The adoption of safe and hygienic menstrual products has increased in the last five years, but in some of India’s poorest states, around one in three women still rely on unsafe protection methods during their menstrual periods, the NFHS has found.

Despite impressive gains in the last five years, as many as 27% of young rural women still use unhygienic methods of protection during their menstrual period, found the fifth round of the National Family Health Survey (NFHS-5) held in 2019-21. The share was 52% in the previous round held in 2015-16.

Around 57% of rural women, and 50% overall, also said they had used cloth for the purpose at some point. Saturday, 28 May, marks the annual Menstrual Hygiene Day, observed globally to raise awareness about safe menstrual protection.

Among the urban population, 10% of young women reported using unhygienic methods, a sharp drop from 22% in 2015-16.

The data covers girls and women aged 15 to 24. Menstrual products such as locally made napkins, sanitary napkins, tampons, and menstrual cups are classified as hygienic methods by the NFHS.

The overall share of women using hygienic menstrual products exceeds 90% in 16 states and union territories (UTs). The 2015-16 survey had found just eight such states. However, some of India's poorest states performed badly on this metric. Women in Bihar were the least likely to be using safe menstrual protection (59%), followed by Madhya Pradesh (61%) and Meghalaya (65%). These states are among the five worst performers on the Niti Aayog’s multidimensional poverty index.

Surprisingly, Gujarat, whose multidimensional poverty rank falls midway among states, had just 67% such women.

The union territories of Puducherry, Andaman and Nicobar Islands, and Lakshadweep, as well as the state of Tamil Nadu, performed best, with more than 98% of young women having access to safe menstruation products.

Among the several items used by women, sanitary napkins were the most popular, with 64% saying they had used them. More sustainable and environmentally-friendly products such as menstrual cups were the least popular (0.3%). Women who were surveyed could pick multiple products that they had used.

Access to safe menstrual periods has been a long battle for Indian women, particularly in rural areas and among poorer groups. Women who have completed their schooling were found to be the most likely (90%) to use hygienic methods, compared to just 44% among those who did not attend school. Among women from the wealthiest quintile, 95% had access to such methods, while the figure for the poorest quintile was 54%.

Menstrual hygiene is critical for women, who make up about half of India's population, but it has been a tough development issue due to taboos associated with it. Mindsets, religious customs, and biases prevent women from discussing menstruation freely, and this hinders access to hygiene. The NFHS-5 findings suggest that India has made significant progress, but there’s still some way to cover.

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