Tracking the Changes in Socioeconomic Disparities in Menstrual Hygienic Product Use Among Young Women in Urban India: A Repeated Cross-Sectional Analysis

During menstruation, the use of hygienic products (HPs), including sanitary napkins, locally prepared napkins, tampons, and menstrual cups, is known to minimize the risk of gynecological diseases. The use of HPs is more unequal in urban India than in rural India. Scant literature is available on socioeconomic disparities in HP usage over time. This study examined socioeconomic disparities in HP use in urban India and its states from 2015–16 to 2019–21 by using the Erreygers concentration index (CI) and rate ratios. Additionally, the study sought to break down the observed inequality into contributing factors. Information of 68,459 and 54,561 urban women (aged 15–24 years) from the fourth and fifth National Family Health Surveys (NFHS-4 and NFHS-5), respectively, were used. The findings revealed a 15% increase in HP use among women in urban India between 2015–16 and 2019–21. The CI for the use of HPs stood at 0.382 in 2015–16 and decreased to 0.302 in 2019–21, highlighting the persistent concentration of HP use among women belonging to wealthier households. Although a decline in socioeconomic disparity has taken place over time, this decline has widely varied across different Indian states. The study revealed that socioeconomic disparity, as measured by CI, has decreased in 21 Indian states out of 28. Notably, Arunachal Pradesh, Telangana, and Andhra Pradesh have successfully reduced socioeconomic disparity by more than 50%. That disparity has noticeably increased in Gujarat and Meghalaya. The results of inequality decomposition highlighted that education and exposure to mass media account for over 80% of the socioeconomic disparity observed in HP use. Targeted interventions are needed to promote equitable access to these products. State-specific policies and addressing factors like education and mass-media exposure can contribute to reducing socioeconomic disparities in HP use.