In sharp contrast to her questioner, who tip-toes around the delicate subject, Akhi Sultana belts out a full-throated response that is audible to everyone in a room full of strangers.

"Before, when I had my period, I could not change my rags or wash properly," the 16-year-old says, referring to the strips of old saris poor Bangladeshi women use to manage menstruation because they cannot afford tampons or sanitary pads.