In India, menstruation is the subject of cultural myths and taboos; a period associated with impurity that should be kept hidden.  Stigmatisation has produced an immense gap in knowledge about menstruation and hygienic practices among women and girls, leading to increased health risks, absence from school and work, and loss of dignity.  Recognising the impact of poor menstrual hygiene on the quality of life, Menstrual Hygiene Management (MHM) has become a core component of the AKDN Comprehensive Sanitation Initiative.

The AKDN Comprehensive Sanitation Initiative was launched in response to the Government of India’s flagship programme, Swachh Bharat Abhiyan, or Clean India Mission.  Started in 2015, the five-year programme is facilitating access to improved sanitation and hygiene to 700,000 beneficiaries in six states: Bihar, Uttar Pradesh, Madhya Pradesh, Gujarat, Maharashtra and Telangana.  Its implementation is a careful collaboration of several AKDN agencies: the Aga Khan Foundation (AKF), the Aga Khan Rural Support Programme (AKRSP), the Aga Khan Agency for Habitat (AKAH) and the Aga Khan Health Services (AKHS).

The Initiative focuses on enhancing access and use of sanitation at the household, school and community level in both rural and urban settings.  This is done through a community-led integrated approach of hygiene promotion, behaviour change and capacity building of local village and government institutions.  In schools, the AKDN is improving water, sanitation and hygiene infrastructure, regularising hygiene promotion and empowering student committees to drive changes forward.