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Paper short abstract

Challenging top-down SRH models, I show how menstrual resources are "captured" by patriarchy in Nepal. In regressive homes, provided "privacy" becomes isolation, worsening distress. Policy must shift from material provision to dismantling power dynamics to ensure reproductive justice.

Paper long abstract

Mainstream SRH interventions often rely on a "resource universalism" logic i.e., a top-down development model assuming that providing material "hardware" (products and privacy) automatically enhances bodily autonomy. This study challenges that colonial logic by presenting empirical evidence of how local power dynamics subvert technical interventions.

Using nationally representative data from Nepal (N=6,480), I employ structural equation modeling to analyze the impact of Menstrual Health (MHH) resources on mental well-being, specifically testing the boundary conditions of patriarchal norms. The analysis reveals a "paradox of patriarchal capture." In progressive households, MHH resources function as intended, promoting agency and reducing distress. However, in households with regressive norms, the relationship reverses: the provision of "adequate" facilities is associated with higher burdens of infection and stigma, and as a result, greater psychological distress.

This finding suggests a "perverse inclusion": without addressing the "software" of agency, the "hardware" of development is co-opted to reinforce surveillance and exclusionary isolation. In these settings, "privacy" functions as confinement. By showing that material interventions can actively harm women when decoupled from justice, this study argues for moving beyond the "logistical" framework toward a paradigm centered on dismantling the structural power dynamics that govern the body.