Persistent economic inequalities in menstrual hygiene practices in India: a decomposition analysis

The purpose of this study is to examine the socio-economic inequalities that exist in the use of unhygienic menstrual practices in India and its states, as well as to identify the contribution of various socio-economic factors that leads to these inequalities.

Data from the National Family Health Survey-5 (2019–21) for 240,285 menstruating women aged 15–24 years is used to examine the above objectives. The concentration index for unhygienic menstrual practices is calculated to measure the socio-economic inequalities, which are then decomposed into their determining factors.

The state of Punjab experiencing the highest level of economic inequality, followed by Telangana and Haryana. The results from decomposition analysis suggest that rural residence (13%), illiteracy (7%), poor economic status (53%), not reading newspaper (12%) and not watching TV (14%) contribute 99% to the total socio-economic inequality in using unhygienic menstrual practices in India. The contribution of economic status to total inequalities is more in all the states except for Kerala and Mizoram, where caste and residence play an important role.

This paper signifies the role of economic inequality in the use of unhygienic menstrual practices in India as well as the contribution of various socio-economic factors contributing towards these inequalities. The results from decomposition analysis suggest the need for unique health intervention strategies for different states following the evidence of major contributions to total inequalities in the use of unhygienic menstrual practices.