Janvi Satpal Babbar

India has a female literacy rate of almost 75% - 77% (2023–2024), yet it still struggles with the understanding and actively participating in self-hygiene, especially during menstruation. What actions from the government and NGOs do you think could fill this gap more quickly?

Bridging the Menstrual Hygiene Gap in India: What the Government and

NGOs Must Do Faster?

India today stands at an interesting yet deeply paradoxical crossroads. On one hand, the country has made substantial progress in female literacy, with women’s literacy rates touching nearly 75–77% in 2023–2024. On the other hand, a significant number of girls and women still lack basic awareness, confidence, and agency regarding menstrual hygiene and self-care. Literacy, therefore, has not automatically translated into bodily awareness, health autonomy, or menstrual dignity. This gap is not merely an issue of sanitation or health — it is an issue of silence, stigma, social conditioning, and systemic inaction.

While working as a Legal Researcher for the Ministry of Rural Development in 2022, I had the opportunity to closely examine one of the government’s important public health interventions — the Menstrual Hygiene Management (MHM) Scheme, 2015, which was later revamped in 2023. Even after years of policy initiatives, the field reality remains concerning. Reports and state-level findings under later scheme reviews indicate that a vast number of rural girls in India still learn about menstruation only when they experience their first period. In many cases, this first experience is accompanied not by guidance, but by fear, confusion, shame, and misinformation. That is where the real problem lies. Menstruation is not a niche “women’s issue.” It is a natural biological process essential to human reproduction, and yet it continues to be treated as if it were something impure, embarrassing, or morally uncomfortable. Until this social mindset changes, no scheme — however well funded — can fully succeed.

The Core Problem: Information Exists, But Conversation Does Not India does not suffer from a complete absence of menstrual schemes. In fact, the government has introduced several notable initiatives over the years. The issue is that policy exists on paper, but menstrual understanding has not yet entered everyday culture.

For instance, the Menstrual Hygiene Management Scheme (MHM) was conceptualized to improve awareness, access, and safe menstrual practices, especially among adolescent girls in rural areas. Similarly, the Suvidha Scheme (2018) made sanitary napkins available at ₹1 per pad through Jan Aushadhi Kendras, making menstrual products more affordable and accessible.

These are commendable interventions. Additionally, the Prime Minister publicly speaking about menstruation from the Red Fort was symbolically significant — because when leadership speaks openly, it challenges silence at the national level.

But the hard truth is this: access without awareness is incomplete, and awareness without comfort is ineffective. A girl may have access to a pad, but if she has been taught that menstruation is “dirty,” she may still feel ashamed to buy it, use it, or ask questions about it. A woman may know what a sanitary napkin is, but may not know about safe disposal, infection risks, menstrual irregularities, reusable alternatives, or when to seek medical help.

This is why the next phase of India’s menstrual policy must move beyond distribution and into social transformation.

What the Government Must Do to Fill This Gap Faster?

1. Make Menstrual Education a Mandatory Part of Schooling: Menstrual awareness must be taught before puberty, not after it. Too many girls in India encounter their first period without any prior knowledge, which is both psychologically distressing and medically irresponsible. The government should make age-appropriate menstrual and reproductive health education mandatory in all schools — government and private, rural and urban alike. Importantly, this education should not be restricted to girls alone. Boys must also be included. When boys are educated, stigma reduces, bullying decreases, and menstruation becomes normalized rather than ridiculed.

2. Shift from “Distribution” to “Dignity-Centered Implementation”: Providing low-cost sanitary napkins is important, but menstrual hygiene policy should not stop at product supply. A truly effective approach must include:

• awareness on menstrual health,

• safe usage and disposal,

• access to clean toilets and water,

• privacy in schools and public institutions,

• and referral pathways for menstrual health concerns.

Menstrual hygiene must be treated as a public health and dignity issue, not merely a welfare issue.

3. Strengthen Grassroots Delivery Through ASHA, Anganwadi, and ANM Networks: India already has a powerful community-based public health structure. The government should leverage ASHA workers, Anganwadi workers, and Auxiliary Nurse Midwives (ANMs) more strategically by giving them:

• specialized menstrual health training,

• local language resource kits,

• myth-busting communication tools,

• and regular community outreach responsibilities.

These women are often the first trusted point of contact in rural and semi urban communities. If empowered properly, they can become the strongest force against menstrual misinformation.

4. Introduce Community-Level Mother–Daughter and Family Sessions: One of the most overlooked realities is that most girls receive their first information about menstruation from home, and often that information is incomplete or fear-based. The government should create village- and ward-level family dialogue modules where mothers, daughters, sisters, and even fathers can participate in guided menstrual awareness sessions. Because the truth is: if menstruation remains taboo inside the home, it will remain taboo everywhere else.

5. Monitor Awareness, Not Just Product Distribution: Schemes are often evaluated by numbers — how many pads were distributed, how many schools were covered, how many beneficiaries were listed. But real success should also be measured through:

• age of first awareness,

• confidence in discussing menstruation,

• understanding of hygiene practices,

• school attendance during periods,

• and access to safe menstrual facilities.

India must begin to measure menstrual literacy, not just menstrual supply.

What NGOs Must Do Differently?

Government schemes create the framework — but NGOs often create the human connection. This is where civil society must step up more meaningfully.

1. Awareness Must Be Active, Not Passive: Too often, menstrual awareness is reduced to a one-time workshop, a distribution drive, or a social media campaign. While these have value, they are not enough. NGOs must move away from passive awareness and toward active, repeated, community-based engagement. Menstrual literacy cannot be built in a single session. It requires trust, repetition, safe spaces, and local ownership.

2. Create Dialogue, Not Just Workshops: Perhaps the most important intervention is this: there must be dialogue among women. Workshops often become top-down — one person speaks, others listen. But what many girls and women actually need is something far more powerful: conversation.

They need spaces where they can ask:

• “Is my cycle normal?”

• “Why do I get pain?”

• “What if my period is irregular?”

• “Can I play sports during periods?”

• “Why was I told not to enter the kitchen?”

• “Why do I feel ashamed buying pads?”

These questions are not solved through pamphlets alone. They are solved when women are allowed to speak without fear of being judged. NGOs should therefore facilitate:

• small group menstrual circles,

• peer-led discussions,

• adolescent girls’ clubs,

• village women’s dialogue sessions,

• and intergenerational conversations.

When women speak to women openly, shame begins to dissolve.

3. Work in Local Language and Cultural Context: Awareness material often fails because it is either too clinical, too urban, or too disconnected from local realities. NGOs must communicate in regional languages, using locally understood examples, and in a tone that is respectful rather than preachy. The aim should not be to “lecture communities,” but to change norms from within.

4. Include Men and Community Gatekeepers: No menstrual movement can succeed if it is discussed only among women while being silently controlled by everyone else. Fathers, brothers, teachers, village elders, and religious/community influencers must also be engaged. If a girl is being restricted from attending school, buying pads, or drying cloth openly, that is not merely her issue — it is a household and social issue.

NGOs must therefore design menstrual awareness campaigns that include:

• men and boys,

• school teachers,

• panchayat representatives,

• and local opinion leaders.

Stigma survives in silence; it weakens in participation.

5. Connect Menstrual Awareness With Legal and Human Dignity: Menstrual hygiene is not only a health issue — it is linked to education, equality, mobility, privacy, and dignity. NGOs, especially those working in law, governance, or women’s rights, should begin framing menstrual health as part of human dignity and gender justice. Because when a girl misses school due to lack of menstrual support, or when a woman is shamed for a biological process, it is not simply inconvenience - it is a denial of equal participation in public life.

The Way Forward: Normalisation, Not Tokenism

India does not need more token acknowledgment of menstruation. It needs normalisation. The real solution lies not only in more pads, more posters, or more policy announcements — but in building a culture where menstruation can be discussed as naturally as fever, nutrition, or school attendance. The government has already laid down important foundations through schemes like MHM and Suvidha. NGOs, educators, health workers, and community leaders now have the responsibility to carry that work into people’s daily lives. Because the true measure of menstrual reform is not whether a scheme exists. It is whether a 12-year-old girl, when she gets her first period, feels informed instead of afraid, supported instead of silenced, and dignified instead of ashamed. That is the India we must work toward — urgently, collectively, and unapologetically.

Your organisation Nari Shakti Morcha is working on menstrual sanitation and sexual health and women's legal rights. How far do you think India is still struggling with toxic mentalities like marital rape and mental as well as physical abuse?

The Nari Shakti Morcha’s (NSM) Approach Is Different: It Treats Menstrual Awareness as a Social Justice Issue What makes the work of NSM especially relevant is that it does not reduce menstruation to a one-dimensional “pad distribution” issue. Instead, it understands a more important truth: period poverty is not just about lack of products — it is about lack of information, lack of comfort, and lack of dignity. NSM’s publicly stated work reflects this broader vision. The organisation has been actively working to spread menstrual hygiene awareness among rural Indian women, while also distributing free sanitary napkins and female condoms as part of its outreach efforts. Its website also highlights interactive educational work aimed at making girls more comfortable with their bodies and with menstruation itself — which is exactly the kind of intervention India needs more of.

What gives Nari Shakti Morcha a stronger and more sustainable identity than many issue-based organisations is that it does not isolate menstrual health from the larger ecosystem of women’s empowerment. Its platform reflects work not only in menstrual hygiene awareness, but also in:

• free legal aid for women and children,

• workshops on legal rights and duties,

• breast cancer and cervical cancer awareness,

• and broader women’s health and mental health initiatives.

This integrated model is extremely important. A girl who is ashamed of menstruation may also be a girl who has never been taught bodily autonomy. A woman who cannot access menstrual products may also be a woman who cannot access justice. A rural adolescent who misses school due to periods may also be someone who has never been informed of her rights, her health choices, or her legal protections. NSM’s work appears to recognise this continuum — that women’s empowerment cannot be fragmented. Health, hygiene, dignity, education, and legal rights are all deeply connected.

NSM Is Not Just Building Awareness — It Is Building a Culture Shift

In a country where menstruation is still whispered about, every organisation working in this field has a choice: either to remain symbolic, or to become transformational. NSM’s stated mission — “Empowering Women, Elevating Lives, Ensuring Hygiene for All” — is important not because it sounds aspirational, but because it reflects a framework India genuinely needs right now. The menstrual conversation in India cannot remain trapped in token campaigns or urban social media narratives. It must travel to schools, villages, colleges, homes, and community spaces — and it must do so in language that is accessible, dignified, and stigma-free.

India’s Deepest Gender Crisis Is Not Just Legal — It Is Cultural

When we speak of women’s rights in India, we often make the mistake of assuming that progress can be measured only through legislation, policy, and institutional reform. But the lived reality of millions of women tells a more uncomfortable truth: India’s deepest gender crisis is not merely legal — it is cultural, psychological, and generational. Even today, despite constitutional guarantees, women’s protection laws, growing literacy, and increasing public discourse around gender justice, India continues to struggle profoundly with marital rape, emotional abuse, coercive control, domestic violence, and normalised female suffering. And perhaps the most disturbing part is this: many of these forms of abuse are still not even recognised as abuse within the social imagination of marriage. That is the real crisis.

Because in India, a woman is often not first taught her rights.

• She is first taught adjustment.

• She is taught that silence is maturity.

• Tolerance is virtue.

• Sacrifice is womanhood.

• And suffering is marriage.

That is why the issue is much bigger than criminal law alone. We believe that a woman must know not only what the law says, but also what she deserves. Because rights are not truly rights if women have been socially trained not to claim them.