Freweini Mabrahtu remembers her first period growing up in Northern Ethiopia. She didn’t understand what was happening to her body and worried about telling anyone out of fear and shame. She lacked access to sanitary products and used old cloths and other unhygienic materials in their place. Sometimes she missed class from embarrassment.
Like many adolescent girls entering puberty, Freweini was unprepared and uninformed about menstruation. Freweini’s story also illustrates the distinct challenges faced by millions of girls in low- and middle- income countries in managing their menses. It is for this reason that Freweini returned home after ten years of studying and working in the United States to launch a social enterprise that produces affordable, high-quality, reusable sanitary pads and underwear. Mariam Seba, named after her daughter, is a for-profit business with a social mission to ensure that girls across Ethiopia have access to menstrual health products and education.
On Menstrual Hygiene Day, Grand Challenges Canada is proud to celebrate the work of social entrepreneurs, advocates and leaders, like Freweini in Ethiopia and across the globe. This is important since the barriers associated with Menstrual Hygiene Management (MHM) are not limited to low- and middle-income countries. In countries like the United States, United Kingdom and Australia, women face discriminatory policies in purchasing sanitary products. Pads and tampons are subject to luxury sales tax, as opposed to items like adult diapers and Rogaine that are not. Canada’s own “tampon tax” was only repealed last summer after significant lobbying efforts.
Clearly, MHM is a multi-faceted issue that encompasses more than access to menstrual products. At the heart of MHM is an entry point to engage adolescent girls and boys with practical, accurate and age-appropriate menstrual, reproductive and sexual health and rights education. Even more, MHM challenges thinking around gender norms and sexual violence, behaviour change, cultural and social attitudes, and stigmas. It also covers adequate water sanitation and hygiene infrastructure and products, privacy and safe disposal, environmental considerations, government policy and taxes.
Due to this intersectionality, a collective impact approach to MHM is required. The MHM field currently consists of a few large multinationals and a considerable number of small, early-stage social enterprises concentrated in the production and/or distribution of menstrual health products. This uncoordinated landscape presents a unique opportunity for players in the public, for-profit and non-profit spheres to align around a common agenda. Such cross-sector partners bring distinctive resources, networks, strategies and finances to the challenge. Together, we can move beyond impact at the enterprise level and address the most entrenched structural barriers associated with MHM.
At the same time, there is a recognized need to strengthen the evidence linking MHM to health, education and empowerment outcomes. While MHM is a basic human right, this evidence is necessary to evaluate the effectiveness of different approaches and interventions, mobilize funding, influence policy and better understand the returns on investment in adolescent well-being. MHM contributes to six of the United Nations’ Sustainable Development Goals, including good health and well-being, quality education, gender equality, clean water and sanitation, economic growth, and responsible consumption and production. MHM could also be a key element in implementing the Global Strategy for Women’s, Children’s and Adolescent’s Health.
With a mandate to support Bold Ideas with Big Impact® in global health and funded by the Government of Canada, Grand Challenges Canada’s goal in MHM is to improve the lives of women and girls in low- and middle-income countries through improved health (including mental health), educational outcomes, empowerment and dignity. We make impact investments – investments intended to generate both social and financial returns – in MHM products, business and social innovations with potential to achieve sustainable impact at scale.
To date, Grand Challenges Canada has invested over $1.8 million CAD in four MHM social enterprises that produce and distribute menstrual products, ranging from biodegradable disposable pads to reusable pads and menstrual cups. The portfolio includes Afripads in Uganda, Sustainable Health Enterprises in Rwanda, Global Medical & Healthcare Innovations in Canada (implementation in multiple low- and middle-income countries) and ZanaAfrica in Kenya.
Grand Challenges Canada has also conducted an initial curation (comparative analysis) of MHM enterprises as a pilot for the Every Woman Every Child Innovation Marketplace, a strategic alliance of development innovation organizations that includes Grand Challenges Canada, the Bill & Melinda Gates Foundation, USAID, Norad and UBS Optimus Foundation. The curation helped identify a number of promising MHM innovations, which we are currently evaluating for potential investment.
Going forward, Grand Challenges Canada seeks to build a diverse portfolio of impact investments tackling the many cross-cutting issues associated with menstrual health, including products, disposal, education, sanitation, service delivery and distribution networks. Even more, we aim to help shape a community of innovators to catalyze partnerships, innovative financing opportunities, and the building and connecting of value chains across organizations.
Worldwide, there are more than 800 million women and girls menstruating on any given day. Like Freweini in Ethiopia and others across the globe, Grand Challenges Canada believes every woman and girl should have the ability to manage her menses in dignity and health. By building strong partnerships across funders, non-profits, corporate players and government bodies, we can help break down the structural challenges surrounding Menstrual Hygiene Management. In doing so, we have a window of opportunity to reach adolescent girls at a critical juncture in their lives and help set them up on a path to lead healthy, empowered lives.