In several parts of India, menstruation is a taboo subject; this ever-pervasive stigma is a product of the cultural myths and long-standing traditions in these regions. Many believe that a period is a sign of impurity or an omen of
bad luck, which has led to a monthly pattern of secrecy and shame amongst women and girls. Women and girls are faced with restrictions at home and may not be allowed to partake in various activities at school, leading to increased isolation and low self esteem. The high level of stigmatisation has produced an immense gap in knowledge about menstruation and the associated hygienic practices, which in turn has led to an ongoing cycle of increased health risks, absence from school and work, and loss of dignity.

In 2015, in response to the Government of India’s Swachh Bharat Abhiyan (“Clean India Mission”), the Aga Khan Development Network (AKDN) launched the Comprehensive Sanitation Initiative. The Initiative is a five-year programme
aimed at facilitating access to improved sanitation and hygiene for over 700,000 people in six states in India. Its implementation is a 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). A key component of this initiative is strengthening knowledge and practice of Menstrual Hygiene Management (MHM) for women and girls in these states.