New Delhi (CNN) Kristin Kagetsu left the United States in 2014 with an idea: to bring sanitary pads to India.

According to a 2011 study by market research firm Nielsen, only 12% of Indian women use sanitary pads during menstruation.

While Saathi claims that number has now risen to 16%, it's still surprisingly low. "Even in cities there isn't full market penetration," Kagetsu said.

Most Indian women still use cloths and rags during menstruation. These are either dumped after use or washed and dried in the sun for the following month.

Sawdust, leaves and even ashes are sometimes used, solutions that can often lead to infections.

Tampons, menstrual cups and reusable pads are practically unheard of, except in elite circles.

Cost is a problem

Affordability is the key factor preventing many women from using sanitary pads.

In India, most brands cost between five to 12 rupees ($0.08 to $0.2) per pad. For lower income families, they can be a luxury.

According to a 2010 study by the NCAER Centre for Macro Consumer Research , on average a person living in rural India spends around 480 rupees (more than $7) per year on health, or around 40 rupees (60 cents) a month.

Saathi Pads said it plans to sell its product for around 15 rupees ($ 0.22) online and in urban areas but will distribute them for free in rural areas, or at heavily subsidized rates.

The lack of proper feminine hygiene and sanitation facilities can affect women's productivity at work and in school. The 2011 Nielsen study found that more than 30% of girls interviewed in northern India dropped out of school after they started menstruation.

A woman creates compostable sanitary pads from banana fiber, a byproduct of fruit production.

Kagetsu and her co-founders -- Grace Kane, Amrita Saigal and Tarun Bothra, all mechanical engineers -- initially planned to manufacture and sell machines for making low-cost sanitary pads. These would be sold to self-help groups in local villages for producing their own pads.

Then they decided to manufacture their own compostable sanitary pads using banana fibers, a byproduct of fruit production.

"We realized our strength and uniqueness was in the banana fiber itself. In Gujarat the plant ends up getting tossed aside on the road," Kagetsu said.

Tarun Bothra, left, Kristin Kagetsu, Amrita Saigal, Grace Kane and Sarah McMillian are the Saathi team.

Slowly changing views

The pads Saathi produces are biodegradable and can be upcycled to compost or biogas after use. The company claims its production process is completely chemical and plastic free -- right down to the boxes and packaging material.

The company's purchase of agri-waste material also helps provide banana growers with additional income.

"Most other pad companies like to think about women as the beneficiaries. That is there, but the greater impact we have is on our supply chain. You can think of it as fair trade and ethical sourcing," Kagetsu said.

When Saathi started out, it took six months to develop the first pad. "It looked a little funny," Kagetsu said.

Saathi now produces about 1,300 pads a day. Its factory in Ahmedabad is run by eight local women from low-income backgrounds in the western state of Gujarat. In 2017, Saathi plans to distribute 1 million pads to rural women in the eastern state of Jharkhand.

Discussions surrounding menstrual health in India are often taboo , something Saathi must face when promoting its pads. Menstruating women and girls are sometimes not allowed to cook or pray within their households and are treated as impure.

But such views are slowly changing. Recently India's Ministry of Health and Family Welfare launched an educational program that informs students about menstrual health and tells girls menstruation is not "pollution."

"If we take it seriously, then other people feel the same way," Kagetsu said. "Once there is no giggling and whispering, then we can talk about it and realize it's not something to be ashamed of."