Pooja Nepali, a grade 12 student at Jeevanjyoti Secondary School in Chaukune in Surkhet district, used to miss school every month during her menstrual cycle. When she first started menstruating in grade 7, the absence of proper facilities at school made it difficult for her to attend classes. Her studies suffered. However, since the school started providing sanitary pads for free four years ago, attending school during menstruation has become much easier.

“Now that I get sanitary pads at school, I can attend classes without fear or discomfort, even during my period,” said Pooja. “It has helped not just me, but many of my other friends as well. No one has to miss school because of the menstrual period anymore.”

Across Karnali province, a federal government scheme to provide free sanitary pads in community schools is improving girls’ comfort, confidence, and attendance during menstruation. Although the scheme is a relief for many, its impact is limited by inconsistent distribution, poor sanitation, and the use of low-quality or ill-fitting pads in some local units.

The free sanitary pad scheme was introduced by the federal government in the policy and programme for fiscal year of 2019-20 with the aim of improving adolescent girls’ health as well as school attendance during menstruation. It falls under the Sanitary Pad (Distribution and Management) Procedure 2019, which mandates the provision of free sanitary pads to all girls in community schools.

“This scheme has been quite helpful in boosting school attendance among adolescent girls, and has also positively impacted their health,” said Brish Bahadur Shahi, a senior public health administrator at the Ministry of Social Development in Karnali province.

Before this intervention, many girls had to rely on cloth, which posed hygiene challenges and discomfort. Sometimes, the cloth would slip or fall, creating embarrassing situations. “Now, we get pads every month, in our own names, right at school. It’s so much more comfortable,” said Pooja. She recalled borrowing handkerchiefs from friends in the past when her period started unexpectedly at school.

Sarita Thapa, who studies in grade 10 at Nepal National Secondary School in ward 3 of Chaukune Rural Municipality, is happy with the availability of sanitary pads at school free of cost. “I get two packs of pads from our female teacher each month. This has helped me attend school regularly,” she said. The school also has a proper disposal bin, which has made managing used pads easier.

Female teachers are first trained in comprehensive sexuality education. They are assigned to distribute the pads and educate girls on proper usage and disposal.

Anjana Kumari Shahi, a teacher at Janajeevan Secondary School in Khandachakra Municipality in Kalikot district, said she has witnessed higher attendance and lower dropout rates since the launch of the free pad scheme. “Previously, girls would return home halfway through the day when they got their periods. That has stopped now. Earlier, the municipality sent pads late and in insufficient quantities, but now schools purchase and distribute them directly,” she added.

According to Karnali’s Social Development Ministry, there are 618,381 students, including 307,769 girls in the province. All 79 local units in the province purchase pads using federal budget support based on user numbers. Local governments spend between Rs500,000 to Rs3 million annually.

However, poor hygiene facilities remain a big issue. Many schools don’t have clean toilets and running water, which makes it difficult for girls to deal with menstruation hygienically.

“We get free pads, but there isn’t enough water and the toilets are dirty. It is especially hard during menstruation,” said Poornima Gautam, a 10th grader at Sheetal Secondary School in ward 2 of Chaurjahari Municipality of Rukum West district. She complained that the foul smell makes it hard to even go near the toilets.

Raj Bahadur Karki, headmaster at Gyanodaya Secondary School in Adanchuli in Humla district, said the lack of water, sanitation and awareness around pad use in remote areas makes effective implementation of this otherwise beneficial scheme difficult. “Even now, many girls in villages hesitate to use pads. Teachers encourage them but it’s a slow process,” he said. Adanchuli Rural Municipality has raised the issue with local authorities, but there has been no response, according to Karki.

While the free pad scheme looks promising, inconsistent implementation remains a major challenge. In some schools, pads are not supplied on time, or not in sufficient quantities. Others have received substandard pads that do not meet government specifications.

According to the 2019 procedure, pads must be at least 240mm long, 60–75mm wide, and 15mm thick. However, some local governments procure pads that are smaller and cheaper, possibly due to budget constraints or irregularities in procurement.

In Palata Rural Municipality of Kalikot, Rs1.2 to 1.8 million is spent annually on pads. The municipal education section chief Kal Bahadur Bhandari said that quantities fluctuate based on student numbers. “We follow the standards set by the federal government and distribute them accordingly,” he said.

But not all students are satisfied. A 9th grader at Tribhuvan Janata Secondary School in Rukum West said that the school-provided pads are so small and loose that she does not use them anymore. “I carry my own pads in my bag,” she added.

Samiksha Chaudhary, president of the provincial child club network, said many girls report receiving too few pads. “Even when they’re available, schools don’t distribute in the required quantity. Some teachers hand them out based on personal discretion,” she said. She also pointed to the trend of purchasing low-quality pads to earn commissions and stressed the need for effective monitoring of the procurement and distribution processes.

The sanitary pad management procedure outlines a four-tier system for distribution oversight—at the federal, provincial, local, and school levels. However, the committees at these levels often remain inactive.

“Complaints about poor quality and insufficient supply persist. As coordinator of the local pad distribution committee, I personally monitor the quality of pads procured by the health section,” said Mina Kumari Rokaya, vice chair of Chingad Rural Municipality in Surkhet. She pledges to strengthen monitoring and make the scheme a success.