Sanitation barriers, lack of awareness and unaffordability affecting menstrual health management among urban low-income group, informal sector women workers: A study from Mumbai suburbs
Shaikh, S., Sharma, S., Shah, V., Mehta, P., Pal, M.
public and global health
Quick verdict
Survey of 100 low-income Mumbai informal workers reports widespread menstrual morbidity and sanitation barriers; policy-relevant but statistically unverified.
Summary
This medRxiv preprint reports a cross-sectional survey of 100 women of reproductive age from low-income households in Mumbai's suburbs (Juhu/Vile Parle, Andheri, Borivali), conducted 20-30 January 2026 by undergraduate students as a university Community Engagement Program project. Using a piloted structured 18-item questionnaire administered face-to-face (explained in Hindi/Marathi where needed), the authors describe menstrual product use, expenditure, hygiene practices, sanitation access, diet, morbidities, and preferred interventions. Key findings: 53% earned under INR 10,000/month; 42% used cheap local disposable pads and 23% cloth; 49% changed absorbents at most twice daily; 15% changed pads in open or unsafe spaces; 67% reported at least one sanitation barrier; 79% reported at least one clinically significant menstrual morbidity (46% rashes/itching, 41% severe pain/weakness, 24% urinary tract infection), with self-reported reliance on self-medication and no prior hemoglobin testing; 76% reported dietary inadequacy during periods; 57% endorsed combining awareness, better toilets, and subsidized pads. Strengths include an understudied adult informal-worker population and coherent multi-domain coverage. Major limitations: purely descriptive analysis with no tests or confidence intervals; an unspecified 'random' sampling procedure; internal numerical inconsistencies (e.g., 58% vs 62% autonomy figures); ethics approval waived despite 13% minors; and no questionnaire, data, or code availability.
Review complete
Assessment at a glance
6
risk flags identified
● high 2
● medium 3
● low 1
4 strengths · 5 weaknesses · 5 author questions
Levels reflect verification complexity — not a quality score. Evolve never rates your paper.
Key claims under review
- 79% of surveyed low-income informal-sector women in Mumbai suburbs experienced at least one clinically significant menstrual morbidity, while relying on self-medication and reporting they had never had hemoglobin checked.
- 67% faced at least one critical sanitation barrier during menstruation, and 15% were forced to change pads in open or unsafe spaces.
- Financial constraint pervades both choice and access: 53% earned under INR 10,000/month, 25% said product choice depended on available funds, and 31% cited lack of money as the main procurement barrier.
- 76% reported some dietary inadequacy during periods, with only 24% eating properly and sufficiently.
- Women want an integrated response: 57% endorsed combining awareness, better toilets, and subsidized pads, and existing schemes exclude this urban adult informal-worker population.
Strengths
Targets a genuinely understudied population
Most MHM research and Indian schemes (RKSK, MHS, Asmita Yojana) target schoolgirls or rural women; this study documents adult women in the urban informal workforce (39% domestic helpers, 19% janitors), a group the authors show falls outside existing program coverage.
Community-embedded, language-accessible data collection
The questionnaire was piloted on 10 women outside the study area, questions were explained orally in Hindi/Marathi for low-literacy respondents, and a second student witnessed each interview (Methods: Research Instrument, Data Collection Method).
Multi-domain design that triangulates one conclusion
Concrete, policy-linked recommendations
Weaknesses
No statistical analysis whatsoever
Sampling procedure is asserted, not described
Internal numerical inconsistencies undermine the descriptive layer
Questionable interpretive moves in Results and Discussion
Reproducibility is essentially nil
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Frequently asked questions
What did the Mumbai menstrual health survey find?
Among 100 low-income women in informal work (domestic help, janitorial, daily-wage) in Mumbai's suburbs, 79% reported at least one menstrual health problem, 67% faced sanitation barriers such as lack of clean toilets or water, 15% had to change pads in open or unsafe places, and only 24% ate adequately during their periods. 57% said awareness, better toilets, and subsidized pads together would help most.
Who was studied and how was the data collected?
100 women of reproductive age from low-income households in Juhu/Vile Parle, Andheri, and Borivali (Mumbai suburbs) were interviewed face-to-face between 20 and 30 January 2026 using a structured 18-item questionnaire, explained in Hindi or Marathi when needed. The interviews were conducted by undergraduate students as part of a university community engagement course.
Is this study peer reviewed?
No. It is a medRxiv preprint posted 16 September 2026 that has not been certified by peer review, and it originated as an undergraduate curriculum project with a waived institutional ethics review, so findings should be treated as preliminary.
What do the authors recommend to improve menstrual health for these women?
Integrated action: awareness campaigns, gender-segregated toilets with reliable clean water near homes and workplaces, subsidized menstrual products, and primary health center services including low-cost biannual hemoglobin screening and treatment of menstrual morbidities, specifically extended to urban adult informal workers whom current schemes (aimed at schoolgirls and rural women) miss.
About this review
This is an AI-generated preliminary review by Evolve.Pub, produced from the openly available text of the paper. It is not peer review and does not represent the authors' views. The canonical record of the paper is at the publisher link above.
- All figures 1-6 (bar graphs and Venn diagrams) are not analyzable from the extracted text; percentages are taken from prose only.
- The 18 questionnaire items themselves are not included in the extracted text, so question wording and response options cannot be assessed.
- The extracted text is interleaved with medRxiv watermark boilerplate; sections appear otherwise complete, but figure-data overlaps could not be checked.
- Several reported percentages are internally inconsistent within the paper, which limits confidence in any single derived number.
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