focus on other marginalised groups within the elderly population, such as those without any pension support, and individuals with chronic diseases and disabilities.

Given all these factors, a new policy approach is needed urgently to help enhance financial security through social-security measures, and promote opportunities for productive engagement to combat social isolation. From an infrastructure perspective, we need to start thinking about creating incentives for the private sector to build and maintain facilities, create budget space for public provision and explore community-led models with support from the government.

We also need to set up an institutional owner with a dedicated budget to help us achieve these goals. The Ministry of Social Justice, in its initial draft of the policy, emphasised the need for a dedicated Department for Senior Citizens, with state commissions and nodal officers at the district level to ensure policies are implemented.

Even as we wait for a clearer view of how India’s population has changed in the next census, we must act now based on what we already know. We need a new policy that views senior citizens not just as passive recipients of welfare schemes but as valuable assets who can contribute significantly to society. To enact such a policy, we need political foresight and the will to prepare for this imminent future.

This would entail exploring existing models in other countries such as Japan’s Community-Based Integrated Care System and Singapore’s ‘Aging-in-Place’ which focuses on supporting the well-being of elderly through home care, healthcare, day rehabilitation centers, senior activity centers, and so on.

Srijan Rai is Associate and Aparajita Bharti is Founding Partner, The Quantum Hub (TQH).

Addressing menstrual hygiene requires a multi-faceted and holistic approach, as it is both caused by and affects a range of other indicators, including gender equality, health, education, and economic empowerment.

Authors: Shubham Mudgil and Dr. S. V. Subramanian
Published: July 10, 2023 in IndiaSpend

Women menstruate for a total of approximately six to seven years in their lifetime. This makes menstrual hygiene a crucial concern for women and girls. Managing menstruation hygienically and with dignity requires adequate knowledge, appropriate facilities, and a supportive cultural environment. However, taboos related to menstruation continue to dominate the mainstream narrative in India and hinder progress in improving menstrual hygiene practices.

Inadequate access to proper menstrual hygiene management has far-reaching consequences, affecting individuals physically, emotionally, and economically. In some cases, it can even lead to depression due to societal stigmatization and cultural taboos associated with menstruation. Tragically, these circumstances may lead to girls discontinuing their education. Dropping out of school has a strong negative impact on girls as they become much more likely to be married young, bear children before the age of 18, experience poorer health and nutrition outcomes and experience reduced earnings in adulthood.

In recognition of the importance of menstrual hygiene, the Supreme Court deemed it an “important issue of public interest” and directed the Central Government to develop a National Policy specifically targeting school-going girls in April 2023. This decision serves as a potent reminder of the urgent need for comprehensive action to ensure access to quality menstrual hygiene management throughout India.

In this context, this data story delves into the prevailing trends of menstrual hygiene at the level of parliamentary constituencies using data from the NFHS Policy Tracker for Parliamentary Constituencies developed by the India Policy Insights initiative at Harvard University. It also tries to highlight the consequential impact of the inadequate management of menstrual hygiene.

1) Menstrual Hygiene levels vary across regions

The current levels of menstrual hygiene vary significantly across the Indian states. These levels vary from 34.5% to 96.6% across parliamentary constituencies. Areas with low levels of menstrual hygiene (highlighted by shades of red) are concentrated in central India. Bihar (59.9%), Madhya Pradesh (61.5%), Uttar Pradesh (74%) and Rajasthan (85.8%) lie in the bottom deciles while states like Tamil Nadu (99.1%), Goa (98.1%), Punjab (95.3%), Kerala (95.2%) and Haryana (95.2%) lead the way in menstrual hygiene.

2) Menstrual Hygiene levels have improved significantly over the years

Fig 2: Change in the prevalence of menstrual hygiene between NFHS 4 and 5

Significant progress has been made in advancing menstrual hygiene between NFHS 4 and 5. An impressive 97.7% of parliamentary constituencies (PCs) registered an average increase of 20.1 percentage points in the prevalence of menstrual hygiene. Aska PC in Odisha saw the highest improvement of 54.7 percentage points in menstrual hygiene as the prevalence went up from 30.4 in NFHS 4 to 85.1 in NFHS 5. Barmer PC in Rajasthan and Maldaha Uttar PC in West Bengal followed next with each registering a 52.5 and 49.3 percentage points increase respectively.

Overall, Odisha, Bihar and Rajasthan have led the way by registering an increase of 34.5, 30.1 and 29.0 percentage points respectively. However, in the same time period, 12 PCs across the nation witnessed a decline in menstrual hygiene levels, 5 of which were in Gujarat and 3 in Kerala. For an indicator which saw vast improvement across the nation, the reasons for regression in these PCs are worth investigating and addressing immediately.

3) Access to Sanitation Facilities: An Important Element of Menstrual Hygiene

Inadequate water and sanitation facilities pose a major impediment to maintaining proper hygiene and privacy for menstruating women. A UNICEF study noted that a higher percentage of women and adolescent girls practising adequate MHM live in households with improved sanitation facilities and with safe excreta disposal on site compared to those who practice inadequate MHM. The NFHS data highlights a similar trend for Indian parliamentary constituencies (PCs).

Most PCs with low levels of menstrual hygiene (highlighted by shades of red in Fig 1) are also found to have a low proportion of households using improved sanitation facilities (highlighted by shades of red in Fig 3). States like Uttar Pradesh, Bihar, Jharkhand, Madhya Pradesh and Tripura have notably low levels of sanitation as well as menstrual hygiene. This warrants immediate attention. Interestingly, Tamil Nadu stands to be an outlier as NFHS reports very high levels of menstrual hygiene but relatively low levels of households with improved sanitation facilities.

4) Inadequate Menstrual Hygiene aggravates the risk of Anaemia

Anaemia is a significant problem among females in India, where per NFHS-5, 57% of females in their childbearing age are estimated to be anaemic in the country. The government has been promoting initiatives to ensure Iron and Folic Acid supplementation, provide fortified food for women at risk and run large-scale awareness drives. However, improvements in promoting menstrual hygiene can also play a significant role in India’s fight against anaemia. Improper menstrual hygiene management can lead to urinary or reproductive tract infections and pelvic inflammatory disease that can further lead to blood loss ultimately resulting in a higher risk of anaemia.

Studies have established “a significant association between poor menstrual hygiene management and anaemia”. This appears to be the case in Fig 1 and Fig 4 as PCs with poor menstrual hygiene overlap with PCs with high levels of anaemia among females across multiple regions in India. Therefore, it is likely that a deeper understanding of the causes of poor menstrual hygiene and addressing related risk factors could also help in curbing anaemia in the country.

Conclusion

Addressing menstrual hygiene requires a multi-faceted and holistic approach, as it is both caused by and affects a range of other indicators, including gender equality, health, education, and economic empowerment. Therefore, a comprehensive policy response to this issue must weave together education, awareness, access to affordable and hygienic menstrual products and improved sanitation facilities. By prioritizing these areas and implementing evidence-based and focused policy strategies, India can make significant strides in ensuring that women and girls have the necessary support, knowledge, and facilities to manage menstruation hygienically and with dignity.

Such efforts would also promote progress on several Sustainable Development Goals (SDGs), including SDG 3: Good Health and Well-being, SDG 4: Quality Education, SDG 5: Gender Equality, and SDG 6: Clean Water and Sanitation. Therefore, by promoting menstrual hygiene management, we can contribute to building a sustainable and equitable future for all.

Shubham Mudgil is a Public Policy Associate at The Quantum Hub and Dr. SV Subramanian is Professor of Population Health and Geography at Harvard University and Principal Investigator of the Geographic Insights Lab at Harvard.

*This data story uses data from the NFHS Policy Tracker for Parliamentary Constituencies developed by India Policy Insights at Harvard University. The tracker is accessible here.