The lack of affordable hygienic products and facilities, compounded by negative cultural attitudes, has profoundly and adversely affected the education of puberty-age girls in Africa. According to UNICEF, one in 10 school-age African girls stays home during her period or drops out entirely. As reported in this Project’s briefing papers, “In countries where menstrual hygiene is taboo, girls in puberty are typically absent for 20 percent of the school year.” Nor is this quandary limited to adolescence; working women also lose productive time during their periods. And even women who attend classes and jobs despite a lack of access to sanitary protection often substitute materials such as bark, rags or mud, with detrimental health consequences.
Participants in the Aspen Design Summit’s Menstruation Project addressed this dilemma not as an isolated predicament but as part of a larger system of economic and cultural forces that offered powerful opportunities for change. The group’s principal objective was to assist team member Elizabeth Scharpf, a social entrepreneur setting up a program in Rwanda to produce and distribute low-coast sanitary pads, in considering ways to innovate her venture, Sustainable Health Enterprises (SHE). “In Rwanda for the last 15 years, it’s only been handout, handout,” Scharpf said. “We’re trying to change that and make it more sustainable.”
Building on Scharpf’s efforts to create businesses in Rwanda through the manufacture and sale of affordable sanitary protection, the team proposed an “eco-system” whereby sanitary pads became a linchpin for local economic growth, for educational programs about health and hygiene and for research into materials that could be adapted to other countries
Combating the Taboo
Scharpf seeks to provide information to maturing girls and women that would help remove the sting of taboo and provide answers to questions as fundamental as “Why am I menstruating?” and “What is going on with my body?” — questions she has heard from women as old as 35.
Such information should be paired with access to affordable sanitary pads and safe, private latrines, Scharpf believes. But how might these initiatives be combined? Scharpf also seeks to jump-start the local economy by opening a factory for the production of low-cost pads and offering them for sale by health workers. But “working in Rwanda, how do we replicate that in other places?” she wondered. “Is there a kit for this? The same issues exist in Madagascar and Tanzania.”
Currently, Scharpf is able to procure generic sanitary pads at a 15 percent reduction simply by buying them wholesale. (The pads, which are packaged in bags of 10, retail for $1.10.) Her organization is training community health workers to distribute the pads door to door, along with information about menstrual hygiene. In turn, the health workers earn 10 percent on the sale of the pads. Sustainable Health Enterprises has recovered some of the expenses for transportation and marketing the pads, but takes no profit.
At the same time, Scharpf is financing a factory in Rwanda that employs men and women from the community to make pads from banana fiber, an absorbent material obtained from the trunk of the banana tree, which is routinely chopped down after each harvest and therefore classified as agro-waste. Combined with local factory production of 5,000 pads a day, this material, Scharpf estimated, will yield a product that costs 75 cents per pack of 10, 35 percent below the lowest price on the market. Manufacturing the pads requires little electricity, Scharpf added, and might even be accomplished through solar power. Recently, she released a video outlining her initiative.
Questions of how to scale this project and extend hygienic knowledge to all sectors of the community so that it reaches the home as well as the classroom, mothers as well as their daughters, and men as well as women led the Project team to propose a number of ways to package and distribute the pads and to cope with the dearth of safe sanitary facilities for changing them. The pads, for instance, could be combined in a two-pack along with a wipe and distributed by individual schools that would in turn be supplied by a Ministry of Education. Related hygiene information or a rewards program for procuring pads could be communicated as text messages. The team even discussed portable or wearable screens that would offer some semblance of privacy in the absence of a latrine. By the same token, it considered the value of researching superabsorbent fibers.
Initially the project team divided the market between schoolgirls and working women. As discussions wore on, however, the team differentiated between girls who have just reached puberty and are most vulnerable to the temptation to drop out, and those who have come to terms with the stresses imposed by menstruation and have chosen to remain in school but would benefit from affordable products.
Mid-Course Revision
An even more pronounced shift occurred when Scharpf decided that framing the problem in terms of eradicating a taboo and restoring a sense of dignity to female development was less concrete and persuasive than addressing the loss of education, productivity and, consequently, income when girls and women remain at home. Attack the issue of productivity, Scharpf concluded, and dignity would follow.
With the team’s encouragement, Scharpf broke her initiative into three “buckets,” autonomous yet complementary pursuits that might attract different funding partners. A “production bucket” would involve the establishment of a local factory that used indigenous materials with the aim of decreasing the product’s price. A “capacity bucket” would contain efforts to reach girls and women though health workers or local schools. And a “knowledge bucket” would encompass information about local customs, materials and production opportunities with an eye toward creating a scalable model.
Next Steps and Action Plan
After sharing the information gained from the Summit internally, with her colleagues, Scharpf will revise her operational plan, including budgeting, and will get feedback on the new three-bucket structure. At the same time, she will seek to form new partnerships and find new funders that match her revised objectives.
Team Members
Moderator: Manuel Toscano, Principal, Zago
Recorder: Julie Lasky, Editor, Change Observer
Mariana Amatullo, Vice President, Director, Designmatters Department, Art Center College of Design
Nathalie Destandau, Partner and Strategist, Tomorrow Partners; Strategy Chair, AIGA Center for Sustainable Design
Christopher Fabian, Communications Officer, UNICEF
Pornprapha Phatanateacha, Assistant Professor, Graphic Design, School of the Arts, VCU Qatar
Elizabeth Scharpf, Founder, Chief Instigator, Sustainable Health Enterprises (SHE)
Contributions were also made by members of the UNICEF Early Childhood Development Project team:
Grant Cambridge, Senior Researcher, The Meraka Institute
Vanessa Eckstein, Principal, Bløk Design
Heather Fleming, CEO, Catapult Design
Hanne Bak Pedersen, Deputy Director, UNICEF Supply Division
Edgard Seikaly, Technical Specialist, Education Unit, UNICEF Supply Division
Diana Velasco, Innovation Officer, UNICEF Supply Division
Jocelyn Wyatt, Leader of Social Innovation, IDEO
Significant contributions to the writing of this report were made by Julie Lasky.
Documents
A PDF of the briefing book chapter on the UNICEF Menstruation Challenge Project is available here.
The original website for the Aspen Design Summit, as well as a list of all participants, is here.
