Managing menstruation on the move: a qualitative study of menstrual hygiene management practices and health challenges among female ticket collectors in India

Working women face unique challenges in managing menstruation in male-dominated workplaces. This study explored menstrual hygiene management (MHM) practices among women ticket collectors with the Kerala State Road Transport Corporation (KSRTC) in India. The research aims were to understand awareness, experiences and practices related to MHM and health among women working in the transport sector, while also identifying barriers and associated health issues. Using a qualitative approach, we conducted in-depth interviews with 36 female ticket collectors. The interviews focused on MHM and health-related knowledge, attitudes and practices and associated infrastructural and societal challenges. Thematic analysis was used to develop insights from the data. Findings indicated serious difficulties in maintaining menstrual hygiene, including lack of toilets/restrooms, limited break time and stigma surrounding menstruation. Health concerns such as urinary tract infections (UTIs) and dermatitis were commonly reported, linked to the prolonged use of sanitary products at work. Cultural taboos and restrictions during menstruation remain widespread. Awareness of government schemes such as She-Pad was notably low. The study highlights the urgent need for systemic changes, including better workplace sanitation, menstrual leave policies and awareness programmes. Collaborative action between the government and employers can help create a more inclusive and supportive work environment.