Menstruation is a natural biological process, yet it remains stigmatised in India, impacting the dignity, mobility, and health of millions of women and girls. The Menstrual Hygiene Day 2025 theme, “Together for a #PeriodFriendlyWorld”, emphasises collective responsibility and the need to normalise menstruation. While national policies like the Menstrual Hygiene Scheme (2011) have improved access, gaps in education, infrastructure, and affordability remain, especially in rural areas (Ministry of Women and Child Development & PIB Delhi, 2023). A truly #PeriodFriendlyWorld demands equity, awareness, and sustained political and social commitment.

Understanding Menstrual Health and Policy Evolution 

Historically, menstruation was mainly referenced in family planning to promote contraceptive use among married women (Stanback et al., 1997). In many low and middle-income countries (LMICs), early puberty changes were overlooked, with health interventions focusing on older adolescent girls due to risks of pregnancy and HIV (Germain & Kidwell, 2005; UNFPA, 2000). Before 2005, menstruation was not seen as a public health concern. The term menstrual hygiene management (MHM) emerged at a 2005 UNICEF roundtable, linking menstrual health to WASH programs focused on sanitation and hygiene (Kirk & Sommer, 2006). In the past two decades, MHM interventions have expanded to address gender equality, education, and rights. MHM includes access to clean materials, private spaces for changing, and proper disposal (McLaren et al., 2021). 

The Government of India introduced the Menstrual Hygiene Scheme (MHS) in 2011 to promote menstrual hygiene among adolescent girls in rural India. The initiative primarily aims to increase awareness about menstrual hygiene, provide access to high-quality sanitary napkins, and ensure environmentally friendly disposal methods. According to the National Family Health Survey 5 (NFHS-5), the percentage of women aged 15-24 years using hygienic methods of protection during menstruation increased from 58% in NFHS-4 (2015-16) to 78% in NFHS-5 (2019-21). Similarly, the usage of sanitary napkins rose from 42% to 64%, demonstrating the success of policy interventions (Ministry of Women and Child Development, Government of India & PIB Delhi, 2023).

Building on these advancements, legislative measures have been proposed to institutionalise menstrual health rights further. The “Right of Women to Menstrual Leave and Free Access to Menstrual Health Products Bill, 2022” aims to address persisting challenges through three days of paid leave for working women during their menstruation and mandating the availability of free menstrual health products to all women, regardless of their socio-economic status. If implemented effectively, this legislation could significantly improve MHH by reducing absenteeism in workplaces and educational institutions, alleviating the financial burden of purchasing menstrual products, and fostering a more inclusive and supportive environment for women (The Right of Women to Menstrual Leave and Free Access to Menstrual Health Products Bill, 2022).

Infrastructure, Education and Implementation Challenges   

Despite government-led initiatives, menstrual health remains a persistent challenge in India, particularly for marginalised communities. Limited access to affordable products, inadequate infrastructure, and deep-seated social stigma hinder progress. The government’s implementational shortcomings could be bridged through public-private partnerships, focusing especially on community-driven solutions.

Many government schools still lack gender-segregated toilets, safe water, soap, and waste disposal facilities, which affects menstrual hygiene and contributes to absenteeism (ANI, 2024; Press Trust of India, 2024a). Taboos and the absence of pre-menarche education isolate girls, leading to shame and misinformation. The lack of sensitisation among boys and community elders reinforces stigma and limits open discussions (McLaren & Padhee, 2021). Moreover, the Supreme Court has questioned whether the newly framed Menstrual Hygiene Policy for School Going Girls (2024) accounted for ground realities, especially in tribal and rural areas where implementation gaps remain acute (Tripathi, 2024; Business Today Desk, 2024).

State Innovations and Community-Based Models 

Under the Pradhan Mantri Bharatiya Janaushadhi Pariyojana (PMBJP), over 9,000 Janaushadhi Kendras have been established across the country to provide oxo-biodegradable sanitary napkins, branded as ‘Suvidha,’ at ₹1/pad. The National Health Mission has decentralised the procurement of sanitary napkins, giving the authority to individual states (MoHFW, 2023). Accredited Social Health Activists (ASHAs) have played a vital role in distribution, receiving an incentive of ₹1 per pack sold and a free pack each month for personal use (Sansad, 2023). ASHAs conduct monthly meetings at Anganwadi Centres and similar platforms to discuss menstrual hygiene (MoHFW, 2023).  

While national policies and legislative measures provide a crucial framework, state-level initiatives have also played a transformative role in advancing MHM. Maharashtra, in particular, has been at the forefront of implementing innovative, multi-sectoral MHM programs over the past decade (UNICEF & DWSS Maharashtra, 2021).

Maharashtra pioneered the development of state-specific MHM guidelines in 2016, setting a precedent for other Indian states to follow. Key initiatives such as the Asmita Yojana, providing subsidised sanitary napkins through women-run self-help groups, and the inclusion of menstrual hygiene education in school curricula have significantly improved awareness and accessibility. Unlike standalone interventions, Maharashtra adopted a cross-sectoral approach, aligning MHM with education, health, water, sanitation, and gender equity efforts. The government’s collaboration with civil society organisations, social enterprises, and academic institutions enabled robust evidence generation and targeted implementation at the grassroots level (UNICEF & DWSS Maharashtra, 2021).

Symbiotic relationships between the government’s vision and the dynamic capabilities of private partners create synergies that not only address the delivery gap but also pave the way for sustained progress and impact. Recognising this, states have been instructed to take up the procurement of sanitary napkin packs in conjunction with private enterprises through competitive bidding.

Harnessing the potential of public-private partnerships, Kumbalangi in Kerala became the first napkin-free village in the country. While led by the parliamentary members, a complete switch to menstrual cups was done in conjunction with HLL Management Academy through their ‘Thinkal’ scheme and Indian Oil Corporation. The project in Kerala demonstrated that structured awareness programs significantly increased the adoption of menstrual cups, with 40.6 per cent of women who received awareness sessions switching to menstrual cups, compared to just 20.7 per cent who received the product without training. This suggests that education and awareness campaigns play a crucial role in driving sustainable menstrual hygiene practices (Varghese et al., 2023). Over 10 years, a single menstrual cup could cost much less than pads or tampons. 

Also read: Reimagining Period Products: What India Needs from Innovation in Menstrual Care

Roadmap to a Period-Friendly India 

Normalising menstrual health in school curricula from primary levels is essential to break stigma early and foster inclusive attitudes. WASH infrastructure—separate toilets, running water, and privacy—must be mandated in every school and Anganwadi to ensure safety and dignity. States should be encouraged to support MSMEs through price preference policies and public procurement to supply low-cost menstrual products. Digital campaigns involving social media influencers can help destigmatise menstruation among youth, especially boys. Safe community spaces where girls can seek support and information without shame must be established. Ultimately, partnerships between the government, civil society, and the private sector can lead to a #PeriodFriendlyWorld.

References available upon request. 

Views expressed by: Lubna Ludheen, Research Associate, and Anandini Gupta, Research Fellow at Centre for Development Policy and Practice (CDPP)

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