Redesigning health education to reflect women’s lived experiences: insights from urban case studies in Pune

Purpose This study explores the gaps in reproductive health education (RHE) experienced by women and adolescent girls living in urban informal settlements in Pune, India. It focuses on how socio-economic, occupational and cultural barriers shape their engagement with sexual health, maternal health and menstrual health education. Design/methodology/approach A qualitative case study approach was employed, drawing on three illustrative cases across different aspects of reproductive health. Data were analyzed thematically and through cross-case comparison to identify systemic, cultural and structural factors influencing access to and engagement with health education. Findings Despite physical proximity to health services, women’s engagement with health education remains constrained by restricted mobility, precarious work conditions, cultural silences and systemic neglect. Public health initiatives often prioritize service delivery over education, resulting in misinformation, harmful practices and emotional distress. Deep-rooted cultural taboos around sexuality and menstruation perpetuate ignorance and reinforce health anxiety. Research limitations/implications The findings highlight the need for health education models that are responsive to women’s intersectional realities, moving beyond static, biomedical frameworks toward culturally resonant, flexible and participatory approaches. Originality/value This study contributes to the growing recognition that empowering women through context-sensitive, rights-based health education frameworks is essential for improving health outcomes and fostering autonomy in low-resource urban environments. It proposes a multilevel framework to reimagine RHE beyond conventional service delivery models.