Menstrual hygiene health education in India is a major issue. Women in India, especially in Rural areas, are unaware of Menstrual hygiene. Critical public health and gender equity issues. Despite increasing awareness, there are many challenges, like cultural taboos, lack of education, and inadequate access to sanitary products.

Menstrual hygiene in Odisha

Menstrual hygiene in Odisha has seen many improvements in recent years. Many Government initiatives, Community-led programs, and Campaigns have led to many changes.

Initiatives,  like the Khushi Scheme and the Menstrual Health and Hygiene policy.

Community-led Programs,  like Gram Vikas, Project Bala, Advika Groups,and Shipra Foundation.

Awareness campaigns, like Let's Talk period cramps, and Community radio programs.

 

These initiatives and the Campaign promote health hygiene in Odisha. They aim to provide Free Sanitary Pads and spread awareness about menstrual health hygiene.

Urban Vs Rural Areas

There is a clear difference in menstrual hygiene practices in urban and rural areas in Odisha. Rural areas do face challenges like a lack of awareness, poor sanitation facilities, and limited access to sanitary products.

Urban Areas

In urban Areas, Women are generally more aware of the importance of proper menstrual hygiene. Urban Areas have better access to schools and education, which has led to an increase in awareness about menstrual hygiene. 

In Urban Areas, Sanitary pads are easily available and affordable. Approximately 49.4% of women in urban Odisha use sanitary pads. However, it still lags behind the national average of 57.6%, according to .The New Indian Express

Rural Areas

In Rural areas, Women lack knowledge of proper menstrual health hygiene because they lack school education and awareness of hygiene, particularly in tribal communities.

Many rural households lack access to sanitation Facilities. Women don’t have access to Sanitary pads. They use old clothes as menstrual absorbents, which can lead to infections if not properly cleaned and dried. Only 30.3% of women in rural Odisha use sanitary pads. The New Indian Express

Safe disposal of menstrual material is a big concern in rural areas, women often restores to improper disposable methods . 

Literacy Level Vs Awareness Correlation

There is a direct relation between literacy level and menstrual hygiene awareness.

Studies show that a higher level of education tends to lead to greater awareness and better practices regarding menstruation. Illiteracy often leads to poor awareness about infections, hygiene practices, and difficulty in managing periods. 

Studies indicate that 92% of women who use clothes are illiterate, and 87.3% are dropouts. Despite efforts, 46.7% of people are unaware of menstruation rural areas have a higher ignorance level.

Cultural Beliefs and Taboos

Menstrual hygiene in Odisha is deeply rooted in cultural beliefs, taboos, and regional practices, which vary across different districts. These norms have a great impact on school-going girls and women's workplace, which affects their health, social participation, and education.

In many tribal communities of Odisha, Menstruation is considered impure, which leads to so many restrictions, like women can't enter temples or the kitchen during these days. They even had to sleep in different areas. 

Communities believe menstruation is a part of shame and have to maintain secrecy to avoid shame.

Juang Community, Women often use old clothes (kaffin) during menstruation, which are washed and dried in secluded areas to avoid any public view and maintain purity. Sometimes, the used clothes are buried to avoid impurity and contamination of other people. 

According to the data, most Juang women (85%) used old clothes during menstruation, and lack of awareness (31%). Around (85%) of women are restricted from participating in religious activities and (94%) avoid social gatherings. (Prashant Kumar Mudi, 2018 BioMed Central)

Seventy-one percent of Juang women experience menstrual problems while only one-third of them are able to solve the problem.

In Malkangiri district, a group of young tribal women formed "Bada Didi" to educate people about menstrual hygiene, traditional taboos, and cultural beliefs.

Impact on School Girls. 

Cultural taboos often lead to school absenteeism among school girls. A Koraput district community feast celebrates the menarche, which helps to educate girls about the natural process and helps to remove the stigma.

However, in Berhampur, urban slum girls are not aware of menstruation before menarche. A study reveals that only 15% of girls were aware of menstruation before menarche, and 73% reused clothes because of the unavailability of sanitary pads and facilities.

Health issues due to poor menstrual hygiene 

Poor menstrual hygiene can lead to severe health problems among women. It can lead to short-term discomfort to long long-term diseases.

Poor menstrual hygiene increases the chances of infection, irritation, rashes, and itching in the vaginal area, and Reproductive health issues cause disturbance in daily routine and tasks.

Practices of poor menstrual hygiene like the use of unclean and absorbent materials, not changing sanitary products for more than seven hours, poor genital hygiene( eg. not washing or using unclean water), and lack of access to washrooms, water, and soap, cultural taboos leading to the secrecy of information. 

Severe health problems

Urinary Tract Infections 

The urethra is close to the vaginal opening, poor hygiene leads to the risk of contamination, prolonged use of sanitary products leads to bacterial infection, inadequate wiping, and improper washing habits during menstruation spread bacteria.

Symptoms like Burning sensation during urination, Urge to urinate, Foul smell in the vagina, and lower abdominal pain.

Complication

If untreated UTI leads to fever, Flank pain, and Kidney damage. UTIs can affect overall urinary health. 

Reproductive  Tract Infection 

It is the infection of reproductive organs, caused by poor hygiene.

The infections are Endogenous infection (overgrowth of the organism in the vagina e.g. Candida), Iatrogenic infection (Caused by medical carelessness e.g. unsafe absorption), and Sexually transmitted infections. 

Symptoms like Abnormal vaginal discharge, itching or burning in the genital area, pelvic pain, pain during intercourse or menstruation.

Long-term reproductive health issues

Persistent poor hygiene and untreated infections lead to Infertility (blockage of the fallopian tube), Ectopic pregnancy(infection damages the fallopian tube), Cervical cancer risk, and Endometriosis(abnormal menstrual cycle).

Sanitary pads vs Cloth vs Menstrual cup

Disposable Sanitary Pads

Cost

Pads used by the majority of women, like Whisper Ultra and Stayfree. It ranges from ₹4 to ₹13 per pad. If we assume 5–6 pads per cycle and 12 cycles per year, annual costs range from ₹240 to ₹936.

Each pad takes around 500–800 years to decompose, contributing significantly to landfill waste.

 Cloth

According to the NFHS-5 (2019-21), about 64% of women use hygienic methods during menstruation. However, in rural areas, women still use old cloth, rags, or ash because of a lack of awareness and the cost of sanitary pads.

Cost

It costs nothing as women use old clothes during their menstrual cycle.

Menstrual Cups

Cost

Menstrual cups are available from ₹249 to ₹1,800, which last up to 10 years. This accounts for an annual cost of ₹25–₹180. It is made up of medical-grade silicone, they are reusable and create minimal wastage.

Adoption

Despite their benefits, adoption remains low in India, with only 0.3% of women aged 15–24 using them, often due to cultural taboos and lack of awareness.

NGOs and other organizations

NGOs (Non-Governmental Organizations) and international organizations play a crucial role in promoting menstrual hygiene management (MHM). These organizations especially work in developing and low-income level countries where cultural norms, taboos, lack of education, and poor sanitation infrastructure make the scenario worse. These organizations aware, educate, and provide access to needed resources.

Non-Governmental Organizations (NGOs) play a crucial role in accomplishing government efforts.

• NGOs conduct workshops and seminars to raise awareness of the importance of menstrual hygiene and the use of sanitary pads among school-going girls.

• NGOs often collaborate with local authorities and assist in the timely distribution of sanitary pads and ensure that no girl is left behind.

• NGOs and government schemes often try to improve policy and better implementation of strategy.

They play many roles listed below:

1. Aware and Educate

NGOs play a crucial role in educating and making aware of menstrual hygiene communities, marginalized groups, and school-going girls. They organize educational campaigns, seminars, and workshops to dispel myths and normalize menstruation. 

They empower women to manage their menstrual cycle effectively and improve their overall well-being.

E.g., UNICEF supports menstrual health education.

       Goonj in India addresses menstrual health hygiene.

2. Access to Sanitary Products

NGOs and other international organizations make sanitary products accessible to rural areas. They distribute free sanitary pads, reusable cloth pads, menstrual cups, etc.

They also promote local production of menstrual products to ensure sustainability and provide livelihoods to women.

E.g., Khushi Scheme of Odisha.

        Plan International supports local women entrepreneurs to locally produce sanitary products.

       

3.  Improving Water, Sanitation, and Hygiene, Infrastructure

NGOs collaborate with governments to provide clean water, toilets, disposable systems, and private washing areas to maintain hygiene in schools and public spaces. They implement a wash program to avoid absenteeism among schoolgirls.

E.g.,  WaterAid works to improve sanitation facilities and train girls in menstrual hygiene.

4. Empowerment and Community Engagement

These NGOs empower women and girls through peer education programs and support groups. It includes both boys and girls to create an inclusive environment for conversation on menstruation. Helps in the local production of sanitary products, including local women.

E.g., The Pad Project (from the film Period. End of Sentence) supports community-led pad-making units in India.

Khushi Scheme

The Khushi Scheme is an initiative taken by the Government of Odisha, on February 26, 2018, Khushi (Happiness) in Odisha is a female health and menstrual hygiene program run by the State Government. It aims to promote menstrual hygiene and reduce the school dropout rates of adolescent girls. This program empowers girls through improved health and menstrual hygiene. The Health Department of the Odisha Government aims to provide free sanitary pads to 1.7 million female students from grades 6th to 12th.Wikipedia

   Objectives of the Khushi Scheme

• The objective of this program is to provide free sanitary pads to all girls in government and government-aided schools from Class 6 to 12.

• It raises awareness among adolescent girls about menstrual hygiene practices.

• This scheme Ensures that menstrual hygiene is not a barrier to education, and motivates girls for better attendance.

• It economically empowers women and girls through promoting local production and distribution of sanitary pads.

 Challenges and Concerns.

Despite the good intentions of the Khushi Scheme, it has faced many challenges.

• In August 2024, reports emerged from Cuttack District Headquarters Hospital that the sanitary pads were expired, highlighting the issue in managing inventory.

• In April 2025, hundreds of unused sanitary pads were found rotting at a school in Bhadrak, which indicated a failure in the distribution process.

• There have been times when the quality of the sanitary pads was found to be poor, it affected the scheme's credibility. 

Rashtriya Kishor Swasthya Karyakram

It is a national-level health program in India. It was launched by the Ministry of Health and Family Welfare (MoHFW). It aims to improve the health and well-being of adolescents through promotive and curative health services and education. It includes Early adolescence (10-14 years), Late adolescence (15-19 years), includes both in-school, out-school, married and unmarried, rural and urban.

The objective of RKSk

 RKSK focuses on mainly six areas:

1. Sexual and Reproductive Health (SRH)

2. Nutrition

3. Non-Communicable Diseases (NCDs)

4. Mental Health

5. Injuries and Violence (including Gender-Based Violence)

6. Substance Misuse

 Components

1. Adolescent Friendly Health Clinics This initiative aims to Set up  Primary Health Centres (PHCs), Community Health Centres (CHCs), and District Hospitals. Provide counseling, curative services, referral, and distribution of commodities like Iron Folic Acid (IFA), sanitary pads, and contraceptives.

2. Peer Educator Programme (Saathiya) Two peer educators (one male, one female) are selected per village, they train to provide information and guide adolescents on health issues. They use the “Sathiya Resource Kit" and a mobile application to disseminate knowledge.

3. Weekly Iron and Folic Acid Supplementation It provides Weekly iron and folic acid tablets to prevent anemia in school-going girls and adolescents.

4. Menstrual Hygiene Scheme It Promotes safe and healthy menstrual hygiene practices,and provides sanitary pads and awareness.

Anganwadis

Aganwadis play a crucial role in promoting menstrual hygiene, especially in rural and semi-urban areas. They act as a key part of the community-level health and education infrastructure in India, operating under the Integrated Child Development Services (ICDS) scheme.

They educate girls and their mothers about the importance of menstrual hygiene practices. Use storytelling, group discussions, and informal sessions.

Aganwadis help in eliminating myths, stigma, and taboos related to menstruation.

Supporting girls who just entered puberty, and providing guidance on how to use and dispose of the sanitary pads. They offer emotional and psychological support to help girls.

Aganwadis work closely with ASHA workers, ANMs, and PHC staff to refer girls with any infection and menstrual problems. Conduct health checkups and awareness camps.

Comparative study of India and Odisha

India

In India, 78% of young women between the ages of 15 and 24 use hygienic methods of protection during their periods, according to the National Family Health Survey (NFHS-5, 2019–21). Compared to 48.2% in 2015–16, this represents an improvement. But there is still a rural-urban divide: Compared to 89.4% of women in cities, 72.3% of women in rural areas practice hygiene.Hindustan Times+2JHPOR+2Indiaspend+2Indiaspend

Odisha

Odisha State Insights: Odisha has made great progress in improving menstrual hygiene, but there are still issues.

Sanitary Napkin Usage: In 2017, only 33.5% of women in Odisha used sanitary napkins, compared to the national average of 57.6%. 

By 2019–21, this number had increased to 79.5% in rural areas. The New Indian ExpressIndiaspend

Unhygienic Practices, Despite improvements, 40.6% of women still used cloth as a menstrual absorbent, and 54.9% reported washing and reusing their menstrual product..PubMed.