In January, India’s Supreme Court has ruled that menstrual health is a fundamental right, directing states and schools to take measures to facilitate menstrual health and sanitation.

The laws of the world’s most populous country are now in line with the United Nations (UN) stand on menstrual health taken in 2024, and one that is also echoed by the World Health Organization. 

India’s Supreme Court directed state governments and schools in the country to build gender segregated toilets, hold menstrual health awareness sessions for both boys and girls, and stock schools with menstrual hygiene products.  

After the ruling, Megha Desai, president of the Desai Foundation,  said she and her team jumped for joy. The foundation works across eight states in India on menstrual health and hygiene awareness, 

“Up until this ruling came through, the responsibility of managing menstruation was left to a 12-year-old girl,” said Desai. “With the Supreme Court ruling, what it has done is shifted that responsibility to the community, and in this case, the infrastructure of the school.”

The court relied on research that showed only half of the girls surveyed were aware of menstruation before puberty, toilets were scarce, and menstruation led to a high level of absenteeism. 

The issue is not restricted to India alone. A 2021 survey by global children’s non-profit Plan International done in the United Kingdom found that 64% of girls aged 14-21 missed part or a full day of school due to their period, and 13% of girls missed an entire day of school at least once a month.

The UN children’s organisation, UNICEF, has long raised the issue of girls staying out of school due to their monthly periods in several continents, such as Africa, apart from Asia.

Precedent for the developing world?

In many parts of the world, especially in rural areas, menstruation is still a taboo subject. Women can be labelled “unclean” and subjected to social isolation. Blood stains due to the periods are perceived to be shameful. 

“This is a very bold move by the Indian government, and I really hope other countries learn from that and decide to do more about it,” said Rannia Elsayed, regional portfolio director for South Asia, the Middle East, and North Africa at Pathfinder International, a non-profit that focuses on women’s health.

Elsayed, who is based in Egypt, said that talking about menstruation is taboo in many rural parts of Egypt and Jordan. 

India may have set a precedent in the developing world with its court ruling.

“In Kenya, there’s been a ruling that mandates free sanitary pads for public schools. Again, but there’s no constitutional rights framing for it,” she said. 

The ruling comes at a time when climate change is making heatwaves more intense and changing rainfall patterns in India as well as the rest of the world. A policy like this will help girls become more resilient to the impact of climate change on menstrual health, Elsayed said.  

Also read: Climate Change Driving India’s Unseasonably Severe Heat Wave

Slew of recent measures to improve health

Over the past decade, the Indian government’s Swachh Bharat Mission has focused on building millions of new toilets in the country with an eye on improving health, sanitation, and women’s lives. 

Despite this, less than half of the schools researchers surveyed in India have gender segregated toilets. The Indian government  claims that 100 million toilets were built by 2019, but the reality is more complex than that. 

“In some of the schools I’ve seen [that the] toilet is there but no water, or the situation of toilets is in such a pathetic condition that you wouldn’t step in,” said Srijana Karki, who oversees the projects in India and Nepal for the international development organisation, World Neighbors.

But in communities where access to toilets has improved, this has also translated into increased mobility of women as they feel more confident about managing their periods, she added.

More toilets are just one of the many requirements to improve menstrual equity, however.

“You have to have awareness [on menstrual health], you have to be educated, and there has to be a functional toilet, not just a toilet, but a functional toilet… clean, have enough water, and then use of sanitary napkins or clean cloths, and knowledge about how to safely dispose the napkins or safely reuse the cotton cloths,” Karki said. 

But the Indian government’s campaign to build more toilets has started a conversation about the relationship between more toilets and improved women’s health. It has also created an appetite for such infrastructure among families, especially from women who are now pushing for it from within families.

“That wonderful campaign with beautiful intentions did change the mindset of communities and community leaders,” Desai said. 

Impact depends on implementation

The immediate impact of the ruling is to provide impetus for development organizations working in this area to speed up their work. 

“Having the support of a ruling allows us to eliminate the debate. So, for me, I can tell you that time is now being saved on the ground where I am now saying, okay, now that we all agree that this is the way forward, let’s work together for the best way to implement,” Desai said. 

She also said that the government can play a big role in the implementation by supporting new infrastructure, and that it is likely that we will see more girls finish school as a result of this ruling.

The ruling has been welcomed by development organizations working in the region, while the non-profit International Planned Parenthood Federation’s South Asia team has called for such a ruling to be extended to workplaces.  

If India does get the implementation part right in the coming years, it could set an example for the rest of the developing world, Desai said.   

Image Credits: Desai Foundation, Yogendra Singh/ Unsplash, World Neighbors, Ignas Kukenys/ Openverse/ Flick.