In many stores across India, shopkeepers wrap maxi pads in black polythene. If they don’t have that, the products go in a small carton or brown paper bag. Absent those, “we try hiding it while walking down the road because of how people would react," says Khushboo Navani, a 23-year-old woman who lives in Bikaner. "People give you weird looks," she adds.
Menstruation is still considered a taboo in India. Lack of accessible and affordable menstrual products, coupled with the shame and silence surrounding them, contributes to millions of girls in India missing school after puberty, according to research conducted for UNICEF in 2015. The survey estimated that 1.9 million girls leave school during their periods each month.
In December 2015, India became one of the few countries to issue menstrual hygiene management guidelines under its Clean India Campaign. Since then, several hundred sanitary napkin vending machines have been installed across the country—in schools, colleges, jails, police stations, bus stands, railway stations, hospitals, and other public places.
Some 70 machines have been installed in the city of Ajmer; 30 more are in Chandigarh, and there are several in Nagpur, Mumbai, Amritsar, Assam, Dehradun, Lucknow, Punjab, and Nagaland, among others. They are funded and installed by the government and local municipal corporations, NGOs, and philanthropists, educational institutes, and private corporations. Installation costs vary from about Rs. 20,000 (about $299 USD) to Rs 45,000 ($673 USD), depending on location and the company. The machines dispense packets containing three pads, which go for Rs 10 ($0.15 USD). From a cost perspective, they’re self-sustaining, because the money collected can then be used to restock the supply.
“Installation of sanitary napkin dispensers is a very basic demand,” says Devika Mittal, a Ph.D. student from Delhi, who successfully appealed to the National Commission for Women to conduct sanitation audits in schools, colleges, bus terminals, and railway stations in 2014, cataloging the availability and cleanliness of toilets. Her letter to the government helped spur pad dispensers in institutions in several cities and districts of Maharashtra, including Nagpur, Mumbai, Chandrapur, Aurangabad, Gadchiroli, and Thane.
Mittal believes that the machines help dispel the stigma that women internalize. "Once you have the machines, you start recognizing menstruation as normal," she says.
Deane de Menezes, a 23-year-old researcher in Mumbai, dealt with the stigma by hiding her pads in a book when she passed through her office to change one in the bathroom. “There are guys sitting around, and sometimes I feel so embarrassed," she says.
The stigma isn’t just a problem in the workplace. An article on UNICEF India website states that "adolescent girls find it extremely difficult to even discuss the issue with their parents or elders in the family." And accordingly, a 2014 study conducted by by Dasra, USAID, and the Kiawah Trust found 71 percent of Indian girls had no knowledge of menstruation before their first period.
The stigma results in many women devising alternatives to store-bought menstrual products. Recent research conducted by Neilsen for UNICEF India found that only 28 percent of girls and women interviewed used sanitary pads. Others opted for homemade napkins or cloth, and other surveys have found that women also use potentially dangerous alternatives such as ash, newspapers, leaves, or sawdust. Of the women who used homemade alternatives to pads, 80 percent cited cost as the main deterrent.
"Not everyone can afford a Whisper or a Stayfree," says Menezes, who started the Red is the New Green campaign, which spreads menstrual awareness and helps institutions install vending machines for pads. But if consumers opt for a well-known brand they recognize—even if they have to stretch to pay for it—they might try to make the package last for the duration of their period, and not replace their pads as often as is recommended, she adds.
Vending machines at public places, especially at educational institutes, can help girls stay in school by offering a clean, private environment they might not have at home. Across India, tens of millions of adolescent girls live in homes without toilet facilities. Squatting in the open poses the danger of sexual harassment. "School would be the best place for them to change and be clean," says Menezes.
India's planning commission has implemented a scheme for promoting menstrual hygiene among teen girls as part of its Five-Year Plan, which spans 2012-2017. A similar goal guides the #OneMillionPads campaign by Saathi Pads, a startup trying to connect biodegradable, banana-fiber menstrual pads to women throughout rural India. The co-founder Kristin Kagetsu explained her vision to Forbes: “The aim is to help with keeping women in work, or at school.”