Curative versus Preventive Healthcare in Developing Countries: The Case of Menstrual Hygiene in India

32 Pages Posted: 23 Oct 2019

See all articles by Prasenjit Sarkhel

Prasenjit Sarkhel

University of Kalyani

Montu Bose

Public Health Foundation of India

Date Written: December 14, 2018


One of the major public health challenges in India is scant private investment in preventive reproductive health care. This is reflected in the poor menstrual hygiene practices where close to 62 percent of the women in India uses absorbents other than sanitary pads since their menarche. Extant studies show that choice to use sanitary napkin is conditioned by the ability to pay but might also respond to peer effects and social learning. We argue that if poor menstrual hygiene leads to disease burden that can be remedied at relatively lesser cost, individuals are likely to discount benefits from preventive investments viz., purchase and use of sanitary pads at a higher rate. We analyse the choice of menstrual hygiene practices using National Family Health Survey data for eligible women in the 15-24 age group and find evidence that the cost of curative health care in general negatively influences the demand for sanitary pads. However, uro-genital disease exposure per se doesn’t have any significant influence on the decision to use sanitary pads and other hygienic methods for menstrual protection. We also find that interaction with community health workers can indeed stimulate the demand for sanitary pad use and policy makers would do good to invest in building sanitation infrastructure for promoting menstrual hygiene practices.

Keywords: Menstrual Hygiene, India, Preventive Health Care, Probit, Multinomial Logit, Bi-Variate Probit

JEL Classification: I180, I120,C350

Suggested Citation

Sarkhel, Prasenjit and Bose, Montu, Curative versus Preventive Healthcare in Developing Countries: The Case of Menstrual Hygiene in India (December 14, 2018). Available at SSRN: or

Prasenjit Sarkhel (Contact Author)

University of Kalyani ( email )

Block C, University Of Kalyani
West Bengal, 741235

Montu Bose

Public Health Foundation of India ( email )

4 Institutional Area
Vasant Kunj
New Delhi, Delhi 110070

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