Challenges in menstrual health service delivery to girls and young women in Mumbai slums: provider perspectives

Although India recognises its importance, good menstrual health management continues to elude women and girls in disadvantaged areas including urban slums, and the role of health care providers is poorly understood. Our objective in this study was to explore the perspectives of healthcare providers regarding the challenges faced in delivering menstrual health services to girls and young women. A total of 16 key informant interviews were conducted with frontline workers, pharmacists and medical practitioners serving urban slums in Mumbai. Provider perceptions suggest that girls' and young women's limited awareness about menstruation, adherence to traditional taboos, lack of health promoting practices, and discomfort about seeking information or care were key barriers to delivering menstrual health services. However, narratives also identified systemic barriers, notably poor waste disposal facilities, limited access to healthcare, erratic supply of government-issued menstrual products, and provider-level challenges such as personal inhibitions, the relatively low priority providers gave to menstrual matters, and their lack of sensitivity and skills to communicate effectively with girls and young women. Findings call for multisectoral programmes, including school-based education, improvements in water, sanitation and hygiene conditions, regular access to affordable menstrual products, and capacity building of providers to ensure more effective menstrual health service delivery.