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Jeanne Charbit

Strategy consultant – Inclusive Business at Hystra. Project Manager Menstrual Health project

Hystra is a global consulting firm specialized in inclusive business.

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Looking more specifically at menstrual health, we have observed a positive increase in the penetration of disposable pads among menstruators in the Global South, mainly driven by the younger generation who are more familiar with disposable pads than are older generations, who rely more heavily on homemade solutions. For instance, while 58% of total menstruators use disposable pads in India, this number rises to 78% for menstruators aged 15-24. While this means that more and more menstruators access disposable pads, at least part of the time, these products are still unsatisfying for most menstruators in the Global South due to cost, quality, and disposal challenges.

In parallel, we have seen the emergence of reusable products (reusable pads, menstrual cups) that could address some of the challenges (cost, disposal) of disposable pads. Qualitative consumer research shows these products generate significant theoretical interest when menstruators know their benefits and prices (60% of first choices went to reusable options based on a survey among 198 menstruators). Innovative companies like Sirona in India and AFRIpads in Uganda have tested commercial approaches to make these products available to menstruators in the Global South, yet their operations remain relatively small-scale and today only 2-5% of menstruators in the Global South use reusable products.

One major challenge in the next three years will be to test commercial approaches for reusable products further, to validate their business case and motivate more players to invest in making these products available on a larger scale. Because reusable products represent significantly lower overall costs for menstruators, they also represent a significantly smaller commercial market for private players than disposable pads, who are thus less interested in investing in these products.

There are many additional challenges to address in the menstrual health sector, especially since it has long been – and remains – an overlooked topic. This includes

Improving menstrual health awareness and education, to address persisting taboos. Improving menstrual health awareness and education, to address persisting taboos, by implementing MHH curriculum from a young age at school and leveraging mainstream media (e.g. TV shows, movies) to normalize this topic

Addressing the quality issues for all menstrual products, notably by supporting the current work done by the International Organization for Standardization.

Donors and private players will need to work together (co)invest in market tests for reusable solutions to determine their business potential for low-income menstruators:

Donors could support market tests on the cost-effectiveness of go-to-market approaches for reusable products (in particular, to understand the costs required to successfully market them), to determine which products and activities are sustainable enough for the private sector, and which ones would need support from governments and donors. They could leverage existing efforts from leading reusable product brands, supporting them to trial new marketing tactics for middle-to-low-income menstruators, e.g., Sirona to adapt its approach to lower-income quintiles in India, or AFRIpads to expand its retail presence with cost-effective marketing efforts in Uganda.

If these market tests show sufficient product adoption to justify an investment, donors could support existing quality private players (e.g., large femcare brands, existing reusable players, and large healthcare brands/distributors) in scaling up and entering new geographies.

Femcare brands could consider adding menstrual cups and/or reusable pads to their portfolio of products, as they have started doing in the Global North. While this may lead to some cannibalization of their disposable pad business, it may also help to prevent their existing consumers from switching to other brands that offer reusable options; and will help truly and fully serve menstruators.

Healthcare distributors (e.g., pharmacies and community health worker networks) reaching low-income segments could leverage their unique distribution assets to add MHH products to their portfolio; ideally as a range of products, including reusable options from the get-go.

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