Period poverty in India: an analysis of the National Family Health Survey-5

Introduction:
Period poverty is global public health challenge, mostly in low-middle income countries. The objective of the study was to analyse the prevalence of period poverty in India and its associated factors.

Material and methods:
We used National Family Health Survey (NFHS)-5 data to determine the prevalence of period poverty. This data were extracted from the DHS program website. The prevalence of period poverty and background characteristics was reported as the percentage and 95% confidence interval. We performed bivariate and multivariable logistic regression to confirm any association between background characteristics and period poverty.

Results:
The study included available data from a representative sample of 241,104 menstruating women aged 15-25 years, covering all states and union territories of India. A high prevalence of period poverty was found in women in the 20-25-years age group, at 52.6% (95% CI: 52.3-52.9); women from rural areas – 57.5% (95% CI: 57.3-57.8); women with no schooling – 80.2% (95% CI: 79.5-80.8); Muslim wo­men – 59.9% (95% CI: 59.4-60.4), tribal women – 58.5% (95% CI: 58.0-58.9); and women from the lowest wealth quintile – 75.1% (95% CI: 74.7-75.5). Multivariable logistic regression showed that women in the 20-25-years age group had an adjusted odds ratio (AOR; [95% CI, p-value]) of 1.25 [(1.23-1.27), < 0.001]; women with no schooling 3.33 [(3.18-3.48), < 0.001]; Muslim women 1.14 [(0.85-1.53), < 0.001]; and women from other backward class (OBC; category as per Indian caste system) 1.23 [(1.20-1.27), < 0.001]; while women from lowest wealth quintile, at 5.27 [(5.08-5.47), < 0.001], had higher odds of facing period poverty.

Conclusions:
Period poverty was significant in illiterate, poor, Muslim women and those from other disfavoured groups. Creating more menstrual hygiene awareness, ensuring free provision of period products, and promoting the use of period products in these disadvantaged populations are crucial in addressing the period poverty in India.