Period Poverty and Menstrual Health Awareness: A Barrier

to Women’s Dignity in India

RAMTILAK PATEL – LOVELY PROFESSIONAL UNIVERSITY

ABSTRACT

Period poverty, which is a shortage of access to affordable menstrual materials, safe sanitation,
and proper rights to menstrual health information, remains a titanic source of shame and
gender disparity against women in India. Millions of women and adolescent girls continue to
suffer menstrual deprivation despite the recent advances such as national efforts at sanitation
and elimination of the GST imposed on the purchase of sanitary pads. The problem is
aggravated by long-standing cultural stigma, the lack of the well-developed infrastructure of
health care, and socio-economic inequalities, which strike the rural population, the non-
combatant households, and marginal social groups, the most. Period poverty has not just
physical discomfort consequences, but also impacts on the educational levels, participation in
the workplace, mental health and general quality of life. Most girls skip school when they are on
their periods in fear of leakages, insufficient privacy, and ignorance of how to use proper toilets
all of which leads to greater dropout rates. Reduced productivity and social isolation also affect
the productivity of working women. Through an evaluation of the government intervention
policies like the Menstrual Hygiene Scheme and school-based awareness, this study points out
the accessibility gaps, distribution, and awareness gaps. Based on the studies of menstrual
equity practices worldwide and In-country socio cultural forces, the paper posits that menstrual
health can be regarded not only as a hygiene factor but also as a fundamental constituent of
human rights, social health, and social justice. Addressing period poverty necessitates a multi-
level approach that incorporates policy change, better sanitation system, menstrual education,
destigmatization, and also fair access to sustainable menstrual pellets. Ensuring that all
menstruating individuals are able to deal with their periods with dignity is vital towards
promoting gender equality and empowering women in India in general.
Introduction

I have always believed that the menstruation is a natural process of recurring blood cycle
occurring in millions of women, girls, and other blood-released people in India. Even though it is
universal, it has a silence, stigma, and socio-cultural taboo that give out false information and
shame. In this regard, period poverty, which entails the lack of access to menstrual products,
safe sanitation and full menstrual education become an extremely important concern about
human rights and health. In India, where there are gender inequalities generations long
intertwined with economic inequality and an inadequate infrastructure, not only the physical
health but also dignity, education, mobility and engagement in the economy suffer because of
period poverty. Period poverty in India is defined by some areas of convergence caused by
various determinants. Financially, a big percentage of women, and particularly amongst the low-
income families, are unable to buy sanitary pads and have to use unclean substitute materials
amongst them, old cloth, ash, rags, or leaves. This increases the chances of contracting
reproductive tract infections and other health related problems. Most schools, workplaces, and
other places of the populace have infrastructures not sensitive to gender in that they do not
have gender-sensitive toilets, clean water, and proper disposal mechanisms, which are major
components in safe menstrual management. The inadequateness of such facilities is a
contributor to school drop outs, dropping socialization, and limited labor force involvement.
Menstrual practices are perceived as ritual in the culture and thus, they follow discriminatory
cultures that excludes women in temples, kitchens, and other daily activities and thus
discriminates them even more.

In women, period poverty affects them particularly severely among adolescent girls. Most of
them undergo menarche without any prior education on menstruation and thus, this results to
fear, confusion and disgrace. Girls will skip school at their cycle due to absence of sanitary
products or toilets which is detrimental to academic performance and causes them to drop-out.
Such an educational capture is not a one-day event, reproducing the cycles of poverty,
deprivation of further empowerment. Equally, informal or low waged women tend to have
difficulties with menstruation in the workplace in the absence of proper sanitary facilities
decreasing the productivity, attendance and general well being. Such governmental efforts as
the Menstrual Hygiene Scheme (MHS), pads distribution schemes, and the GST exemption on
sanitary pads in 2018 all are steps in the right direction in terms of access and affordability. But
there are still missing links in implementation, awareness and community outreach. Some
women do not know about schemes available; some are inconsistently supplied, or their culture
does not accept it; some have a lack of product choice. These issues show the importance of
having a more in-depth, rights-based approach to menstrual health- not just product
distribution, but also systemic injustices.
Modern studies conducted around the world with some investigating menstrual inequity among
college students in high-income nations indicate that financial issues, stigma, and the lack of
sufficient institutional matter are issues of a global concern. However, those problems are
compounded in India due to increased socio-economic inequalities, deep-rooted patriarchy, and
lack of infrastructure. Period poverty thus needs a multi sectoral approach which involves the
reform of policies, education, community involvement and the normalization of menstrual
discourse.It is critical to make sure that any menstruating individual in India has the ability to
cope with their period in a safe, comfortable, and dignified way that will lead to gender equality.
The acknowledgment of menstrual health as a priority of public health and as the basic human
right is the key to having an open and equal society.

Objectives of the Study

We have an interest in establishing a good understanding of period poverty in India, trying to

find the answer to the question of how bad menstrual hygiene feelings influence the dignity,
well-being and opportunities of women and girls. The question of what the actual meaning of
poverty is takes root here in regards to money obstacles, infrastructure malfunctions, cultural
shame, and educational gaps in the process. Another large section is the observation on how
old taboos and inaccurate concepts during time contribute to shame, silence, and
discrimination, and how it drives women out of social life and suppresses their independence.
We also will examine how period poverty upheavals major spheres of life such as the classroom,
hospitals and employment since when individuals are unable to have access to pads or secure
toilets, they miss classes, fall ill and lose working hours.

Secondly, we will criticize the existing policy picture, particularly the government ones, the
Menstrual Hygiene Scheme, pad drives, and new tax reforms, to assess what works, what does
not, and why they are difficult to implement. Also, we would like to trace how NGOs, civil
activists, and campaigns are driving forward the issue of menstrual health and unfreezing the
stigma.

Ultimately, it is hoped to propose concrete, achievable recommendations that can strengthen

menstrual policies, improve the accessibility of pads and clean toilets, create awareness, and
present menstruation as a human right. We would like this study to be a step towards the larger
cause of menstrual equity and a guard against the humiliation of every menstruating individual
in India.1

Patel, R. Period Poverty & Menstrual Health Awareness – contextual analysis of India.
Acquiring the Period Poverty: Concept and Components.

Period poverty is a condition in which menstruating persons cannot have this access to
resources, infrastructure, and knowledge to manage menstruation safely, comfortably, and with
dignity. Although the term is frequently used as a synonym to the unavailability of affordable
menstrual products, the situation is much bigger. Period poverty includes financial limitations,
lack of sanitation services, cultural stigma, discrimination, as well as lack of education between
menstruation. The combination of those factors creates a world in which menstruation is used
as an impediment to health, involvement and equality.

Economic Constraints

A stimulus to purchase menstrual products is one of the most obvious aspects of period
poverty. A large portion of girls and women in India are unable to afford sanitary pads, reusable
cloth pads or menstrual cups. The expensive prices of branded products, combined with low
income and unequal distribution of resources to the women, compel a great number to resort
to unhygienic substitutes such as used cloth, paper, ash, or husk. These substitutes increase the
chances of infections, pain, and embarrassment. Although in 2018 the government eliminated
GST on sanitary pads, in terms of affordability it is a key issue, as there is an unequal
accessibility of such products, and a way of staying poor.

Infrastructure and lack of Sanitation.

In other words, basically to handle periods safely, one does require their own rooms, running
tap water, running bathrooms, and a system in place to dispose of the trash. A ton of schools,
places of work, rural households and public places in India completely lack this gender-sensitive
arrangement. There has been a case when girls do not attend their classes on their period due
to broken toilets, no door, no running water, and no bin and incinerator. Women who were on
the informal jobs would run into the same wall ‑ the workplace tended to be either too crowded
or cold to give any personal space. The lack of proper infrastructure will only cause physical pain
and psychological inconvenience, as period management will be coarse and embarrassing.

Approximately 23 million girls drop out annually due to lack of menstrual facilities (Ministry of Education, 2021
report).
Disposable menstrual alternatives such as ashes, rags & husk increase RTI risk — National Family Health Survey
(NFHS-5).
Stigma, Taboos and Cultural Practices.

The Indian culture delivers the menstrual cycles to this huge taboo: it is regarded as being
unclean. Due to it, you cannot worship, cook and interact with friends, not to mention going
out. Those taboos make the subject confidential and disgraceful, preventing people to discuss
the issue of menstrual health abilities. Many girls are completely panic-stricken and confused on
the occasion of their first period since it is something families avoid discussing. Stigma spreads
over to product preferences as well some families refuse to consider modern means of
menstrual birth control such as menstrual cups or reusable pads because they have
misconceived. This complete silence disseminates issues of misinformation, dramatics and
injustice.

Deficit of Menstrual Health Education and Awareness.

Lack of data on periods is a massive aspect of period poverty. Adolescents receive

discontinuous, erroneous or inaccurate education regarding their body changes. Even in schools
where it is taught, they tend to follow a book on biology which ignores the emotional or
practical aspect. There are cultural vibes in which teachers feel uneasy discussing periods and in
most cases, the male students are not included in the discussion. Girls may fall off the right path
or resort to unsafe procedures or allow their shame to prevail without good knowledge. Class is
not only about hygiene, but it is also about squashing stigma.

Social and Structural Inequality.

All the big social gaps are caught up in period poverty. The amount of finances, caste, country
vs. urban life, disability, and isolation among many others all have a strong influence on period
management. The disadvantaged individuals have a hill to climb: poor cash-flow, bad
infrastructure, social isolation, and mobility. Trans and non-binary menstruators are taken to a
whole new level, largely due to the fact that they are neglected by the policy. These disparities
in power only exacerbate the menstrual inequity of everyone and demonstrate that period
poverty is not an individual inconvenience, but a systematic issue.2

Shame-based social exclusion during menstruation has roots in caste-gender hierarchies (Haque, 2019).
GST exemption on sanitary napkins: Notification No. 19/2018 – Central Tax (Rate).
Many rural households lack separate latrines for women — Swachh Bharat Evaluation Report 2020.
LITRATURE REVIEW

MENSTRUAL health has gained more focus in research lately - still, experts stress uneven
access to supplies among different populations. Fariha Haque argues biology alone doesn't
define periods; instead, societal norms shape women’s behavior while menstruating. In her work,
she shows people who bleed frequently absorb feelings of embarrassment, changing how they
move, speak, or act because of judgment fears and learned culture. She points out taboo around
periods isn’t just tradition - it functions socially, limiting autonomy and erasing needs.

A legal angle appears in Salim & Salim’s analysis, showing how menstrual well-being ties
directly to constitutional guarantees - especially the Right to Life. Instead of viewing it just as a
health matter, they claim recognition under law must go hand-in-hand with action and oversight.
Not including menstruation in policymaking, they note, undermines fairness, control over one's
body, along with personal dignity for those assigned female at birth. Because of this gap, the
researchers support a system grounded in rights - one where sanitary access isn’t framed as
charity, rather as something citizens are legally due.

Empirical data from Durva Dhok backs this claim using measurable outcomes - menstrual-
related absences tied to lower learning results. In her research in Maharashtra, female students
often miss classes when menstruating because sanitation infrastructure is missing - toilets, clean
water, or ways to dispose materials. These missed days aren't minor; ongoing absence slowly
weakens classroom engagement, reduces confidence, and raises chances of leaving school
entirely. Dhok highlights a deeper issue: even if sanitary items exist, poor facilities combined
with social taboos push girls toward hiding their periods, which then disrupts emotional
development and personal worth.

These writers together show period poverty goes beyond just lacking money for hygiene items.
While Haque focuses on the emotional weight and cultural taboos tied to periods, Salim & Salim
point out how laws and systems ignore menstrual needs. In contrast, Dhok reveals how poor
facilities hurt girls’ education during menstruation. Their combined findings suggest unequal
treatment stems from weak policies, societal attitudes, and failing public services. As seen across
all three studies, menstruating in India often means silence is enforced, discomfort is accepted,
and marginalization becomes routine. Thus, according to this body of work, achieving fairness
isn't only about giving out supplies - instead, it involves changing mindsets, updating laws,
improving infrastructure, and building knowledge through active engagement.3

Haque, F. — argues stigma shapes behavioural control & silence around menstruation.
Salim & Salim connect menstruation to Article 21: Right to Life with dignity.
Dhok highlights link between absenteeism & learning decline in Maharashtra schools.
RESEARCH GAP

The existing research on menstrual health and period poverty reveals key issues like cultural
taboos, financial limits, also lack of proper facilities for those who menstruate. Although Fariha
Haque examines personal experiences during menstruation - showing how embarrassment,
secrecy, along with learned habits shape women's everyday lives - her work stops short of
assessing policies or state duties. Likewise, Salim & Salim introduce a legal perspective that
stresses constitutional rights linked to menstrual dignity; however, they provide little evidence on
real-world law enforcement or how people actually benefit from such rules within communities.
When it comes to education, Durva Dhok clearly links periods to school interruptions - but her
study is restricted to secondary schools in Maharashtra, without looking at job settings,
differences across urban-rural areas, nor lasting effects on workforce engagement. In each of
these three analyses, a common shortcoming stands out - research tends to focus on menstrual
exclusion separately, whether framed as a societal issue, a gap in legislation, or an obstacle
within education systems. Instead of treating them apart, what’s missing is an integrated look at
period hardship that combines shame, real-world access to clean facilities, policy execution, cost
barriers, and how dignity plays out daily. Few papers assess if public efforts like the Menstrual
Hygiene Scheme actually work; nor do they often check how giving away low-cost pads or
changing tax rules impacts people using them. Hardly any research tracks shifts in mindset after
outreach campaigns, links supply levels to actual use patterns, or compares urban-rural
differences shaping menstruation realities.

Thus, existing literature lacks a full analysis treating period poverty as both a social and legal
challenge, while also considering education and human worth in India. Research is still needed
that looks at barriers, then checks if today’s solutions actually remove them; otherwise, it must
explore deeper system changes. This work fills the void by framing menstrual health through
rights linked to access, fairness, daily experience, and respect - shifting focus from toilets alone
toward real empowerment.
RESEARCH METHODOLOGY

This study uses a descriptive and interpretive method to explore period poverty in India,
particularly how poor menstrual care impacts women’s self-respect, schooling, or involvement in
community life. It aims to fill gaps found in earlier work by viewing menstrual inequity not just
as a medical problem, yet also through factors like cultural beliefs, weak enforcement of policies,
limited knowledge, availability of supplies, along with sanitation facilities.

The study uses mostly existing data, such as journal papers, official policies, findings from
global and local agencies, survey results, media reports, or human rights materials. Sources by
Haque, alongside those by Salim & Salim and Dhok, provide key ideas; meanwhile, other
scholarly and policy texts add context and contrast. This approach helps explore different
viewpoints, compare areas, also reveal how plans differ from real-world outcomes. Alongside
looking at documents, a thematic approach groups data into ideas like stigma, financial limits,
how policies work, poor infrastructure, schooling, or sense of worth - using these to spot trends.
Because themes highlight missing parts in services, they help judge if state programs truly fit
user demands. By comparing city and village experiences on menstruation, this way reveals
layered inequalities shaping resource access. Data interpretation here relies on description
instead of statistics, since the goal isn't numbers but insight into real-life experiences of period
poverty drawn from earlier work. Analysis emphasizes careful reading, spotting recurring
themes, comparing results across sources, while combining diverse scholarly perspectives.
Instead of quantitative methods, it examines policy documents, personal accounts, classroom
observations, alongside cultural factors reported in literature - building a fuller picture of
menstrual injustice as a matter of basic rights.

This approach finally provides thoroughness, side-by-side understanding, also logical flow,
enabling the research to add value to current discussions about menstrual dignity in India.

DATA ANALYSIS & FINDINGS

The review of current studies suggests period poverty in India stems from overlapping social,
financial, and systemic gaps - not just one cause. Looking at patterns across sources, poor
menstrual health connects closely to scarce availability of hygiene items, weak toilet
infrastructure, while cultural shame persists. Research consistently points out - those without
knowledge or means often face emotional strain, miss school or work, struggle with self-worth
when on their periods. These findings show it harms bodily care as well as personal respect,
freedom of movement, fair opportunities. A key result shows clear differences in how periods
affect city versus village populations. While urban females, particularly working women, might
get better supplies, they still deal with stigma and awkwardness at jobs - Haque points this out.
On the flip side, rural teens confront bigger physical barriers: many schools don’t have clean
water, usable restrooms, or ways to throw away pads, which pushes them to skip school when
menstruating. According to Dhok, missing class due to cycles links strongly to lower grades,
proving poor period support harms girls’ learning outcomes over time.

The study also shows government efforts - despite good intentions - are unevenly applied.
Programs for distributing products frequently miss recipients on a regular basis, whereas
outreach campaigns seldom tackle ingrained social stigmas. According to Salim & Salim's legal
review, menstruation-related health still isn't seen as an essential right, leading to scattered rules
instead of cohesive rights-based strategies. Results suggest that if menstrual respect isn’t
embedded within national laws and public health systems, actions taken will stay superficial.
Some studies show knowledge isn't enough to bring shifts. Although girls understand periods,
they often stay silent because of embarrassment - yet likewise, numerous women skip medical
help when experiencing pain. Such patterns suggest stigma takes root inside individuals, rather
than coming only from outside pressure. Hence, period-related disparities continue existing even
where sanitary supplies are easier to get, showing cultural norms weigh just as heavily as lack of
money.

Findings show period poverty isn't just about cost - it's tied to shame, poor policy action, and
lack of planning. This study’s data suggests change must happen in how people think, laws
respond, schools are built, products are priced, while shifting focus from secrecy to respect.
Results highlight that tackling menstrual health in India means adopting an inclusive, rights-
focused strategy.
4

Most Indian research isolates menstruation into single dimensions—social OR policy based.
Very few studies evaluate effectiveness of pad distribution schemes post-2018.
Intersectional menstrual needs of rural-urban and working women lack longitudinal
analysis.
Study primarily follows qualitative interpretive analysis of literature + policy papers.
Thematic coding included: stigma, affordability, sanitation, policy, access.
Period data compared using non-numerical descriptive analysis method
Urban users have product access, yet stigma remains high (Haque, 2019).
Rural educational losses correlate with infrastructure gaps (Dhok, 2021).
Policy success depends on implementation continuity, not announcement alone.
SUGGESTIONS & RECOMMENDATIONS

Findings show tackling period poverty in India calls for broad strategies focused on rights, not
just handing out supplies. Instead of scattered actions, government should treat menstrual health
like food or clean water - key to well-being. Rules ought to shift from charity models toward
guaranteed support, giving everyone who menstruates access to low-cost items, safe restrooms,
and trustworthy knowledge. These plans work only if real-world delivery improves, turning
promises into steady help reaching everyday communities. Focusing on better facilities matters
just as much - particularly in learning centers, work areas, and community spots. Restrooms
suited for menstrual needs, including clean water, private stalls, or trash bins, must be required in
training and job settings. Where females find secure places to handle periods, fewer miss school
or duties while engagement rises. For lasting change, small-scale eco-friendly pad making could
grow via village teams, shared worker models, or home-based factories. Such efforts boost
access - not only that, they open income paths for women.

Still, just improving access won't stop period-based bias if cultural shame stays unchallenged.
That’s why schools need to teach kids - both male and female - about menstruation early on,
replacing secrecy with openness. Teachers, local health guides, medical staff, and outreach
volunteers can shift deep-rooted views when they lead learning efforts together. Public mindset
might change more quickly if movies, athletes, media spots, or online personalities present
periods as natural, not dirty or embarrassing.

Meanwhile, ongoing oversight should be set up to check if public initiatives work well - using
repeated surveys, response tools, or local reviews helps spot issues in access, standards, or
knowledge. Cooperation among state agencies, charities, medical staff, schools, and business
partners supports broader progress. Achieving fair periods isn’t just about supplying napkins; it’s
building communities where females handle their cycles privately, freely, respectfully, and
without fear. In sum, findings suggest clear steps: laws must acknowledge menstrual needs,
systems should improve access, ongoing outreach helps reduce shame, social views need
shifting, policies require follow-up. Where such parts connect effectively, periods stop blocking
school, movement, or respect - instead turning into a normal body function without bias, pain, or
hush. Reaching this goal isn’t merely about health duties - it’s an ethical duty tied to fairness
between genders and basic rights across India.5

Menstrual equity must shift from charity-based supply to rights-based entitlements.

Community pad-manufacturing units = dual benefit: access + livelihood.
Menstrual education for boys & teachers reduces shame-rooted silence.
CONCLUSION

The study finds period poverty in India is still a serious rights issue tied to stigma, poor facilities,
income gaps, also limited knowledge about periods. Although menstruation is natural, society
often sees it as something dirty or embarrassing - this pushes females into quiet suffering.
Evidence shows unequal treatment around periods isn't just medical - it affects self-worth, limits
movement, lowers confidence, disrupts learning, further deepens gender bias. Absenteeism from
school among girls, reduced work involvement by women, reliance on unsafe products because
of price or availability - isn't random; these reflect deeper structural neglect where menstrual care
is seen as optional instead of essential. Even though state programs like free pad distribution and
tax waivers show some improvement, results stay limited without consistent follow-up, ongoing
checks, or actions to challenge social taboos. Research shows that simply providing sanitary
products won't end period-based disparities when latrines are poor, knowledge is weak, and
shame still shapes women's lives. Instead, fixing this issue means linking supply chains with
better facilities, policy support, learning campaigns, and reducing stigma. Managing
menstruation should be treated as a core part of community well-being, fairness between
genders, and basic respect - connected closely to the fundamental right to live with dignity.
Finally, ending period poverty means everyone must take part - governments, schools,
households, local groups, or broader social networks. Menstrual fairness becomes real once
periods are seen as ordinary, each girl can go to class without fear, or no female feels
embarrassed by her body’s functions. Progress relies on creating societies where having a period
doesn’t limit potential instead, it's met with dignity, ease, because open acceptance replaces
silence.6

Menstrual poverty aligns to dignity & Article 21 — recognition as human right needed.
Stigma + poor sanitation + affordability together sustain menstrual inequality.
BIBLOGRAPHY
1. Haque, F. (2019). Menstrual Behaviour & Social Stigma in India: Cultural Conditioning
& Embodiment.

2. Salim, A., & Salim, S. (2020). Menstrual Dignity & Constitutional Protection Under
Article 21. Indian Law Review.

3. Dhok, D. (2021). Educational Absenteeism Linked to Poor Menstrual Sanitation in

Maharashtra Government Schools.

4. UNICEF. (2022). Menstrual Hygiene & Global Access Report.

5. Ministry of Health & Family Welfare. (2011). Menstrual Hygiene Scheme (MHS) —
Policy Document.

6. Government of India. (2018). GST Exemption Notification No.19/2018.

7. NFHS-5 (2019–21). National Family Health Survey.

8. ASER. (2021). Annual Status of Education Report – Sanitation Facilities in Rural

Schools.

9. UNFPA. (2023). Menstrual Health & Dignity: Global Framework.