Sanitation and Menstrual Health Challenges Among Pandharpur Women Pilgrims: An Exploratory Study With Recommendations

Background: In the state of Maharashtra in India, a pilgrimage called “Pandharpur Wari” attracts half a million pilgrims annually. Orthodox Hindu culture is generally resistant to allowing women to participate in religious functions during their menstruation. With a significant female presence, ensu...

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Main Authors: Manisha Gore, Avinash Patwardhan
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:Journal of Primary Care & Community Health
Online Access:https://doi.org/10.1177/21501319251359136
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author Manisha Gore
Avinash Patwardhan
author_facet Manisha Gore
Avinash Patwardhan
author_sort Manisha Gore
collection DOAJ
description Background: In the state of Maharashtra in India, a pilgrimage called “Pandharpur Wari” attracts half a million pilgrims annually. Orthodox Hindu culture is generally resistant to allowing women to participate in religious functions during their menstruation. With a significant female presence, ensuring adequate Water Sanitation and Hygiene (WASH) facilities and Menstrual Health and Hygiene (MHH) is crucial. Due to scant reliable quantitative data, a qualitative study was conducted to investigate first-hand accounts of experiences of WASH facilities and MHH practices of women pilgrims during 2023 pilgrimage. Methods: This study employed a qualitative design with convenience sampling, selecting 100 women pilgrims (aged 18-45 years) from the pilgrimage across 3 sites. Data were collected through semi-structured interviews. Descriptive and thematic analyses were conducted to examine experiences, challenges, and suggestions. Results: Over half (53%) were aged 32 to 41 years while (18%) were between 22 and 31 years. Most had studied up to secondary level (77%) and were married (95%). Thirty-four percent were farmers and a few had some other day job (7%). A large majority (97%) faced difficulties accessing toilets and bathing facilities, with some resorting to open defecation (36%). About (2%) used oral contraceptive to delay periods and (7%) experienced menstruation during pilgrimage. Lack of facilities for bathing and toilets along the pilgrimage route was one prominent challenge. Other challenges were, needing to bathe in the open, lack of gender-segregated facilities, and scanty sanitary facilities along the route. Women were found to be resilient in managing menstruation amidst systemic gaps. It was also found that cultural beliefs shaped pilgrimage participation while in menses and how it was hard to manage menstruation during pilgrimage without adequate infrastructure. Conclusion: The pilgrimage poses logistical, sanitation challenges for the pilgrims. Strategic planning, including mobile toilets, private bathing, menstrual hygiene support can improve the experience.
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spelling doaj-art-36a7074b53544b72aa0c3e2fc994f37a2025-08-20T02:40:47ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272025-07-011610.1177/21501319251359136Sanitation and Menstrual Health Challenges Among Pandharpur Women Pilgrims: An Exploratory Study With RecommendationsManisha Gore0Avinash Patwardhan1Symbiosis International (Deemed) University Lavale, Pune, Maharashtra, IndiaGeorge Mason University, Fairfax, VA, USABackground: In the state of Maharashtra in India, a pilgrimage called “Pandharpur Wari” attracts half a million pilgrims annually. Orthodox Hindu culture is generally resistant to allowing women to participate in religious functions during their menstruation. With a significant female presence, ensuring adequate Water Sanitation and Hygiene (WASH) facilities and Menstrual Health and Hygiene (MHH) is crucial. Due to scant reliable quantitative data, a qualitative study was conducted to investigate first-hand accounts of experiences of WASH facilities and MHH practices of women pilgrims during 2023 pilgrimage. Methods: This study employed a qualitative design with convenience sampling, selecting 100 women pilgrims (aged 18-45 years) from the pilgrimage across 3 sites. Data were collected through semi-structured interviews. Descriptive and thematic analyses were conducted to examine experiences, challenges, and suggestions. Results: Over half (53%) were aged 32 to 41 years while (18%) were between 22 and 31 years. Most had studied up to secondary level (77%) and were married (95%). Thirty-four percent were farmers and a few had some other day job (7%). A large majority (97%) faced difficulties accessing toilets and bathing facilities, with some resorting to open defecation (36%). About (2%) used oral contraceptive to delay periods and (7%) experienced menstruation during pilgrimage. Lack of facilities for bathing and toilets along the pilgrimage route was one prominent challenge. Other challenges were, needing to bathe in the open, lack of gender-segregated facilities, and scanty sanitary facilities along the route. Women were found to be resilient in managing menstruation amidst systemic gaps. It was also found that cultural beliefs shaped pilgrimage participation while in menses and how it was hard to manage menstruation during pilgrimage without adequate infrastructure. Conclusion: The pilgrimage poses logistical, sanitation challenges for the pilgrims. Strategic planning, including mobile toilets, private bathing, menstrual hygiene support can improve the experience.https://doi.org/10.1177/21501319251359136
spellingShingle Manisha Gore
Avinash Patwardhan
Sanitation and Menstrual Health Challenges Among Pandharpur Women Pilgrims: An Exploratory Study With Recommendations
Journal of Primary Care & Community Health
title Sanitation and Menstrual Health Challenges Among Pandharpur Women Pilgrims: An Exploratory Study With Recommendations
title_full Sanitation and Menstrual Health Challenges Among Pandharpur Women Pilgrims: An Exploratory Study With Recommendations
title_fullStr Sanitation and Menstrual Health Challenges Among Pandharpur Women Pilgrims: An Exploratory Study With Recommendations
title_full_unstemmed Sanitation and Menstrual Health Challenges Among Pandharpur Women Pilgrims: An Exploratory Study With Recommendations
title_short Sanitation and Menstrual Health Challenges Among Pandharpur Women Pilgrims: An Exploratory Study With Recommendations
title_sort sanitation and menstrual health challenges among pandharpur women pilgrims an exploratory study with recommendations
url https://doi.org/10.1177/21501319251359136
work_keys_str_mv AT manishagore sanitationandmenstrualhealthchallengesamongpandharpurwomenpilgrimsanexploratorystudywithrecommendations
AT avinashpatwardhan sanitationandmenstrualhealthchallengesamongpandharpurwomenpilgrimsanexploratorystudywithrecommendations