Achuthan Krishnashree, Khobragade Sugandh, Kolil Vysakh Kani
Center for Cybersecurity Systems and Networks, Amrita Vishwa Vidyapeetham, Amritapuri, School of Engineering, Amrita Vishwa Vidyapeetham, Kollam, Kerala 690525, India.
Health Policy Plan. 2025 Feb 6;40(2):218-233. doi: 10.1093/heapol/czae117.
Menstrual hygiene management (MHM) among girls in rural India poses a substantial challenge for public health, education, and quality of life, exacerbated by limited access to and affordability of menstrual products. In response to these issues, the Government of India initiated the Menstrual Hygiene Scheme (MHS) to enhance access and awareness. This study evaluates the impact of the MHS in Assam and Tripura, designated as "treatment states" with consistent pad supply from 2017 to 2021 compared to neighboring "control states" with negligible pad distribution. Utilizing data from two National Family Health Surveys, NFHS-4 and NFHS-5, and employing the propensity score matching difference-in-differences approach, we isolated the causal effect of the MHS distribution program. The key findings reveal a significant rise in sanitary pad and hygienic method usage in the treatment states, particularly among girls aged 15-19 years who received pads during the survey period. Their sanitary pad usage increased by 10.6 percentage points [95% confidence interval (CI) (0.046, 0.167)], and adoption of hygienic methods overall saw a 13.8 percentage point [95% CI (0.087, 0.188)] jump. Notably, younger girls aged 15-19 years also experienced a 6.1-percentage point [95% CI (0.004, 0.118)] increase in their understanding of ovulation, showcasing the MHS's potential to go beyond providing products and promoting menstrual health awareness. A rise in reported sexually transmitted infections in both age groups, with a statistically significant 1.8-percentage point [95% CI (0.004, 0.032)] increase for younger girls, warrants further exploration. Disparities in impact were observed, with girls with high media exposure and greater autonomy demonstrating greater improvements in hygienic practices, highlighting the importance of information dissemination and empowering girls. Most socioeconomic groups, except the highest wealth and education levels, witnessed rises in hygienic method usage, indicating the scheme's potential to reduce inequalities while hinting at the need for tailored interventions for marginalized communities.
印度农村地区女孩的经期卫生管理（MHM）对公共卫生、教育和生活质量构成了重大挑战，而经期用品的获取渠道有限且价格高昂使这一挑战更加严峻。为应对这些问题，印度政府启动了经期卫生计划（MHS），以增加获取渠道并提高 awareness。本研究评估了MHS在阿萨姆邦和特里普拉邦的影响，这两个邦被指定为“处理州”，在2017年至2021年期间有稳定的卫生巾供应，而与之相邻的“对照州”卫生巾分发量可忽略不计。利用两次全国家庭健康调查（NFHS-4和NFHS-5）的数据，并采用倾向得分匹配法的差分法，我们分离出了MHS分发计划的因果效应。主要研究结果显示，处理州的卫生巾和卫生方法使用率显著上升，尤其是在调查期间收到卫生巾的15至19岁女孩中。她们的卫生巾使用率提高了10.6个百分点[95%置信区间（CI）（0.046，0.167）]，卫生方法的采用率总体跃升了13.8个百分点[95%CI（0.087，0.188）]。值得注意的是，15至19岁的年轻女孩对排卵的理解也提高了6.1个百分点[95%CI（0.004，0.118）]，这表明MHS不仅有提供产品的潜力，还有促进经期健康 awareness 的潜力。两个年龄组报告的性传播感染均有所增加，其中年轻女孩的增加具有统计学意义，为1.8个百分点[
