Approximately 44% of Karnataka women aged between 15-24 still use cloth during their menstruation cycle

On the occasion of Menstrual Hygiene Day, a survey was conducted by NFHS to check the statistical analysis of the hygiene awareness amongst women in India. Years after Independence and educational developments in the country, there are still areas where the lack of hygiene awareness and facilities are below average.

The survey revealed that 44% Karnataka women aged between 15-24 still use cloth during menstruation cycle. Using a cloth is utterly unhygienic and leads to many serious diseases but lack of awareness is the root cause of such problems. 44% in Karnataka is the highest percentage among South Indian states while Kerala is at 40.2% and Andhra Pradesh at 36.2%. Reports suggest that 19% households do not have toilet facilities.

The percentage of women in Karnataka using Sanitary napkins is 69.1%, menstrual cups are 0.3%, 21.9% are local sanitary pads, and tampons are 2.9%.


In Puducherry, the percentage of women aged between 15-24 using menstrual hygiene protection is 99.1%, one of the highest rates in India. Following Puducherry is Andaman with 98.8% and the Nicobar Islands with 98.4%.

The lowest percentage apart from the above mentioned south Indian States is Bihar with 59%, Madhya Pradesh with 61% and Meghalaya with 65%.

If overall looked, 77.6% of Indian women would use a hygienic protection method all over India during their menstrual days. 64.4% of women prefer to use sanitary pads, while 15% still prefer to use local napkins. The NFHS-5 revealed that Indian women are not more comfortable using anything rather than pads and cloth. The percentage of women using menstrual cups and tampons is meagre, even in developed Indian cities. India has 1.7% of women who prefer using tampons and 0.3% of women who are open to the idea of using menstrual cups.

The percentage of women in the highest wealth quintile and lowest wealth quintile is twice with 95% VS 54%. In urban areas, 90% of women are aware of the cons of being unhygienic and use hygiene methods for menstrual protection. For the same, the percentage is 73% for rural women.

Hema Divakar, a Consultant obstetrician and gynaecologist, said that menstrual hygiene is not prioritised in India. This thinking can only change if attempts are made to educate and empower girls on the pros and cons of not maintaining menstrual hygiene. This education can bring a significant change in the following decades if women start to use sanitary pads or, a better option, menstrual cups.

Although the government is distributing sanitary pads free of cost or at low cost to educate women about hygiene during their menstrual days, the proper disposal of sanitary pads is neglected. Improper disposal of sanitary pads creates environmental pollution. Dr Hema Divakar is also the head of the Well Woman Health Care Committee at the International Federation of Gynaecology and Obstetrics (FIGO).

Manisha Singh, a senior consultant of gynaecology and sub-specialist in reproductive medicine and surgery at Fortis Hospital, opines that menstrual cup is the future, and the government should prioritise educating women about menstrual cups, not just sanitary napkins. The government should implement programs that should teach rural women how to use and dispose of menstrual cups properly.

Which Indian states have the highest and lowest percentage of women still preferring to use cloth during their menstruation?

• With 69.4% Uttar Pradesh has the highest percentage of women still using cloth.
• And following UP is Assam, with 69.1% of women using cloth.
• At the same time, Andaman and Nicobar Islands have the lowest rate of women preferring cloth with 8.2%
• And after Andaman and Nicobar Islands is Tamil Nadu with 12.7% of women suing cloth

How do schooling and proper education impact menstrual hygiene?
The NFHS-5 survey intending to know the reason why women prefer cloth as menstrual protection found out that the impact of education is a major driving force. Women who have attended schooling for twelve years or above are more prone and aware of hygiene and do not prefer to use cloth. This stands the opposite for women with no education. The difference percentage is 90% VS 44%. There exists a direct link between education and hygiene methods of mensural protection. There is a taboo associated with not speaking about menstruation, and it is the primary reason why rural women are not aware of menstrual hygiene.