Bridging the Gaps in Menstrual Hygiene Management in India: A District-Level Analysis Using NFHS-4 and NFHS-5 Data

Menstrual hygiene management (MHM) is a fundamental component of public health and gender equity, yet it remains a neglected area of intervention, particularly in low- and middleincome countries. Using data from the National Family Health Survey (NFHS) rounds 4 (201516) and 5 (2019-21), this study assesses the trends, regional disparities, and socio-economic determinants associated with the use of hygienic menstrual protection methods among women aged 15-24 across India. While significant improvements are observed in the adoption of sanitary napkins at the national level, substantial regional and socio-economic disparities persist, especially in states such as Bihar, Madhya Pradesh, and Uttar Pradesh. This paper provides a detailed analysis of menstrual hygiene trends, with a focus on Delhi to highlight district-wise variations in MHM outcomes and practices. The findings point to progress driven by policy initiatives and awareness campaigns, but also underscore the urgent need for contextsensitive interventions to address persistent barriers such as affordability, accessibility, and stigma. Policy recommendations emphasise the importance of sustained public investment, targeted behaviour change communication, and inclusive MHM programming that considers the diverse needs of young women across different socio-economic strata.