If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
Contextualizing the socio-economic and spatial patterns of using menstrual hygienic methods among young women (15–24 years) in India: A cross-sectional study using the nationally representative survey
The use of menstrual hygienic methods sharply increased 58%–77% in NFHS-4 to NFHS-5.
•
Education and Wealth are foremost factor to practice hygienic methods.
Abstract
Background
Utilizing hygienic methods during the menstrual cycle reduces women's health vulnerabilities and promotes their overall well-being. However, the usage of unsanitary menstrual methods is sizable among young women in India. Therefore, the current study aims to determine the socioeconomic and geographic distribution and predictors of using menstrual hygiene methods among Indian women.
Methods
The present study used secondary data, i.e., the National Family Health Survey-5 (2019–2021). The total sample of the study consisted of 241,180 young women aged 15–24 years. Descriptive statistics, bivariate analysis with the Pearson chi-square significant test, and multivariate analyses were applied to accomplish the study objectives.
Results
In India, about 77% of women utilized hygienic menstrual methods. However, there were significant sociocultural and geographic differences in sanitary menstruation procedures. Menstruation hygiene practices were far less common in India's socioeconomically underperforming districts. Age, education level, social status, religion, place of residence, and geographic region were discovered to be significant factors in utilizing hygienic menstruation techniques. Women's exposure to mass media, autonomy, and household wealth were determined to be motivating factors for using clean menstrual procedures.
Conclusion
Majority of young women adopted hygienic menstrual methods, yet socioeconomic and geographic inequalities still raise questions. Therefore, the population and spatial stratification strategies should be used to diminish regional heterogeneity and encourage the use of hygienic menstruation practices by all. Further study is encouraged to investigate how behavioral and socioeconomic factors influence menstrual choice and practice in India using qualitative research approaches.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
During the menstruation cycle or period, using hygienic methods (locally prepared napkins, sanitary napkins, tampons, and menstrual cups) lessens women's health vulnerabilities, promoting a reproductive tract infections (RTIs)-free life and overall well-being.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
Menstrual absorbents are unhygienic because these materials are often reused without proper cleaning using any soap or disinfectant solution and dried without direct sunlight or air.
A cross-sectional study on awareness regarding safe and hygienic practices amongst school going adolescent girls in rural area of Wardha District, India.
In particular, the use of unhygienic absorbents increases the risk of urinary tract infection (UTI), sexually transmitted infections and diseases (STI/STD), and so on.
A previous study by Garg et al. (2010) found a positive association between using unhygienic absorbents and the likelihood of STIs. Further, long history of STI resulted in gynecological complications.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
India has made significant progress in promoting hygienic menstrual practices. However, the progress and acceptance of using hygienic menstrual methods differ with space, population, and time.
The temporal change in practicing hygienic menstrual methods is found to be noteworthy, but socioeconomic heterogeneity in practice remains a concern in India.
It has been found that demographic characteristics such as a woman's age, marital status, age at marriage, and length of married living are significant predictors of menstruation practices in India and other nations.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
In addition to the demographic context, the practice is strongly correlated with women's educational attainment and socioeconomic standing. A significant regional and rural-urban variation was also observed in the prior analyses.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
The well-known taboos like restrictions to attending any social occasions and restriction of entry into kitchen and worship places during the menstruation cycle also shape menstrual practices in India.
Besides, menstruation is typically perceived as a private matter; therefore, girls/women usually prefer menstrual absorbents and use unclean, dirty, and unhealthy menstrual absorbents to maintain privacy.
A small-scale survey found that the reuse of cotton cloths as an alternative to using disposable pads is substantial in India (ranging from 43% to 88%).
To encourage and promote menstrual hygiene practices, the Government of India (GoI) launched a number of programs, including the National Menstrual Hygiene Scheme (NMHS), subsidized sanitary napkin distribution via the Accredited Social Health Activists (ASHA) and self-help groups (SHGs), and free sanitary napkin distribution.
In India, women's standing has also improved over time regarding education, independence, and empowerment. As a result, India has been transitioning to the use of sanitary napkins. For instance, the level of sanitary napkin use among young women (15–24 years) increased from 58% in 2015–16 to 78% in 2019–21.
The socio-cultural and economic diversity is considerable in India, which shapes the patterns of menstrual practice (hygienic/un-hygienic methods). However, no prior research has documented the current scenario of menstrual practices among young women (15–24 years old) in India. Therefore, the present study is intended to re-examine the levels, patterns, and predictors of hygienic menstrual methods practice in India among young women using the latest nationally representative dataset (i.e., the fifth round of the National Family Health Survey, 2019–21). Understanding the patterns and causes affecting young women's menstruation practices in India and comparing changes in practice to previous research will be straightforward tasks for the current study. In addition to district-level spatial patterns of menstrual behavior, the current study also explores hotspot clusters. This information will be helpful to researchers and policymakers in framing policies or carrying out further research.
2. Materials and methods
2.1 Study setting
India is charecterized as the world's second-most populous country (1.4 billion population), with 28 states and eight union territories (UTs). Each state and UTs are further divided into districts. Districts are subdivided into census enumeration blocks and wards in rural and urban areas, respectively. The Indian government currently offers a variety of options for public health promotion and has taken several policies for promoting hygienic menstrual practices. Assam, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, and Rajasthan were considered as EAG states to prioritizing socio-economic up gradations and public health promotions.
We conducted secondary data analysis on the NFHS-5 dataset. Initially, the current research proposal was submitted to Demographic Health Survey (DHS), after which authorization to use data was obtained. NFHS surveys capture data on the health and welfare of the Indian population through a nationally representative sample.
We included female participants between the ages of 15–24 years, those who reported their hygienic menstrual practice. Young aged (15–24 years) women were considered to evaluate the patterns and predictors of using menstrual blood strain protection methods.
2.3 Sample size and sampling technique
Census enumeration blocks and wards were chosen from district-level rural and urban areas, respectively, through a two-stage sampling procedure. Data collection was done using Computer-assisted personal interviews (CAPI) from 2019 to 2021 with a well-structured schedule and proper maintenance of the confidentiality of respondents’ answers. A detailed description of the sampling design and survey procedure has been provided in the national report of NFHS-5.
Total 7,24,115 of women completed the questionnaire, and 4,82,132 participants did not meet our eligibility criteria, so they were excluded from this study. However, the NFHS only gathered data on menstruation practices from women aged 15–24 years.
The dependent variable of this study is hygienic practices during menstruation of young women. In NFHS-5, women aged 15–24 were asked what method or methods they use for menstrual protection (survey question: what do you use for protection?). The responses were captured in the following six categories: (a) cloth, (b) locally prepared napkins, (c) sanitary napkins, (d) tampons, (e) menstrual cups (f) others, and (g) nothing. To prevent blood stains during the menstrual cycle, sanitary napkins, locally produced napkins, menstrual cups, and tampons have all been considered hygienic menstrual practices. If a woman uses any of these four methods during her menstruation period considered as hygiene practice (coded as ‘1’), on the contrary, the use of cloths and others is indicated as unhygienic practice (coded as ‘0’). The details of the questionnaire and responses are available in the public domain
The independent variables for assessing the utilization of hygienic menstrual methods were socio-demography and behavioural and family characteristics. Some of the covariates are age (categorized as 15–19 years and 20–24 years); respondent's education (classified into no education”- those who had no formal education, primary, secondary, higher), religion (Hindu, Muslim, Christian and others), social group (scheduled caste, scheduled tribe, other backward classes and general), wealth quintile (poorest, poorer, middle, richer and richest), type of toilet (flush, pit/dry, others, open), women's autonomy (low, medium and high), and exposure to mass media (no, partial and full exposure). Following earlier studies, classifications of women's autonomy and media exposure were created.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
Spatial heterogeneity and socio-economic correlates of unmet need for spacing contraception in India: evidences from National Family Health Survey, 2015-16.
For the geographical distribution of menstrual hygiene practices, we adopted the NFHS-5 classification of regions where Indian states and union territories are grouped into six regions: north, central, east, northeast, west, and south.
STATA 14.2 (Stata Corp, College Station, Texas, USA) was used for statistical analysis. Before analyzing, all flagged, missing, and no information cases were removed during the recoding of variables. The NFHS sampling weights were used to justify the differential probabilities of participant selection and ensure the validity of our study findings.
The “svyset” command was used to state the dataset as survey type and to estimate the weighted proportion of using hygienic menstrual methods. Hygienic menstrual methods utilization across predictors was estimated using the weighted proportion with a 95% confidence interval (CI) and Pearson chi-square significance test. Multivariate logistic regression was performed for all the selected independent variables with the outcome and reported an adjusted prevalence ratio (OR) with 95% CI.
Consequently, multivariable regression was done after checking for collinearity among the variables using the variance inflation factor (VIF).The “svy” command was used for generalized linear model and adjusting for sampling weights to assess the independent effects influencing the usage of hygienic menstrual methods. Results with p values less than 0.05 were considered statistically significant in the final model. To determine the spatial distribution of the usage of hygienic menstrual methods in India, we used ArcGIS 10.3.1 software. To represent it nationally, we used the weighted proportion for this.
3. Results
Table 1 depicts the percentage of different methods used to protect bloodstain at the time of menstruation. Sanitary napkins, locally prepared sanitary napkins, tampons and menstrual cups are considered as hygienic methods, whereas cloths and other are considered unhygienic methods. Nearly, one-third (64%) of women use sanitary napkins, whereas nearly half (49%) of women use clothes to protect bloodstains during their menstruation. Nevertheless, about 0.2% of women still do not use any methods at all.
Table 1Menstrual absorbent use among women aged 15–24 years in India, NFHS-5, 2019–2021.
Fig. 2 shows the level of hygienic methods across all Indian states. On average, 77% of the respondents use hygienic methods during menstruation. In state-wise distribution, the use of menstrual hygienic methods is highest in Tamil Nadu (98%), followed by Goa (97%) and Kerala (93%), whilst the lowest is found in Bihar (59%) and followed by Madhya Pradesh (63%), Meghalaya (65%), Gujarat (66%) and Assam (67%). Furthermore, the usage of hygienic methods found to be lower among the districts belonged to the central, western and eastern region (Fig. 3).
Fig. 2State-wise pattern of using menstrual hygienic methods among women aged 15–24 years in India, NFHS-5, 2019–2021.
Table 2 reveals the socioeconomic characteristics of women aged 15–24 years in India, NFHS-5. The majority of women are belongs to Hindu (80%) and others backward classes (43%). A negligible proportion of the respondents (7%) have no formal education and more than two-third of the respondents (68%) have secondary level of education. Nearly, one-third (29%) of the respondents are from urban areas. Nearly, two-third of women (70%) have a medium level of autonomy in household. The majority of the respondents (71%) have partial exposure to mass media. About one-fifth (20%) of women still defecate in open fields. Most of the respondents are from the central region (28%) and followed by the east (24%) and south (17%).
Table 2Background characteristics of women aged 15–24 years in India, NFHS-5, 2019–2021.
Table 3 presents the prevalence of hygienic menstrual practices with socio-economic backgrounds. Concerning religious affiliations of respondents, use of hygienic methods is higher among Christian women (86%) compared to Hindus (77%) and Muslims (74%). The use of hygienic methods is highest among general caste women (85%), while the lowest proportion of hygienic method is found among scheduled tribe women (65%). There is a linear association between women's education and use of hygienic methods. For instance, the use of hygienic methods varies from 43% in illiterate to 93% in higher educated women. The use of menstrual hygienic methods is higher among urban women than rural counterparts (89% vs. 72%). The prevalence of menstrual hygienic methods also increased from the bottom to the upper quintile of household wealth. About 95% of the richest quintile of women uses the hygienic methods during menstruation, while the corresponding figure for the poorest quintile is 53%. There is a positive association between women's autonomy and the use of hygienic methods. Furthermore, hygienic methods are considerably higher among women who have higher (88%) exposure to mass media. Households having a flush toilet are a significantly higher prevalence of menstrual hygienic methods among women. Apparently, geographical location also varies the use of menstrual hygienic methods.
Table 3Use of hygienic menstrual methods among women aged 15–24 years in India, NFHS-5, 2019–2021.
Table 4 presents multivariate logistic regression analysis for assessing the socioeconomic correlates of menstrual hygienic methods in India. Women aged 20–24 years had less likelihood to use of menstrual hygienic methods (AOR: 0.81; 95% CI: 0.71–0.92) compared to peers to protect the blood stain. Women belonging to ST had a lower probability (AOR: 0.84; 95% CI: 0.72–0.97) of hygienic methods compared to SC women. Apparently, the prevalence of menstrual hygienic methods was significantly higher among general caste women (AOR: 1.17; 95% CI: 1.31–2.42) compared to SC and ST women. Higher educated women had 5 times odds to use of hygienic methods (AOR: 5.36; 95% CI: 4.18–6.87) than illiterate women. Likewise, women residing in urban areas (AOR: 1.74; 95% CI: 0.64–0.87) were more likely to use of hygienic methods than those living in rural areas. Women from the richest quintile were almost 6 times more likely to use hygienic methods (AOR: 6.17; 95% CI: 4.61–8.26) compared to those from the poorest quintile of household wealth. Women's autonomy played a positive role to use of hygienic methods. The odds of menstrual hygienic methods was significantly higher among women who have higher autonomy (AOR: 1.36; 95% CI: 1.13–1.65), higher mass media exposure (AOR: 1.47; 95% CI: 1.15–1.86). The probability of hygienic methods was significantly lower among women who resided in no toilet facility (open defecation) in household (AOR: 0.82; 95% CI: 0.72–0.93). Compared to women from the north, the use of hygienic methods were significantly higher among the women from the south (AOR: 1.18; 95% CI: 0.95–1.47).
Table 4Logistic regression analysis showing the factors associated with menstrual hygienic methods among women aged 15–24 years in India, NFHS-5, 2019–2021.
We further assessed the interaction of important socio-economic factors with place of residence and household wealth status to demonstrate the study findings in a more nuanced level of analysis (Fig. 4). Compared to the poorest women from urban areas, the women belonged to poorest quintile in rural area were less likely to use hygienic methods. Similar patterns also followed with urban richest and rural richest groups (Fig. 4a). Compared to urban-illiterates, the rural-illiterates less likely adopted hygienic methods (Fig. 4b). Furthermore, higher educated women in rural areas less likely preferred hygienic methods compared to their urban counterpart. The rural-urban differentials in using hygienic methods across social groups also found to be considerable (Fig. 4c). Regarding the interaction of household wealth status and education shows that compared to illiterate women from poorest quintile, illiterate women belonged from richest quintile are about 5 times more likely to opt for menstrual hygienic practice (Fig. 4d).
Fig. 4Adjusted odds ratios of using menstrual hygienic methods by (a) place of residence-household wealth status, (b) place of residence-education, (c) place of residence-social group, (d) wealth quintile-education categories of women, India, NFHS-5, 2019–2021.
Using the most recent nationally representative survey, the current research attempts to re examine the patterns and predictors of menstrual hygiene behavior among young women (aged 15 to 24) in India (NFHS, 2019–21). The following are the study's key findings: First, 77% of young women in India followed hygienic methods to control their menstrual blood. Indian young women are reported to adopt more hygienic methods than women in other south Asian countries, including Bangladesh, Pakistan and Nepal.
The variances in practice may result from sociocultural differences among countries, which impact menstrual behaviors and customs. Secondly, within the Indian geographical boundary, the regional and district-level heterogeneity in using hygienic methods was also observed, the result in line with previous studies.
The north-south regional gap was broad, and practice was substantially lower in the northern and central regions (i.e. Bihar, Madhya Pradesh, Uttar Pradesh, Chhattisgarh, and Jharkhand) as compared to the southern region. More particularly, the EAG states performed lower than forward states and the national average. The spatial diversity in socioeconomic backwardness, knowledge of managing menstrual health care, and social acceptability likely explain the regional discrepancy in hygienic menstrual practices.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
Third, the present study identified a considerable rural-urban disparity in using hygienic menstrual procedures, pointing to rural-urban differences in population, policy, and practices. The results are consistent with those of other research conducted in India and other LMICs.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
India must therefore close the rural-urban divide to become a country free of unhygienic practices. Economic scarcity, ignorance, a lack of female autonomy, reluctance to purchase sanitary products from shopkeepers, and a lack of improve toilet facilities are the leading causes of the usage of low-hygienic practices in LMICs, including India.
According to a community-based study conducted in rural northern India, the absence of sanitary napkins and other hygienic alternatives in rural marketplaces led to the use of alternative, homely available unhygienic methods.
Menstrual morbidities, menstrual hygiene, cultural practices during menstruation, and WASH practices at schools in adolescent girls of North Karnataka, India: a cross-sectional prospective study.
The impact of household-level poverty may be the result. Previous research revealed that women in rural and poorer areas tend to have poor washing habits due to the absence of clean restrooms and access to water.
Fourth, In India, it was determined that following hygienic menstrual procedures significantly linked with women's educational level. This result is consistent with several earlier studies conducted in South Asian nations, including India.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
Spatial heterogeneity and socio-economic correlates of unmet need for spacing contraception in India: evidences from National Family Health Survey, 2015-16.
which favorably encourages acceptance and use of sanitary practices. Fifth, the economic and social backgrounds of the young women were found to be crucial predictors of using hygienic menstrual methods in the present study; the finding is consistent with previous studies.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
Furthermore, the women who belonged to the poor household quintile and socially poor groups were found to be less likely to use hygienic methods, particularly in rural settings (Fig. 4). Some previous investigations tried to explain the issue of lower uses of hygienic methods among the poor with affordability.
As an illustration, a box of 20 branded sanitary napkins costs about 100 rupees. As a result, the young woman from lower socioeconomic groups refrained from using hygiene methods.
concerns about the products' quality and accessibility persist.
Our analysis demonstrates that socially disadvantaged populations typically employ unsanitary practices. Similar results were also reported in earlier research, which suggested that they might be consequences of extreme socioeconomic and geographical destitution (i.e. high female illiteracy, low women's autonomy, low household income, and living in remote areas).
In addition to their socioeconomic disadvantage, their attitudes toward employing unsanitary procedures are influenced by traditional practices and a lack of menstruation awareness. Previous small-scale research also showed that the Gujjar, Sarava, and Japatu tribal women in India were less likely (less than 3%) to adopt hygienic methods.
Further research is encouraged to better understand tribal women's menstrual hygiene practices.
In India, inter-religious inequality in the use of hygienic methods was also found to be significant, similar to social group differences; this conclusion is consistent with many earlier studies.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
In addition, it was lower among Hindus and Muslims than among Christians and other groups associated with religious belief and practices, as shown by earlier studies.
How do women and girls experience menstrual health interventions in low-and middle-income countries? Insights from a systematic review and qualitative metasynthesis.
The well-known taboos among Muslims and Hindus, such as forbidding entry into the kitchen and places of worship while a woman is menstruating, are also tangentially related to menstrual rituals in India.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
women's autonomy and exposure to the media were favorable factors in choosing hygienic methods, as found in the present study. The results of this study and previous studies support the notion that employing hygienic methods while menstruating is highly influenced by media knowledge of personal cleanliness. Similarly, women's autonomy increases women's reproductive rights and choices, which positively reflects in hygienic method practices.
Spatial heterogeneity and socio-economic correlates of unmet need for spacing contraception in India: evidences from National Family Health Survey, 2015-16.
our study established that India could reduce the additional burden of UTIs, STIs, STDs, and other menstrual illnesses and infections by increasing the coverage of universal sanitary menstruation methods. India needs to prioritize the use of hygienic menstruation techniques for all women and to lessen socioeconomic and geographic heterogeneity. Through the use of rural health volunteers like Accredited Social Health Activists (ASHA), the GoI established the Menstrual Hygiene Scheme (MHM) and Rashtriya Swasthya Karykram (RKSK) programs to encourage the usage of hygiene standards. Additionally, GoI launched several initiatives to increase teenage girls' understanding of hygienic habits and ensure the accessibility of reasonably priced sanitary products, particularly in rural areas.
However, a sizable percentage of young women used the unsanitary practices identified in the study, which points to the inadequacy of current policies and initiatives or may raise concerns about tradition, socioeconomic status and poverty.
4.1 Recommendations for the further study
The present study merely examined the spatial and socioeconomic patterns and predictors of using hygienic methods among young women in India. Therefore, further study is needed to measure the socioeconomic disparity in using sanitary methods, which will help to understand the contribution of socioeconomic factors to the practice. The present study is limited to answering the behavioral aspects of the choice of methods; therefore, qualitative research is needed to explore the in-depth views of the practice. The present study is purely cross-sectional. As a result, a longitudinal study is required to investigate the relationship between menstrual practices and socioeconomic and demographic factors.
4.2 Clinical implications for health managers and policy makers
The clinical implications for health managers and policy makers may be followed some strategies to overcome the issues of unhygienic menstrual practices: Firstly, to solve the issue of burden of menstrual infections and related diseases need to be focus on universal coverage of unhygienic menstrual methods and to promote hygienic practice.
Secondly, it is necessary to strengthen the programs already in place to encourage young women who reported using unclean procedures to use hygienic alternatives.
Finally, policymakers and health managers should incorporate population-centric and regional approaches to solving the heterogeneity in using hygienic practices based on region and socio-economic settings.
4.3 Strengths and limitations of the study
The present study has several strengths. Firstly, the study will be helpful to understand the current scenario of using menstrual hygienic methods among young women and to understand how the results are similar or dissimilar to existing findings. Secondly, the study is also valuable in comprehending the areas of India where unclean practices are most prevalent. It would be useful to public health policymakers and health managers to formulate new policies and programs or to revise existing policies. Finally, the results of this study will be used by researchers to do further research in the area of public health.
However, the present study has certain drawbacks. Firstly, due to the cross-sectional design, the study is limited to describing the causal relationship between the outcome variable and the predictors. Secondly, the results are based on self-reported responses, which could be affected by the reporting (under or over-reporting) based on the socio-economic background of the population, site, and situation during the interview. Finally, the present study is limited to understand how young women are using their sanitary napkins (like the duration of using a sanitary napkin, practicing proper wash after using sanitation, and so on), which affects the results of hygienic practice.
5. Conclusion
The present study concludes that unhygienic methods were widespread in India, particularly in rural settings. Regional and socioeconomic differences in the usage were also considerable. In particular, it was shown that using unhygienic methods was concentrated in EAG states and was more common in socioeconomically disadvantaged groups. However, previous research findings have suggested that using unhygienic methods is positively associated with menstrual infections and related diseases. Therefore, it is crucial to focus on the accessibility, acceptability, and affordability of hygienic methods in India to achieve universal coverage. The current study encouraged program administrators and managers of health services to critically examine ongoing programs to comprehend the reasons behind spatial and socioeconomic disparities in menstrual practice in India using spatial, and population stratification approaches.
Ethics approval and consent to participate
This study is based on secondary data which is available in the public domain. Therefore, ethical approval is not required for conducting this study.
Consent for publication
Not Applicable.
Availability of data and materials
The dataset analysed during the current study are available in the Demographic and Health Surveys (DHS) repository, https://dhsprogram.com/data/available-datasets.cfm.
Source of funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Declaration of competing interest
The authors have no competing interests.
Acknowledgements
The authors are thankful to Dr. Avijit Roy during this venture. The authors are also grateful to International Institute for Population Sciencess (IIPS), Mumbai, and DHS fo data support.
References
Anand E.
Singh J.
Unisa S.
Menstrual hygiene practices and its association with reproductive tract infections and abnormal vaginal discharge among women in India.
Prevalence and correlates of menstrual hygiene practices among young currently married women aged 15–24 years: an analysis from a nationally representative survey of India.
Eur J Contracept Reprod Health Care.2021; 26: 1-10
A cross-sectional study on awareness regarding safe and hygienic practices amongst school going adolescent girls in rural area of Wardha District, India.
Spatial heterogeneity and socio-economic correlates of unmet need for spacing contraception in India: evidences from National Family Health Survey, 2015-16.
Menstrual morbidities, menstrual hygiene, cultural practices during menstruation, and WASH practices at schools in adolescent girls of North Karnataka, India: a cross-sectional prospective study.
How do women and girls experience menstrual health interventions in low-and middle-income countries? Insights from a systematic review and qualitative metasynthesis.
00040-4&id=gr1.jpg){kind=link}
00040-4&id=gr2.jpg){kind=link}
00040-4&id=gr3.jpg){kind=link}
00040-4&id=gr4.jpg){kind=link}