How young girls in rural Bihar are taking charge of their menstrual health

Young girls are creating access to safe menstrual products and safe places to talk about reproductive and sexual health issues



Growing up in Darbanga, Bihar, 17-year-old Aarti Kumari’s knowledge about menstruation was the bare minimum. But she, like most girls in her community, was taught two things. Old, flimsy clothes – ones that weren’t deemed fit to be worn anymore – are used to absorb the blood flow; and talking about menstruation or the accompanying pain was a strict no.

Almost 200km away, in Nawada, women in another 17-year-old’s family maintained the same silence about menstruation for generations and also depended on discarded pieces of cloth. “You don’t know better because no one really tells you this is not the right way. When you can’t even talk openly about anything related to periods, be it the pads or pain, important information such as about infections remains unknown,” Jyoti Kumari says.

Period education remains largely inaccessible to menstruating people in rural regions, where stigma further pushes women’s health to the periphery. Having grown up seeing the women in their families and neighbourhood struggle in silence, Aarti and Jyoti are now creating access to knowledge and menstrual hygiene products in an attempt to break the generation cycle.

The two girls are part of a network of 10,000 youth who are creating awareness and generating demand for adolescent reproductive and sexual health (ARSH) in the Darbhanga and Nawada districts of Bihar. They have formed Kishori Samoohs (youth groups) and facilitated the Population Foundation of India (PFI), a non-profit organisation that advocates for the effective implementation of gender-sensitive population and health policies, to address the challenges young girls and women face in their communities.

“We held discussions with young girls and talked to them about the importance of using hygienic products during menstruation, how anaemia affects menstruating women and safe practices. When these girls talk to people in their community, many listen because they know them,” says Sheela Devi, one of PFI’s community facilitators. When talking about sexual and reproductive health, familiar the face, the more open the door is.

Currently, in Bihar, more than 40% of women aged between 15 and 19 years said they don’t use hygienic methods such as sanitary pads during menstruation in the National Family Health Survey, published in 2021. Moreover, over 65% of women in Bihar aged between 15 and 19 years were found to be anaemic.

One of the main barriers to accessing safe menstrual products is the cost. “Young girls and women often stay at home so where will the money come from? Often, compared to boys, our health is not a priority,” Jyoti says. The one thing the Kishori Samoohs changed was giving women a safe place to talk about their issues—something that was inaccessible to them before. It is also where their entrepreneurship journey began.

During one such meeting in 2016 in Rajauli, the absence of one of the girls raised concerns. Later, upon enquiry, the girl confided that she had Leucorrhoea, a condition where there is excessive vaginal discharge, which usually indicates an underlying issue such as infection. “She said the constant use of dirty clothes during menstruation had caused an infection. This pushed us to set up a sanitary bank,” says 22-year-old Mausam, who started a pad bank when she was 15.

As the girls have little or no savings, they save Rs. 1 every day to add up to 
Rs. 30 every month to buy the pads, which they get from wholesale markets at lower prices. Some of them are also learning to make cloth pads, which are the most sustainable, and at times, cost-effective. Along with Mausam, Aarti and Jyoti have also started pad banks in their communities.

“Once you start understanding the impact of poor menstrual hygiene on your health, which even our mothers and aunts were unaware of, you want to make the changes. Who would willingly put their health at risk?” says Mausam. Today, most women in their respective villages are using sanitary pads or cloth pads—a big relief for the girls.

Aarti also conducted surveys on how the lack of reproductive and sexual health services is affecting adolescents in the area. All three girls are also staunch advocates of broader health issues such as the need for iron and folic acid supplements for women.

Around 2021, Aarti also approached the local authorities to start Yuva (Youth) clinics in their districts. “Women need a safe space as well as access to doctors who can guide them about reproductive and sexual health problems otherwise the shame and silence will continue. Yuva clinics have made it possible for them to open up about the issues and seek guidance, which has been missing for generations,” says Aarti, who wants to become a nurse.

The youth champions also talk to community members about the importance of practising safe sex, family planning and having access to nutritious meals for girls and women.

The pad banks have also ignited entrepreneurship dreams in some of the girls. For instance, Jyoti confides that she wants to become a “businessman” – the idea that women also do business might be alien to them but it definitely doesn’t stop them from nurturing the dream.

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