Championing the cause of menstrual hygiene in rural Madhya Pradesh

By Asees Kaur*

‘Menstruation is the only blood that is not born from violence, yet it’s the one that disgusts you the most.’ – Maia Schwartz

Menstruation has been a taboo topic from time eternal especially in India. The archaic view that this natural cycle is a ‘curse,’ ‘impure,’ and ‘dirty’ is still widely prevalent in our society, especially in rural areas. Even now, millions of women and young girls go through extreme struggles to manage their period every month. At the outset, it is imperative to highlight a few disturbing facts and figures around menstrual hygiene in India. The below-mentioned statistics will give readers a good insight into the extent and the graveness of the problem.

  • 71% of girls in India report having no knowledge of menstruation before their first period.
  • Further, 70% of women in India cannot afford to buy sanitary pads.
  • Only 36% of India’s 355 million menstruating females use sanitary napkins. The rest use old rags, husk, ash, leaves, mud, soil, and other life-threatening materials to manage their flow.
  • Nearly 23 million girls drop out of school annually after they start their periods.
  • As of 2012, 40% of all government schools lacked a well-functioning toilet, and another 40% lacked a separate toilet for girls.
  • Schools that are a critical part of the supply chain have been shut since the onset of the pandemic. This has left millions of teenagers across the country with no means to secure sanitary pads.

To know more about the issue, I interacted with Ms. Seema Verma, who has been a prominent voice in the space of menstrual hygiene. She was the President of Defence Wives Welfare Association, wherein she spearheaded multiple social projects pertaining to education, toilets for girls, vocational training for war widowed women, and waste segregation. Ms. Seema is currently at the helm of operations at her NGO- ‘Saksham- SERI’ based out of Bhopal. The focus area of the NGO is SEHER, i.e., Skill Development, Environment, Health, Education, and Rural Tourism.

During the course of the interaction, she advocated that in the recent years, the Government has taken up this issue seriously. However, several challenges persist despite the tax removal on sanitary pads and continuous efforts to provide pads at a lower cost to women in rural India. The challenges as mentioned by her have been outlined below

  • Low quality of napkins given by Government/NGO’s: Women still rely on cloth since the quality of the pads provided by the Government is abysmal.
  • Affordability of good quality pads: Given the recurring nature of this purchase, coupled with the requirement of multiple pads during a single cycle, sanitary napkins end up being an expensive proposition for women in low-income background settings.
  • Clothing limitations: Many rural women do not use undergarments, and sanitary napkins cannot be used without underwear.
  • Cultural Challenges and Traditional Practices: The archaic myths and ideologies are still prevalent in our society which refrains women from buying sanitary napkins.

Further, there are mounting environmental costs associated with the use of sanitary napkins

  • Environmental Catastrophe: India has 12 billion disposable sanitary napkins to take care of every year, most of which are not biodegradable/compostable, whereas WaterAid India, a non-profit organization, puts the figure at 21.7 billion. At 30% of the menstruating women using sanitary pads and more women being encouraged to use, this figure will only increase.
  • Lack of proper Disposal Mechanisms: This leads to an unhygienic environment, consumption by stray animals, which leads to severe consequences

Having stated the problem and challenges, the second half of the article will focus on the Pilot Project being run by Saksham- SERI in Madhya Pradesh.

Pilot Project in Madhya Pradesh by Saksham-SERI

As per Ms. Seema, a viable alternative to the use of sanitary napkins is menstrual cups. Menstrual cups are better since it is more affordable, environmentally friendly and is a medically superior product.

Saksham- SERI ran a small pilot project in one village of Raisen District of Madhya Pradesh to improve the adoption of menstrual cups among the menstruating population of the village.

There are 90 households with a menstruating population of 156 in the village.

The organization adopted a comprehensive approach to facilitate this adoption following these three key steps:

  • Awareness: Conducted door to door mobilization, IPC, demonstrations, and medical camps to spread the importance of menstrual hygiene and the advantages of menstrual cups
  • Access – Raised funds and tied up with menstrual cup suppliers to meet the increasing demand for menstrual cups at discounted rates. The cups are being distributed free of cost.
  • Capacity building – Young girls are being trained to ensure faster dissemination of information. These girls regularly take feedback and send it to the NGO.

Impact of the Project:

142 women (almost 90%) have tried the cups. Out of these 142, 5 young girls have been unable to insert. Most women have had a very high satisfaction level. Given the positive feedback of the cups, the remaining women are showing interest and are expected to give it a shot in the near future. Women from other villages, namely Rampura Kalan, Nateran, Dist Vidisha, and Village Khemkheda, are also showing a keen interest.


  • No physical discomfort like itching, scratching or bruising while working in the rain for paddy cultivation
  • Girls feel more empowered and hope to have higher attendance in school/college once the institutions reopen after the pandemic.
  • Felt less dirty
  • Ease of carrying the cup
  • No hassle of disposing of used pad/cloth
  • No stress of looking for cotton cloth.
  • No washing and drying issues
  • Inconvenience of waiting for men folk to retire for the day to go to the farms to burn the pads/cloth
  • Don’t have to rely on money to buy pads as the cup given by Saksham-SERI lasts 10 years
  • Some did not wear underwear and were happy about it.
  • Many talked about not getting any body odour /menstrual odour

What have been the quality of life improvements?

  • Increased ability to work during menstruation because no leakage and discomfort.
  • Physical Comfort
  • Menstrual management with zero financial investment
  • Anticipated gains: increase in school attendance during the menstruation cycle, increased work productivity
  • Not feeling dirty could easily be the first step towards educating them against taboos.

Scaling this model up to adjoining villages requires assistance

The initiative has huge possibilities in promoting health benefits as well as prevent environmental degradation. Therefore, it needs to be scaled up. In this context Saksham-SERI would require resources for community mobilization, travel costs, capacity building costs, management costs and is looking for resources in terms of funding and guidance. Saksham SERI would like to collaborate with the appropriate UN agency and turn the project an Indian success story.

To conclude, I think it is high time that India battles the shame of period stain and does away with the myths associated around it. To achieve this, it is essential that we support initiatives that are being taken by NGOs such as Saksham-SERI and at the same time do our bit by educating the society.


*Student of IIM Bangalore, PGP 2020-22

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