India, a country celebrating its 75th Independence anniversary, has achieved significant milestones as the world’s third-largest economy in terms of purchasing power parity. However, it continues to face persistent challenges, especially concerning its female population. One crucial challenge is ensuring women have access to appropriate and dignified period products to manage their menstruation effectively.
Menstrual Health and Hygiene (MHH) play a pivotal role in the well-being and empowerment of women and adolescent girls. The World Health Organization (WHO) reports that over 300 million women worldwide experience menstruation on any given day. Shockingly, in total, approximately 500 million women lack access to essential period products and proper facilities for effective menstrual hygiene management (MHM). This highlights the resource and support gap, particularly in low- and middle-income countries like India, hindering women’s ability to manage their menstrual needs.
Recent studies based on National Family Health Survey (NFHS-5) have revealed concerning findings about managing the menstrual health of girls and women. A significant number of adolescent girls do not use period products, with only half of the surveyed girls (15-19 years) reporting their usage during menstruation.
The National Family Health Survey-5 data further unravels a distinct disparity between rural and urban areas when it comes to the exclusive usage of period products, including sanitary napkins, locally prepared napkins, tampons, or menstrual cups. Approximately 42% of adolescent girls in rural areas report exclusive use of period products, compared to 68% in urban areas. This rural-urban divide underscores the urgent need to address the underlying factors that hinder access to period product usage in rural areas.
Central Indian states, in particular, show lower period product usage rates than southern and northern states. However, the data consistently reveal that urban areas have higher percentages of period product usage, indicating better accessibility and availability. Notably, states and Union Territories like Mizoram (96%), Puducherry (92%), Chandigarh (91%), and Tamil Nadu (91%) demonstrate commendable rates of period product usage in urban settings.
In contrast, the usage of period products in rural India is concentrated in specific pockets of the country, such as Tamil Nadu (85%) and Telangana (83%). However, the rest of rural India consistently reports alarmingly low percentages of period product usage. Central Indian states, including Uttar Pradesh (24%), Madhya Pradesh (27%), and Bihar (29%), depict a grim picture of limited access to period products in rural areas.
The rural-urban gap in period product usage further compounds this issue, illustrating a substantial divide in the usage of period products. States like Madhya Pradesh stand out with a substantial gap of 36 percentage points, followed by Meghalaya with 34 and Odisha with 26 percentage points. These variations reveal the disparities between urban and rural areas within these states and the necessity for targeted interventions to address the imbalance in period product usage.
The challenges faced by adolescent girls, especially those in rural and remote areas, are multifaceted. Affordability remains a significant issue, as many families struggle to provide them with the necessary period products. Second, the prevailing taboos and misconceptions surrounding menstruation, which generate feelings of shame and stigma, have a particular impact observed in rural areas. This deeply ingrained cultural context makes the individuals who menstruate hesitant to visit pharmacies to procure period products, and they may feel uncomfortable approaching male family members for assistance. Consequently, these factors contribute to the significant disparities in the usage of period products between urban and rural populations.
Recognising the urgency of addressing these challenges, the government has launched various schemes and initiatives to reach out to adolescent girls. One such scheme is the Menstrual Hygiene Scheme under National Health Mission, which focuses on providing sanitary napkins to adolescent girls. Additionally, the government has implemented the Rashtriya Kishor Swasthya Karyakram (RKSK), a comprehensive adolescent health program that includes menstrual health education as a vital component. In addition to the central government’s initiatives, several state governments in India have taken proactive measures to address adolescent girls’ menstrual health and hygiene needs.
These programmes empower girls through education, accurate information, and decision-making skills, fostering agency and control over their bodies. However, despite these efforts, there remains a significant rural-urban gap in the usage of period products, emphasising the need to focus on rural women and address implementation challenges in rural areas. Lack of menstrual awareness, the persistence of taboo and stigma around menstruation and poor access to and affordability of period products are some factors contributing to the gap in period product usage in urban and rural areas.
Despite various initiatives, a considerable portion of the population continues to forego the use of period products, indicating the urgent need to address their accessibility and affordability, especially in rural areas of India.
To bridge the rural-urban gap, it is crucial to create an inclusive environment that ensures every individual who menstruates, irrespective of age or socio-economic background, has access to safe and affordable period products.
By prioritising the needs of individuals who menstruate and ensuring equitable access to information and resources, we can create an enabling environment that promotes their overall development and well-being. Furthermore, it is essential to work collectively to bridge the rural-urban gap and ensure that individuals who menstruate can embrace their periods with confidence, dignity, and pride.
Together, we can strive for a future where menstrual health is universally supported and empowered.
Mahashweta Chakrabarty is a junior research fellow at the department of geography, Banaras Hindu University.
Karan Babbar is an assistant professor, Jindal Global Business School, OP Jindal Global University and research advisor at pandemic periods.
Aditya Singh is an assistant professor at department of geography, Banaras Hindu University & an external research collaborator at Girl Innovation, Research and Learning (GIRL) Centre, Population Council, New York.
