Summary
- Menstrual hygiene in India remains deeply unequal, with limited access and affordability affecting millions of women and girls
- Gaps in WASH infrastructure, including lack of safe toilets and disposal systems, continue to restrict safe menstrual management
- Social stigma and silence around menstruation undermine awareness, dignity and informed decision-making
- Poor menstrual hygiene impacts education, workforce participation and long-term economic outcomes
- Government efforts exist but face challenges in last-mile delivery and sustained implementation
- Integrated approaches, including CSR-NGO partnerships like Smile Foundation’s Swabhiman programme, are critical to ensuring access, awareness and dignity at scale
Indian women are steadily making their mark across the globe from entertainment and sports to academia and financial institutions. Yet, their true potential can only be realised when they have unequivocally equal access to education, healthcare and economic opportunities, just as men do in a truly progressive society. This Menstrual Hygiene Day, it is important to pause and reflect on the everyday challenges that still shape how women, especially in rural and remote communities, are able to manage their menstrual hygiene with dignity.
Menstrual Hygiene: A Multilayered Challenge
- Access and Affordability
Women and girls in India face significant challenges in accessing menstrual hygiene products. Out of an estimated 350 million women, aged 12-45, only 12% can afford sanitary towels, highlighting a critical affordability gap in menstrual hygiene.
At a basic level, access to sanitary products, appropriate underwear and related essentials remain a transactional challenge, particularly for low income and rural populations.
- Infrastructure and WASH Gaps
India’s fight to eradicate menstrual health challenges for young girls and women in India has been a long battle. With multiple policies to enhance menstrual hygiene management, India has been working towards full proof menstrual management for young girls and women. However, the execution of these policies has still been a challenge. Menstrual hygiene management is further constrained by
- Inadequate WASH (Water, Sanitation and Hygiene) infrastructure
- Lack of safe, private toilets with functional doors
- Limited access to clean water
- Inadequate disposal mechanisms for menstrual waste
These challenges are especially pronounced in schools, workplaces, public spaces and health centres, with many rural households still lacking access to toilets altogether.
- Social Norms and Cultural Barriers
Beyond infrastructure, menstrual hygiene is deeply influenced by social norms and cultural perceptions.
- Menstruation continues to be viewed as impure or unclean
- A pervasive culture of silence restricts open conversations
- Limited awareness impacts both women and men
This environment not only restricts access to information but also undermines the dignity and health of women and girls.
- Social and Economic Consequences
The implications of poor menstrual hygiene extend beyond health.
- School absenteeism among girls due to lack of facilities and support
- Reduced participation in education and workforce
- Long-term economic implications for individuals and national productivity
Additionally, many girls avoid using public toilets, further restricting their mobility and access to sanitation.
- Environmental Impact
Even with relatively low usage rates, menstrual waste poses a growing concern.
- Less than 18% of women use sanitary pads
- Paradoxically, urban India generates approximately 58 million discarded pads annually
This creates a significant burden of non-biodegradable waste, highlighting the need for sustainable menstrual hygiene solutions.
Managing Menstrual Hygiene in Rural India
At least 500 million women and girls worldwide still lack access to adequate menstrual hygiene management (MHM) facilities, highlighting a persistent gap in basic dignity and health. In India, the Swachh Bharat Mission has brought MHM into sharper focus by supporting the construction of girl-friendly sanitation facilities and promoting awareness within communities, including among boys and men, to help break long-standing taboos around menstruation.
Globally, similar efforts are gaining ground. In Liberia, the Education Sector Plan integrates MHM and disability-inclusive infrastructure into school and WASH planning. In Ethiopia, school-based WASH programmes prioritise MHM to improve girls’ enrolment and attendance. Together, these initiatives, supported by partnerships between governments and organisations such as the World Bank, are helping elevate MHM from a neglected issue to a national priority.
Beyond Health: The Cost of Poor Menstrual Hygiene
Menstrual hygiene is closely linked to education, dignity and economic participation. When addressed holistically, it enables girls and women to stay in school, access opportunities and lead healthier lives.
However, on ground experience across rural and tribal communities highlights a few common and persistent barriers that extend beyond access alone. Deep rooted social norms often create mistrust towards external interventions. Conservation around menstruation remains limited and unfamiliar service providers are not always readily accepted, restricting timely access to essential care and information.
- Dropping out of school
Infrastructure gaps further compound the issue. The absence of clean, safe and private sanitation facilities in schools continue to impact adolescent girls disproportionately, often leading to absenteeism or permanent dropouts at critical stages in their education.
- Lack of reproductive health agency
Equally significant is the lack of agency around reproductive and menstrual health. Many women and girls do not have access to reliable information or the freedom to make informed choices about menstrual products and practices. This limits their ability to manage their health with dignity and confidence.
- Lack of emergency preparedness
Recent crises like the pandemics or natural disasters, further exposed the vulnerabilities faced by women. Disruptions in supply chains, restricted mobility and financial strain reduces access to essential menstrual hygiene products and management, reinforcing the existing inequalities. These challenges underline the urgent need to integrate menstrual health into emergency preparedness and ensure continuity of care in uncertain times.
As highlighted by UNICEF and Indian constitution, menstrual hygiene is a fundamental right and bringing this in full effect for every female in India, sustainable community engagement is required to strengthen infrastructure and collaborative efforts that place dignity, awareness and accessibility at the centre of focused menstrual health interventions.
Role of the government
The Ministry of Health and Family introduced the Menstrual Hygiene Scheme under the National Health Mission’s Menstrual Hygiene Management Programme, to improve awareness, expand access to affordable sanitary napkins and promote safe disposal practices.
However, the impact has been limited. The scheme envisioned distributing sanitary napkins across 107 districts while enabling self help groups to produce and sell low cost pads (under Rs 8 per pack) in an additional 45 districts, but due to inconsistent supply and weak last mile delivery, the action plan couldn’t be implemented to its full potential.
And this is where CSR-NGO Partnerships can come into the picture to execute the government’s action plan.
Promoting women’s menstrual health with Smile
Menstrual hygiene management (MHM) cannot be viewed as sanitation alone. For millions of women and girls it is closely tied to dignity, bodily autonomy and their ability to access, education, work and wider life opportunities. Addressing MHM, therefore, is fundamental to advance gender equality in a meaningful and sustained way.
As guided by the World Bank, the efforts to strengthen the MHM agenda must include technical expertise, data-driven insights and ecosystem building efforts which can be achieved through targeted partnerships for women’s health. One such example in India, is Swabhiman by Smile Foundation. With over two decades of grassroots engagement and 400+ partnerships, Smile Foundation has reached more than 1.90 lakh women and girls in FY 2024–25 alone.
Through its Swabhiman programme, the organisation combines health, nutrition, and livelihood support delivering integrated maternal and adolescent healthcare through lifecycle approach, ensuring the young girls and women of rural communities of India, can access, avail and afford menstrual hygiene with ease and for long term.
1. Why is Menstrual Health Day important for global development?
Menstrual Health Day highlights the link between menstrual hygiene, dignity, education, and economic participation. It drives global awareness and encourages multi-sectoral action to ensure women and girls can manage menstruation safely and without barriers.
2. What are the key barriers to menstrual hygiene in India?
Limited access to menstrual hygiene products, inadequate WASH infrastructure, affordability constraints and deep-rooted social stigma collectively restrict women’s ability to manage menstruation safely and with dignity.
3. How does access to menstrual hygiene products impact girls’ education?
Reliable access to menstrual hygiene products reduces school absenteeism and dropout rates. When girls can manage menstruation safely, they are more likely to attend school consistently and participate fully in academic and social environments.
4. How can CSR partnerships strengthen menstrual health outcomes?
CSR-NGO partnerships can improve last-mile delivery of menstrual hygiene products, strengthen community engagement, and enable behaviour change interventions—ensuring sustainable, scalable menstrual health solutions in underserved regions.
5. Why is Menstrual Health Day relevant for corporate stakeholders?
Menstrual Health Day offers an opportunity for organisations to align ESG and CSR strategies with gender equity goals, supporting initiatives that improve access, awareness and infrastructure for menstrual hygiene management at scale.
6. What role do menstrual hygiene products play in economic empowerment?
Access to affordable menstrual hygiene products enables women to participate consistently in the workforce, reducing productivity losses and supporting long-term economic inclusion, particularly in rural and low-income communities.
7. How can Menstrual Health Day drive behaviour change at the community level?
Through targeted campaigns, Menstrual Health Day helps normalise conversations, reduce stigma, and promote informed choices creating an enabling environment where women and girls can adopt safe and hygienic menstrual practices.
8. What makes menstrual hygiene a multi-sectoral development issue in India?
Menstrual hygiene intersects with health, education, gender equality, and sanitation. Ensuring access to menstrual hygiene products, awareness and infrastructure is critical to achieving inclusive and sustainable development outcomes in India.
