In the remote, high-altitude region of Spiti Valley, Himalayas, India, a quiet revolution is underway—one that challenges deep-rooted taboos and redefines menstrual health. Period poverty, the lack of access to menstrual hygiene products, sanitation facilities and education and awareness to manage menstrual health, is a serious global health issue. According to United Nations Women, over 2 billion people worldwide menstruate, and a significant portion of them experience period poverty.
Spiti Monthly Matters: A Bold Step Toward Inclusive Menstrual Health
A transformative initiative led by Dr. Tejinder Pal Singh (TP), Associate Professor in the Division of Public Health, Department of Family and Preventive Medicine at the School of Medicine, is reshaping the narrative around menstrual health in Spiti Valley. In collaboration with the local NGO Ecosphere and the communities of Spiti, the Sustainable Health and Development Project (SHeDS) was launched to address pressing public health challenges through community-driven solutions.
One of the flagship efforts under SHeDS is Spiti Monthly Matters, initiated in 2021 with a bold and inclusive vision: to actively engage men in menstrual health education and break the silence and stigma surrounding menstruation. Historically, cultural norms and limited awareness have excluded men from these conversations, reinforcing taboos and misinformation.
Spiti Monthly Matters challenges this status quo by creating safe spaces for dialogue, education, and shared responsibility. The initiative recognizes that sustainable change in menstrual health cannot be achieved without the involvement of all community members—especially men. By fostering understanding and empathy, it aims to build a more supportive environment for women and girls, while promoting gender equity in health education.
Community Voices and Collaborative Solutions in Menstrual Health
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ver a period of four years from 2021 to 2024, extensive surveys were conducted among women in Spiti Valley to assess their knowledge, attitudes, and behaviors related to menstrual health. In parallel, the issue of solid waste management—particularly the disposal of menstrual hygiene products—was examined to understand current practices and explore sustainable solutions.
Through a series of in-depth discussions with community members, key informants, and healthcare workers, a clear message emerged: addressing menstrual health requires a collaborative, community-driven approach. Stakeholders emphasized the need to improve access to sustainable and culturally acceptable menstrual hygiene products, deliver targeted education to bridge knowledge gaps, and enhance sanitation infrastructure across villages.
One resounding insight stood out—these goals cannot be fully realized without the active involvement of men. Their participation is essential not only in supporting menstrual health initiatives but also in breaking the silence and stigma that often surround menstruation. By engaging men as allies, the community can foster a more inclusive and supportive environment for menstrual health management.
Training Men to be Allies in Menstrual Health
In the summer of 2025, 36 male participants aged 18 to 45 in five villages of Spiti Valley—from farmers and government workers to teachers and local leaders—took part in structured training sessions. These sessions covered the basics of menstrual health, hygiene practices, and the social implications of period poverty. The program used both quantitative and qualitative surveys to assess changes in knowledge, attitudes, and practices before and after the intervention.
The results were striking. Post-training, 95% of participants demonstrated a significant increase in understanding of menstrual health, and 75% reported feeling more comfortable discussing menstruation with women in their families and communities. These numbers reflect more than just improved knowledge—they signal a cultural shift toward openness and empathy.
The initiative’s success lies in its community-based approach. By involving men directly, it fostered dialogue and mutual respect, breaking down barriers that have long isolated women during their menstrual cycles. Participants shared stories of how their perspectives changed, with many expressing a newfound commitment to supporting menstrual hygiene at home and in public spaces.
The program also emphasized strategic actions for sustainability. These included ongoing educational outreach, creating safe spaces for discussion, and ensuring access to menstrual products. Importantly, it recommended that future menstrual health and management efforts continue to include men—not as passive observers, but as active allies.
Images from the sessions show men attentively engaging with facilitators, asking questions, and participating in group activities. These visuals challenge stereotypes and underscore the message that men are not inherently resistant to menstrual health education—they are simply uninformed and excluded. When given the opportunity, they can become powerful advocates for change.
As global health practitioners look for scalable models to address period poverty, the Spiti Valley initiative offers a compelling blueprint. It reminds us that menstrual health is not just a women’s issue—it’s a whole of community issue. And when communities come together, even the most entrenched stigmas can be overcome.
In Spiti Valley, the conversation around menstruation has begun to shift—from silence and shame to understanding and support. And it all started by inviting men to listen, learn, and lead.
A special acknowledgement for the commendable work done by all students who were a part the summer learning abroad 2021-2025. Photos are courtesy of students and communities of Spiti Valley. The training workshop in 2025 was conducted with the valuable contribution of University of Utah students: Ruby Joshnston, Katelyn Egbert, Sam Young, Evan Battermann, Grace Watkins and Emma Hartline.
The work continues as a part of the Summer Learning Abroad to Kaza, Himalayas led by Dr. Tejinder Pal Singh (TP). For details of upcoming projects in the Himalayas contact TP at tp.singh@utah.edu