Manasi Satalkar
Abstract
Female athletes in India face multidimensional challenges, ranging from menstrual health stigma and nutrition deficiencies to infrastructural barriers. Conventional top-down research often fails to capture these lived realities. Participatory Action Research (PAR) offers a transformative approach by involving athletes as co-researchers, ensuring interventions are contextually relevant, sustainable, and empowering. Drawing on global evidence and India-specific data, including the Play Without Pause report from Uttar Pradesh, this article analyzes how PAR can improve menstrual health literacy, foster behavioral change, and strengthen the ecosystem of women’s sport in India. Policy pathways to institutionalize PAR and integrate athlete-centered approaches into national sports programs are outlined.
Introduction: Beyond Numbers in Athlete Health Research
When policymakers hear “research,” the immediate image is often survey tables or top-down reports. While useful, such methods often fail to capture the lived experiences of female athletes, especially in India, where social stigma, infrastructural gaps, and gendered expectations compound health challenges.
Participatory Action Research (PAR) redefines research as a collaborative, democratic process. Athletes, coaches, parents, and administrators are co-researchers, not mere subjects: they help define problems, test solutions, and evaluate outcomes. Globally, PAR has been successfully applied in education, community health, and disability sport (Robinson et al., 2023). In elite sport, it has empowered women athletes to articulate priorities regarding menstruation, contraception, and mental health (Stanford Children’s Health, 2023).
In India, PAR offers a promising framework to move beyond piecemeal interventions toward sustainable systems that genuinely reflect athlete needs.
Why Female Athlete Health Requires a PAR Lens
Female athlete health extends beyond injuries to include menstrual health, iron-deficiency anemia, and social stigma. Para athletes face additional hurdles: inaccessible facilities, reliance on caregivers, and higher infection risks. Conventional surveys can quantify prevalence—such as missed training days due to menstruation—but rarely explain why these patterns exist.
PAR addresses these gaps by involving athletes in co-creating tools such as diaries, reflection exercises, and story circles. For instance, when athletes design a tracking diary themselves, they are far more likely to engage consistently. This participatory approach ensures that interventions are grounded in lived realities rather than assumptions, increasing adherence and long-term effectiveness (Badenhorst, 2024; Simply Sport Foundation, 2025).
Global Lessons: PAR in Action
PAR in sport has yielded several notable insights:
● School and Disability Sport Programs: Initiatives like Game Changers in Australia show how co-created programs empower marginalized students and generate actionable insights that top-down surveys often miss (Robinson et al., 2023).
● Elite Female Athlete Research: Top-tier athletes have identified menstrual health, contraception, and mental well-being as priorities, guiding research agendas and intervention design (Stanford Children’s Health, 2023).
● Menstrual Health Interventions: Holistic strategies integrating education, tracking, and nutrition improve participation and performance while addressing the persistent sex data gap in sports science (Badenhorst, 2024; McGawley et al., 2023).
In all cases, research conducted with stakeholders, rather than on them, creates more relevant and enduring change.
Behavioral Nudges: Practical Implications
My own experiences working with young female athletes in Uttar Pradesh highlighted how even rudimentary behavioural tools, when co-created, could shift health outcomes.
● Period Tracking Diaries: Athletes recorded cycles, symptoms, nutrition, and training, reducing missed training days from 40% to 23% over six months (Simply Sport Foundation, 2025).
● Experiential Workshops: Interactive activities such as anatomical balloon demonstrations and role-playing stigma-laden scenarios normalized menstrual conversations.
● Peer Reflection Groups: Discussing diaries in groups fostered social reinforcement and strengthened consistent health behaviors.
These interventions highlight that even low-cost, locally adapted strategies—designed with input from athletes—can produce meaningful and measurable outcomes. While not full PAR, these co-created initiatives exemplify how athlete-informed solutions can enhance engagement, adherence, and overall well-being in grassroots sport programs.
Accounting for Diversity Across States and Sports
India’s female athletes are not homogeneous. Challenges differ by state, sport, and socioeconomic context:
● Uttar Pradesh: Stigma and infrastructural gaps dominate, including coded language, absence of disposal facilities, and limited product access.
● Para Sports: Accessibility challenges—including caregiver support, product availability, and toilet design—can dictate consistent participation.
● Aquatic Sports: Anxiety regarding tampons, menstrual cups, and competing during periods is common, as observed in Karnataka swimming trials.
PAR allows localized adaptation while feeding insights into broader policy frameworks, ensuring interventions reflect contextual realities.
Beyond Health: Economic and Strategic Implications
Healthier athletes sustain longer careers, creating stable teams and dependable seasons, underpinning commercial growth in women’s sport. PAR enhances this by fostering authentic storytelling: athlete-generated narratives resonate with sponsors, broadcasters, and fans, enhancing engagement and sponsorship opportunities. Commercial viability and athlete well-being, therefore, are mutually reinforcing when programs are co-created.
Policy and Program Recommendations
To institutionalize PAR in India’s sports ecosystem, three strategies are recommended:
1. Embed PAR in State Sports Ecosystems: Collaborate with local NGOs and universities to include co-research methods in athlete development programs.
2. Link PAR with Government Schemes: Programs like the Menstrual Hygiene Scheme, Anemia Mukt Bharat, and Khelo India can be adapted locally through participatory processes.
3. Capacity Building: Train coaches, physiotherapists, and athletes in PAR methods, including diary facilitation, participatory mapping, and reflection exercises, to create a multiplier effect.
Conclusion
Female athlete health is a social, cultural, and infrastructural challenge. Without menstrual literacy, nutrition support, and inclusive facilities, many girls drop out before realizing their potential. PAR offers a pragmatic and ethical framework: it listens, co-creates, and adapts. Policies designed in Delhi can, through PAR, resonate in Bareilly, Bengaluru, and Bhubaneswar alike. Ultimately, PAR not only improves health outcomes but also strengthens the commercial and cultural ecosystem of women’s sport in India, ensuring athletes are seen, heard, and empowered.
References
1. Robinson, D. B., Harenberg, S., Walters, W., Barrett, J., Cudmore, A., Fahie, K., & Zakaria, T. (2023). Game Changers: A participatory action research project for/with students with disabilities in school sport settings. Frontiers in Sports and Active Living, 5, 1150130. https://doi.org/10.3389/fspor.2023.1150130
2. McGawley, K., Sargent, D., Noordhof, D., Badenhorst, C. E., Julian, R., & Govus, A. D.(2023). Improving menstrual health literacy in sport. Journal of Science and Medicine in Sport, 26(7), 351–357. https://doi.org/10.1016/j.jsams.2023.06.007
3. Badenhorst, C. E. (2024). The Menstrual Health Manager (MHM): A resource to reduce discrepancies between science and practice in sport and exercise. Sports Medicine (Auckland, N.Z.), 54(11), 2725–2741. https://doi.org/10.1007/s40279-024-02061-w
4. Stanford Children’s Health. (2023). Menstruation, birth control, and mental health: Top Team USA female athletes set the research agenda. Retrieved from https://healthier.stanfordchildrens.org/en/menstruation-birth-control-mental-health-top-tea m-usa-female-athletes-research-agenda/
5. Simply Sport Foundation. (2025). Play Without Pause: Impact report on female athlete health and participation in Uttar Pradesh. Bengaluru, India: Simply Sport Foundation. Retrieved from https://www.simplysport.in/_files/ugd/9b1da6_8b8bc94cae414f00aae8d7109c621793.pdf
Manasi Satalkar is a physiotherapist and sports rehabilitation professional, currently serving as the Research Lead for Women’s Health Initiatives at the Simply Sport Foundation (SSF). She holds a Bachelor’s in Physiotherapy from Government Medical College, Nagpur, and a Master’s in Sports Rehabilitation from Manipal College of Health Professions, where she stood first in the entrance exam.
At SSF, she leads the Research for Womens Health initiative designing and delivering programs across Bihar, Uttar Pradesh, and Odisha ; Pan India programs that focus on menstrual health, nutrition, emotional wellbeing, and injury prevention for adolescent female athletes. Her work is rooted in the lived realities of girls in sport—often navigating silence, stigma, and systemic gaps.
Manasi sees research as more than data—it’s a way to honor stories from the field and push them into spaces of power. Through the IMPRI Fellowship, she hopes to strengthen her qualitative research and policy engagement skills, so that grassroots voices especially those of young athletes can inform the future of inclusive health and sport in India.
Disclaimer: All views expressed in the article belong to the author and not necessarily to the organisation.
Acknowledgement: This article was posted by Aashvee Prisha, a research intern at IMPRI.
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