Beyond Periods and Patriarchy: The Intersections of Reproductive Health, Agricultural Work, and Climate Change in India
By guest contributors Phoebe Han, Seleena Jarligo, Steewa Philip, and Alyssa Victorino
On January 30th 2026, the Supreme Court of India made a significant ruling with global impact: it declared menstrual health and hygiene a fundamental right. In doing so, the court issued a mandate for free sanitary products and functional toilets in every school across the country. Many celebrated the historic ruling, yet it reveals how much more remains to be addressed in women’s health in India.
The decision was built around a critical and well-documented need: keeping young girls in school during their periods. This focus on adolescents has long anchored menstrual health interventions in the country, alongside maternal health, and both remain urgent. But this moment also opens an opportunity to broaden the conversation about who else menstrual and reproductive health policies must reach.
If we focus on India’s agricultural industry, which accounts 64% of Indian women in the workforce compared with 37% of working men, we can begin to account for some of those who have fallen outside the scope of the ruling. The sexual and reproductive health (SRH) of women working in agriculture has historically been neglected in formal health systems. For example, many women working in the sugar cane sector have undergone forced hysterectomies (or were pushed into the decision based on socioeconomic factors) in order to work longer hours and increase their daily wages.
Many in these communities are older women who have SRH needs that are closely related to the nature of their work and go beyond menstrual health. For example, there are substantial reproductive health consequences to spending eight hours a day in ever-rising heat, bent over pesticide-infested rice paddies with no toilet within walking distance. It is the compounding of institutional patriarchy, strenuous agricultural labour, and climate change that invisibilize the range of women’s health issues in agricultural areas.
Organizations such as Transform Rural India (TRI) are working to address these intersecting challenges through holistic community-based approaches that connect health, livelihood, and gender to strengthen rural systems and improve women’s well-being.
To better understand these dynamics, we partnered with TRI to conduct fieldwork in peri-urban villages in Aligarh, Uttar Pradesh. Through focus groups with women’s collectives and key informant interviews with health practitioners, we learned about the SRH challenges women working in agriculture face in their daily lives.
“Why does it matter? Everyone goes through it.”
In our focus groups, women shared common SRH issues such as uterine prolapse, painful and irregular periods, vaginal infections, and premature hysterectomies, while attributing them to rising temperatures and strenuous physical labour while working in the fields.
However, not all women considered their conditions or symptoms as a health concern. This is an issue because without problem identification, health mobilization efforts are thwarted and policies meant to address SRH concerns will inevitably be underutilised.
We found that women’s health-seeking behaviours were hindered by a widespread normalisation of both SRH pain and a triple burden of care (i.e. agricultural work, caregiving, and housework) that leave women at a loss for time. Both factors are a manifestation of deeply entrenched patriarchal values within the villages that minimise women’s contributions to the family and broader community, as well as their experiences of pain. When asked about menstrual cramps and aches, one participant asked, “Why does it matter? Everyone goes through it.” Another participant minimised their burden of care, stating that “Everyone is trapped with responsibility.”
A fractured system
These factors are further complicated by unreliable local health infrastructure. For example, many women mentioned not receiving government-subsidized sanitary pads from locally based Accredited Social Health Activists (ASHAs). Upon further discussion with ASHAs in Tappal, we learned that the supply of pads was both limited and given on a first-come first-serve basis, leaving some women unable to access them when needed.
Women frequently described barriers to accessing care and expressed a strong preference for nearby, yet temporary, health camps that were easy to get to during their busy schedules. Many also wished that there were more female clinicians in local health centres so that they could comfortably address their SRH needs with trusted professionals.
Currently, women’s health, climate change, and agricultural development initiatives in India often operate in different policy siloes, which risks overlooking connections between the issues. Given projections that warming temperatures are only worsening, it is ever urgent to create intersectional responses to the SRH outcomes women working in agriculture are facing, such as increased use of pesticides in crop fields to compensate for rising heat leading to higher rates of reproductive health challenges.
Future Directions
Because women’s health policies and programmes are often created in isolation, broader consultations need to be taken to gain a more comprehensive understanding of how women’s lived realities prevent them from accessing SRH care.
Across India, health mobilisation efforts and community-based programs like SHGs can be expanded by educating all community members about pressing social issues, and not just the women themselves. This can look like involving men and boys in women’s health issues and gender training modules to dispel menstrual myths, improve gender equity, and create collective capacity to address the intersecting problems influencing women’s SRH outcomes. Self-Help Groups (SHGs) are great avenues in which to mobilise entire communities as they have been shown to be effective in education and resource sharing across multiple topics such as gender-based violence, reproductive health, and the COVID-19 Pandemic.
Organisations facilitating gaps in health system delivery, like TRI, should also explore partnering with agricultural and climate change-oriented CSOs, think tanks, and other research centres. These partnerships can help develop climate adaptation strategies for women working in agriculture that explicitly factor in their health needs and can also help to generate more research and climate-forward solutions to improve women’s health outcomes and achieve their rights.
The Supreme Court’s decision marks the beginning of a new era in women’s rights and health in India. However, there is much more work to do going forward to ensure that policy is equitable, particularly in that it applies a lifelong and locally informed understanding of SRH for female agricultural workers.
About the authors:
Phoebe Yi Wen Han is a graduate student at the University of British Columbia’s School of Public Policy and Global Affairs. Her interests are in postcolonial state development, South-South cooperation, and health policy. Currently, Phoebe is a Research Fellow at the Centre of Southeast Asia in the Institute of Asian Research.
Seleena Jarligo is a Master of Public Policy and Global Affairs candidate at the University of British Columbia. She previously served as an immigration law clerk supporting corporate clients with complex cross-border legal processes. More recently, she completed a co-op placement with the Canadian federal government.
Steewa Maria Philip is a second-generation Malayali immigrant and MPPGA candidate at UBC, with a BA from Christ University, Bangalore. Her policy interests span climate adaptation, rural healthcare, and ethics in AI. She has worked on menstrual health in Karnataka as a UN Millennium Fellow and on climate adaptation with BC Nature, and is currently at the Centre for Study of Democratic Institutions researching platform governance in elections.
Alyssa Victorino is a Master of Public Policy and Global Affairs student at the University of British Columbia where she is also a Research Fellow at the Centre for Southeast Asia Research. Her policy and research interests lie around race and racialization, Asian migration and diasporic studies, memory and archives, and gender-based violence and gender justice.
Disclaimer: Views expressed by contributors are solely those of individual contributors, and not necessarily those of PLOS.
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