ThisseriesonInclusiveInnovationsexploresbusinessmodelsthatimprovethelivesofthoselivinginpoverty.EditorsareElaineTinsleyandNataliaAgapitova.WrittenandresearchedbyEndevaandAshleyInsight.

INCLUSIVEINNOVATIONSChangingtheLivesofWomenandGirlsthroughAffordableFeminineHygieneProductsLow-costproductssavelives,reduceschoolandworkabsenteeism,andincreasetheincomesofwomenatthebottomofthepyramid

SummaryWomenandgirlswhouseunhygienicalternativesforsanitarypadsortampons(suchasnewspapers,leaves,cloth,andcowdung)notonlyfacehealthissues,butalsotendtomissworkorschoolmorefrequently. Indeed, most women in developing countries, particularly in Asia-Pacific and Sub-SaharanAfrica,donotuseadequate femalehygieneproducts.This lackofusenegativelyaffectstheirself-esteemandparticipationineducationandemploymentandultimately,insociety.

Social enterprises have responded by developing low-cost methods of sanitary pad productioncoupled with innovative models for distribution and marketing. Women at the Bottom of thePyramid (BoP) are included at all stages of the value chain—as entrepreneurs or employees inproduction,distributors,healtheducators,andconsumers.

DevelopmentChallengeOnlyasmallfractionofwomenindevelopingcountriesusesanitaryproductsduringmenstruation.Mostmakedowithnewspapers,leaves,piecesofcloth,cowdung,andothermaterials,whichcausechafing, urinary tract infections, reproductive tract infections, and other reproductive healthproblems,includingfataltoxicshocksyndromeandinfertility(BooseyandWilson2013;UNICEF2009).Lackofsanitaryproductsalsocausesgirlstostayhomefromschoolandwomentomisswork.AthirdofUgandanschoolgirls cite lackofpadsas the reason formissing school (CroftsandFisher2012).Nextbillion(2013)estimatesthatlackofaccesstosanitaryproductscauseslow-incomewomentolosean average of five years of lifetimewages. Inadequatemenstrual hygiene also prevents girls andwomenfromperformingotheractivitiesandengagingwithothers(Montgomeryandothers2012).Themarketforfemininehygieneproductsishuge.InIndiaalone,wheremorethan300millionwomendonotuseadequatesanitaryproducts, it isestimatedtobeworthmorethanUSD200million(ACNielsen2011;Economist2013).Thechallengeistomakeproductsaffordableandconvincewomenandgirlstousethem.

HIGHLIGHTS• Socialenterprisesareproducing

andsellinggood-qualitysanitaryproductsataffordableprices.

• Manufacturingsanitarypadsinruralandremoteareas,usinglocallyavailablerawmaterials,widensreachandreducescosts.

• Womenareinvolvedineverystageofthevaluechain,oftenproducingandsellingpadsthemselves.

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BusinessModelComponentsoftheModelSocialenterprisesandNGOsproducebothsanitaryproductsandsimplemachinesthatallowwomeninvillagestoproducesanitarypads.Manufacturersofsanitaryproducts(mostlypads)procuretherawmaterials,producetheproducts,andorganizedistribution(Figure1).Manufacturers ofmachines (Aakar Innovation, Jayaashree Industries [JI], and Saathi) produce themachines,identifywomen’sgroupsinterestedinbecomingmicroentrepreneurs,andprovidetrainingandinsomecasesassistanceinfinancingthepurchaseofthemachine.Women’sgroupspurchasethemachines; organize the production process; purchase raw materials; share knowledge aboutmenstrualhygiene;engageinword-of-mouthadvertisement;andsellpadsdoortodoor,fromhome,orbacktothemachinevendorforsaletoconsumers.Althoughthismodelrequiresalargeupfrontinvestment,itgeneratesaconstantrevenuestreamforruralwomen.Manynon-stateactorstrainhealtheducatorsandorganizeawarenesscampaigns.Figure1.Featuresofthefemininehygieneproductsmodel

CostFactorsSanitaryproductssellforUSD0.03–0.16apiece—30–80percentlessthanbrand-nameproducts.Theperitemcostishigherforreusableproducts(e.g.,AFRIPadsreusablepadscostUSD4–5per4-pack)thanfordisposableproducts,buttheannualcostisonlyabout20percent.Pad-producingmachinescancostUSD500–USD1,500plus installationandtraining.Rawmaterialsused in production (papyrus, banana trunk fiber, bamboo, water-hyacinth pulp) are often locallyavailable.RevenueStreamsEnterprisessellingproductionmachinesgeneraterevenuefromsellingthemachines.Saathi,anIndiancompany, supplements these revenues by selling banana fiber to women’s groups using their

Make sanitary products accessible and affordable for low-income women

FEMALE CUSTOMERS• Sell in bulk, such as to hospitals,

or sell to individual customers• Give easy access to products• Help reduce missed days of

schooling and employment

SANITARY PRODUCTS • Offer cheaper alternative to

existing brands and substitutes• Customize products by size and

packaging• Sell disposable versus reusable

FEMININE HYGIENE MODEL • Target low-income females• Build capacity of women along

the supply chain• Conduct community awareness• Manage sales and installations

AWARENESS AND DEMAND • Offer informal or formal

education, such as workshops, female sales agents, teachers, village meetings, toll-free hotline

• Synergize with schools

COMMUNITY DISTRIBUTION • Use trusted network of door-to-

door sales agents and in-school distributors to remove taboos

• Generate income for female sales agents and entrepreneurs

FEMALE HYGIENE

DECENTRALIZED • Focus on local production

operated by women• Involve schoolgirls sometimes

with in-school production• Minimize supply chain

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machines.Aakar,anotherIndianenterprise,buyssanitarypadsfromwomen’sgroupsandsellsthemataprofit,generatingadditionalincomeforthesocialenterprise.Micro-entrepreneursgeneratemonthlyprofitsofUSD50–100(Sandhana2012).BothJIandSaathireportthatwomen’sgroupsearnanaverageprofitofUSD400amonth(CNBC2014;NewInventionsn.d).Donorsandinvestorsprovidefunding,rangingfromstart-upgrantstoinvestments.TechnologyforTomorrow(T4T)receivedaUSD78,000two-yearresearchanddevelopmentawardfromGIZandtheRockefellerFoundation(Adelphi2013).Otherenterprises(Saathi,SHE,T4T)havewonfinancialawardsin business competitions. Afri-Can received seed funding from the US Agency for InternationalDevelopment(USAID)andcrowd-fundingthroughIndiegogo.FinancialViabilityBothJIandT4Treportthattheyareprofitable.T4TreportedearningUSD300,000.Itsells90percentofitspadstotheUnitedNationsHighCommissionerforRefugees(UNHCR),whichdistributesthemtorefugeesinUganda(UniversityofOxfordHumanitarianInnovationProject2013).PartnershipsHalf of the social enterprises work with partner organizations to accelerate distribution. T4TdistributesitsMakaPadsthroughUNHCR.Azadi,AFRIpads,RubyCup,OneGirl,andJIusepartnerstoidentifywomen’sgroupsinlocalareas.OtherssellpadstointernationalNGOsfortheirredistribution.Implementation:DeliveringValuetothePoorAwarenessManygirls andwomen lack adequate knowledgeof reproductivehealth in general andmenstrualhygieneinparticular,leavingthemsusceptibletomythsandmisconceptions(Garg,Goyal,andGupta2012).Tofillthisgap,femalesalesagents,teachers,andcommunityhealthworkersworkingfororwithsocialenterprisesprovideeducationatinformalknowledgesharingsessions,formalworkshop,schools,andvillagemeetings.Afri-Canemploys teachersassalesagents, training themtoeducateschoolgirls on menstrual hygiene; it also organizes school health clubs. AFRIpads uses radio todisseminateinformationabouthygieneandraiseawarenessaboutitsproduct.Azadioperatesatoll-freemenstrualhelplinetoprovideinformationtogirls.RubyCupsellsitsproductonlyafterafemalementorexplainshowitisused.SustainableHealthEnterprises(SHE)operatesmenstrualhealthandmanagementclubsrunbyteachersat10schools.AcceptanceCulturaltaboosreduceacceptanceoffemininehygieneproducts.Reusablepadsneedtobedriedinthesunandarethusvisibletoothers,whichistabooinmanyplaces(Women’sGlobalToolkit2013).In Kenya, for example, a father is not allowed to see his daughter’s blood. Tampons are oftenconsideredtaboo,becausesomeculturesbanoninsertingforeignobjectsintothebody(CroftsandFisher2012).However, insomeplaceswherewatersuppliesmaybemorelimited,menstrualcupshavebeensuccessfullypromotedandadopted,astheyrequirelesswatertocleanthanreusablepadsandonecupcanlastformanyyears.Toenhanceacceptance,enterprisesadaptproductsandpackagingtocustomers’needsandwants,selltheminkits,distributethemthroughlocallytrustedpartners,andcreatelocalbrands.Anumberof businesses conducted trials and studies to understand consumer preferences before beginningproduction. Product adaptations that resulted from these efforts included adding a string thatattachesthepadtothebodyforuserswhowearnounderwear.

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Toencourageadoptionoftheirreusablepads,somecompaniesselltheminkitsthatcontainsoap,aholder,underpants,bagsforusedpads,andinstructionsinlocallanguages.Mostproductsareproducedanddistributed locally,oftenby localwomen’sgroupsorcommunityhealthworkers.Manywomen’sgroupscreatetheirownbrands,identifyingpadswithlocalproductionandallowingforaculture-specificapproach.Enterprises address cultural taboos through community events involving both men and women.Programsat thevillage level includeawarenesssessionsandplays todestigmatize taboosubjects.Employing salespeople who are sensitive, empathetic and trusted by the target group facilitatesuptake(Economist2013).AccessibilityWithouttheeffortsofsocialenterprises,manywomenwould lackaccess toproductsbecausethemarket is dominated by multinationals, whose distribution networks are limited in rural areas(Inclusive Business n.d.). Social enterprises ensure accessibility through local production, whichminimizes transport requirements; door-to-door sales; and distribution through schools andhumanitarian organizations, such as UNHCR. Many distribution models circumnavigate outletsdominated by men, because women are more comfortable buying sanitary products from otherwomen(Price2014).Door-to-doorsalesare themostcommonformofdistribution.Abouthalfofbusinessmodelsalsodistributeproductsinschools.InSierraLeone,OneGirldistributespadsforfree;Afri-Can,SHE,andImpact Africa sell their products to schoolgirls. In India 126 machines produced by JI have beeninstalledinschools.Schoolgirlsinvestinrawmaterialsandproducethepads,whichtheyselltootherstudentsandcommunitymembersataprofit.SHEsellsitspadsthroughcommunityhealthworkers.AffordabilityLow-incomecustomerscanaffordtheproducts,becauseenterpriseskeepcostslow,throughashortsupplychain,theeliminationofmiddlemen, localproduction,useof local inputs,andavoidanceofmarketingcosts.Flexiblepaymentalsofacilitatesaffordability.JIacceptsbarterandlatepaymentforitsmachines,asdowomensellingJIpadstootherwomeninruralareas.OneGirlsellspackswithasfewastwopadstowomenwithinsufficientcashflow(Table1).Production machines are made affordable by selling to women´s groups rather than individuals.Machinesaretypicallymanual,avoidingdependenceonelectricity.Table1.SellingpointsandpricesofselectedsocialenterprisessellingfemininehygieneproductsModel/country Producttype Sellingpoints PriceAakarInnovation(India) Production

machineShops,salesagents

Machine:USD6,800Pads:40percentlessthanbrand-nameproducts

Afri-CanTrust(Kenya)I-Carepads

Reusablepad Schools,shops AroundUSD2.50forapackagethatlastsayear(45percentlessthanleastexpensiveproduct).

AFRIpads(Uganda) Reusablepad Salesagents,partnerorganizations

USD4–5perpack.AFRIpadsDeluxeMenstrualKithasasetof4reusablesanitarypads,plus1storagebag.(20percentofthecostofbrand-nameproducts)

Azadi(India) Compostable,biodegradablepad

Partnerorganizations,salesagents

USD0.04apiece(43percentlessthanbrand-nameproducts)

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ImpactAfrica(Kenya,Rwanda,SouthSudan,Tanzania,Uganda)(SafiPads)

Reusablepad Sellingpointsininformalsettlements,schools

Halfthecostofbrand-nameproducts

JayaashreeIndustries(India)

Productionmachine

Salesagents,schools

Machine:USD1,500Pads:USD0.03apiece(80percentlessthanbrand-namebrands)

OneGirl(SierraLeone)(PadsprovidedbyTechnologyforTomorrow)

Compostable,biodegradablepads

Salesagents,schools,partnerorganizations

Freeinschools,USD0.68perpack(of10pads)

TechnologyforTomorrow(Uganda,exportstoSierraLeone)

Compostable,biodegradablepad

Partnerorganization,salesagents

USD0.41–0.82forapackof10pads(one-thirdthecostofbrand-nameproducts)

RubyCup(Kenya,SouthAfrica,Uganda,Zambia)

Reusablecup Salesagents,partnerorganizations

USD0.11–0.16apiecethroughsalesagentsinKenya,USD30onlineandinshopsinGermany

SaathiHealthcare(India) Productionmachine

Salesagents Machine:USD500Pads:USD0.03apiece

SustainableHealthEnterprises(SHE)(Rwanda)

Compostable,biodegradablepad

Salesagents(communityhealthworkers),schools

USD0.03apiece(30percentlessthanimportedbrand-nameproducts)

ResultsandCost-EffectivenessScaleandReachThenumberofpeopleenterprisesreachrangesfrom1,200(OneGirl)toabout7.5million(JI)(Table2).JIisthemostmaturemodel;ithasbeenreplicatedin17countriesthroughtheexportofmachinesandthedisseminationofinformationonitsmodel.AFRIpadsisthesecond-mostmaturemodel,witha reach of 500,000 women. Afri-Can Trust has educated some 30,000 girls in menstrual hygienemanagementat290schools.Fourofthe11socialenterprisesstudiedareexpanding(ImpactAfrica,JI,RubyCup,T4T).Manymodelstargettheruralpoor,thoughsomemodelscatertothepoorinurbanareas.Afewtargetspecificgroups.Afri-Cantargetslow-incomeworkingwomen;AakarInnovationtargetsurbanareas,sellingproductsingroceryshopsandbeautyparlors;andRubyCupfocusesonslumareas.Table2.Numberofwomenandgirlsreachedbyselectedprovidersoffemininehygieneproducts

Enterprise/countryNumber of women and girlsreceivingproduct

Afri-CanTrust(Kenya) 35,000AFRIpads(Uganda) 500,000Azadi(India) 300villagesImpactAfrica(Kenya,Rwanda,SouthSudan,Tanzania,Uganda) 125,000JayaashreeIndustries(India) 7.5millionOneGirl(SierraLeone) 1,200RubyCup(Kenya,SouthAfrica,Uganda,Zambia) 5,000SaathiHealthcare(India) About12,500(infivevillages)TechnologyforTomorrow(T4T)(Uganda,exportstoSierraLeone) 34,000

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ImprovingOutcomesFemininehygieneproductsreducehealthrisks,suchasreproductivetractinfectionswhichcanleadtoinfertilityandotherchildbirthcomplications.Theseproductsalsoincreaseschoolattendance.Followingtheintroductionofitspads,Afri-CanTrustreporteda40percentincreaseinschoolattendancefor30,000girlsacross250schoolsinWesternKenya. Sanitarypads andmenstrual hygieneeducation reducedabsenteeismamong schoolgirls inGhana from 21 percent to 9 percent (Montgomery and others 2012). Girls also reported greaterconfidence and self-esteem,more participation in chores and everyday activities, less shame andisolation,andimprovedwell-beingduringmenstruation.Women’sproductivityathomeandatworkriseswhentheyhaveaccesstofemininehygieneproducts.Intheabsenceofaccesstohygieneproducts,300milliongirlsandwomeninruralIndiahavetostayconfined at home during their periods. An average woman living in poverty, loses five years ofunearned wages over her lifetime due to ineffective menstruation options—income that couldotherwisebeput towardshealthcare,educationor foodexpenses. (Nextbillion2013). Ina surveyconductedin9citiesinIndia,around31percentwomenreportedadropinproductivitylevelsduringtheirperiods,missing2.2daysofworkonanaverage.(ACNielsen2011).Productionandsaleofproductsalsogeneratesemployment,mostlyforwomen.Some21,000femalemicro-entrepreneursworldwideproduceandsellsanitarypadsusingthemachinesJIproduces.T4Temploys250people,mostofthemfromvulnerablegroups, includingwomenatthebottomofthepyramid, peoplewith HIV, and refugees. Sanitary pad production also generates income for localfarmers,whosee increaseddemandforpapyrus,bananatrunkfiber,bamboo,andwaterhyacinthpulp.Womenalsoworkassalesagentsandeducators.

A2011studyestimatedthataccesstosanitaryproductsbyallwomeninIndiacouldincreaseIndia´seconomicgrowthrateby4percentagepoints(ACNielsen2011).InRwanda,SHEestimatesthat18percentofgirlsandwomenmissedoutonschoolandworklastyearbecausetheycouldnotaffordtobuymenstrualpads,theseabsencescanadduptoconsiderablepotentialGDPlosses(SHEn.d.).

Cost-EffectivenessMostmodelsareprofit-oriented.Someservethebottomofthepyramidbycross-subsidizingsales.RubyCup,forexample,isasiliconeproductthatcanbeusedforupto10years,eliminatingtheneedforsome12,000tamponsorpads.ThecompanychargesjustUSD0.11–USD0.16percupindevelopingcountries, subsidizing these salesby chargingaboutUSD30 for itsproductonlineand in shops inGermany(Emma2014).ScalingUpScaling up is possible, thanks to cost-effective, standardized production using locally availablematerials. JI’ssimpleandopensourcetechnologyhas ledtothemodel’sadoption in18countries.Partnerships with women’s groups and other actors, such as local businesses, NGOs, andgovernments,canalsofacilitategrowthandreplication.Media attention can be a powerful driver of success. JI’s founder, ArunachalamMuruganantham,spentyearsdevelopingamachine thatenabled ruralwomen toproduceaffordable sanitarypads.OncehisstorybecomepopularizedinIndia,supportbypartnersanddemandfromwomen’sgroupsand customers increased, leading to international fame, including a documentary(http://www.menstrualman.com/).ChallengesSeveral constraints risk limiting growth and impact. Inadequate sanitation facilities, particularly atschools,areamajorimpedimenttogrowth:Evenwithaccesstosanitarypads,girlsmaystayhome

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fromschooliftherearenotoiletfacilitieswithrunningwater,wheretheycanreplacethepadorwashinprivacy.SanitationfacilitiesinUgandaareoftenunsuitableforchangingpads,becausetoilets(pitlatrines)arelocatedseparatelyfromthebathingblockswherewaterisavailableforwashing.Movingbetweenthetoiletsandwashingblocksisinconvenientforgirlstudentsasthisimpactstheirprivacysinceotherscannoticethattheyareontheirperiod.(CroftsandFisher2012).AstudyinTamilNadu,India,foundthatthemaincausesofschoolabsenteeismwerelackofwater(89percent)andprivacy(50percent)forwashing(JothyandKalaiselvi2012).Disposal of sanitary products is another important issue, both from a waste management and aculturalperspective.InUgandan65percentofgirlsthrowdisposablepadsintopitlatrines,causingblockages;thepadsalsocausethelatrinestofillupmorequickly(BharadwajandPatkas2004;CroftsandFisher2012).Somemodels, such asAakar Innovation,Azadi,OneGirl, and T4T, produce compostableproductsmadefrompapyrusleaves,whichdisintegratewithinayearinpittoilets.T4Talsosellsincineratorsofdifferentsizestoschoolsandhealthfacilities.Compostableorreusableproductspartlyaddresstheenvironmentalissue.Lackofprivacycreatesshame,particularlygivenculturaltaboos,whichpreventgirlsandwomenfromwashingareusableclothinapublicspace,suchasschool.Dryingreusableproductsinthesunisalsodifficult.InaUgandanstudy,79percentofgirlsreporteddryingtheirsanitarypadsintheirbedrooms(CroftsandFisher2012).Thebeliefthat localproductsare inferiorto importedonesalso limitsuptake.Ugandanschoolgirlsprefercommerciallyproduceddisposablepadsbecauseoftheirlighterweight,greaterabsorbency,andlowerlikelihoodofleakage;theyalsolikedthe“modern”imageofimportedproducts(CroftsandFisher2012).Combiningthesaleofsanitaryproductswithmenstrualhygieneeducationandinformationiskeytoaddressing some of these constraints, particularly cultural taboos andmisconceptions. It has thepowertoerodetaboosandbreakdowngenderbarriersmoregenerally.RoleofGovernmentandPublicPolicyBothdonorsandrecipientgovernmentshavebeguntoaddressmenstrualhygieneasakeyissueinwomen’s health and girls’ education. International institutions such as theWorld Bank, UNESCO,UNICEF,theWorldHealthOrganization(WHO),andothershavestartedincludingmenstrualhygienemanagement, including the provision of sanitary products, in their research and support togovernments. Includingmenstrualhygieneinnationalsanitationandhygienestrategiesandschoolhealthpoliciesisanimportantsteptowardimprovingawarenessoffemininehygieneproducts.Alsocritical is ensuring that toilet facilities with running water and sanitary pad disposal facilities areavailabletogirls(UNICEF2012).Recognizingtheimportanceofsanitaryproducts,severalgovernmentshavestartedsubsidizingpadsormakingthemavailableforfree.In2010,thegovernmentofIndiainitiatedtheMenstrualHygieneScheme,whichprovideshighlysubsidizedsanitarypads to ruralgirls livingbelowthepoverty line.Stategovernmentsfollowedsuitwithsimilarinitiatives.In2011,thegovernmentofKenyaallocatedalmostUSD4milliontoprovidefreesanitarynapkinstoschoolgirls;itcommittedanadditionalUSD2millionin2014(EastAfricanBusinessWeek2014;PacificStandard2014).Cuttingtaxesisanotherwaygovernmentscanfacilitateaccesstosanitaryproducts. In2011Kenyastopped levying duties on imported pads, a move that reduced their cost by 18 percent (NewInternationalist2013).

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Facilitatingknowledgesharinganddiscussionisanotherwayinwhichgovernmentscanplayarole.In2014, the Ugandan government supported the first national conference on menstrual hygienemanagement,whichsoughttobreakthesilenceonmenstruationandkeepgirlsinschool.AFRIpadstook on the role of national coordinator of Menstrual Hygiene Day. Together with partners, itpresentedamenstrualhygienemanagementchartertothespeakerofParliamenttoraiseawarenessabouttheneedtoincludemenstrualhygienemanagementinhealthandeducationpolicies.Table3.SelectedsocialenterprisesthatproducefemininehygieneproductsEnterprise Country DescriptionAakarInnovation Pvt.Ltd.

India

Producesanddistributesaffordable,high-quality,compostablesanitarynapkinsandraisesawarenessofmenstrualhygiene.http://www.aakarinnovations.com

AFRIpadsLtd. Uganda Manufacturesandsellswashableclothsanitarypads.http://afripads.com/

Afri-CanTrust Kenya

Produceshigh-quality,affordable,reusablesanitarypadsandprovidespracticallifeenhancementtrainingthatequipswomenandgirlstolivefreelyandtakechargeoftheirlives.Productcanbeusedforuptoayear.http://www.icarepads.com/

Azadi India

Developed a 100-percent biodegradable sanitary napkin that is 43percent less expensive than average retail price. Enterprise alsooperatesatoll-freemenstrualhelpline,sponsorsa ‘menstrual-friendlyschools’initiative,andsupportsan“AzadiInstigators”programinwhichtrainedoutreachteammembersdeliverempoweringpubertyeducationsessionstolow-incomeyouth.http://azadi.co.in/

ImpactAfrica Kenya,Rwanda,SouthSudan,Tanzania,Uganda

Provides affordable sanitary kits that include inexpensive, reusable,washablesanitarypads.http://impactafricaindustries.com/

JayaashreeIndustries

Indiaand17othercountries

CompanyfoundedbyArunachalamMurugananthamproducesworld’sfirst low-cost machine to produce sanitary pads. More than 600machines have been installed in 27 states in India and 17 othercountries.Machinesaresolddirectlytoruralwomen’sself-helpgroupsthrough the support of bank loans and not-for-profit organizations.Machine operator can learn the entire pad-making process in threehoursandemploythreeotherstohelpwithprocessinganddistribution.http://newinventions.in/

MiriamSeba Ethiopia ProducedinEthiopia,MiriamSebamakesenvironmentallyfriendly,lowcost,reusablepadsthatlast12–18months.Madeofcottonwithwaterproofliningtopreventleaks.Producesabout600,000padsperyear.http://www.dignityperiod.org

OneGirl SierraLeone Delivers affordable, biodegradable sanitary pads, through network offemaleentrepreneursandschoolsystems.http://www.onegirl.org.au/what-we-do/launchpad

RubyCup Kenya,Zambia,SouthAfrica,Uganda

Partners with NGO networks across Africa to distribute siliconemenstrualcupthatcanbeusedfor10years.SubsidizesdistributioninAfricawithsalesinEurope.http://www.ruby-cup.com

SaathiHealthcarePrivateLtd.

India

Developed small-scale manufacturing process to produce affordablesanitary protection from banana tree fiber waste. Pads aremanufacturedandsoldbylocalwomen.http://www.saathipads.com/

SHE(SustainableHealthEnterprises)

Rwanda

Helps women jumpstart social enterprises to manufacture anddistributeaffordablemenstrualpads.http://sheinnovates.com

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Technology forTomorrow(T4T)

Uganda,exportstoSierraLeone

ProducesMakaPad,asanitarynapkinmadeofpapyrusandpaperwaste,thatismanufacturedinUgandawithouttheuseofelectricity.Companyalsosellsspecial incineratorstodisposeofnonbiodegradablewasteinschools,clinics,andhospitals.http://t4tafrica.co/home

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Sandhana,Lakshmi.2012.“India´sWomenGivenLow-CostRoutetoSanitaryProtection.”TheGuardian.January22.http://www.theguardian.com/lifeandstyle/2012/jan/22/sanitary-towels-india-cheap-manufacture.

SHE(SustainableHealthEnterprises).“TheSHE28Campaign.”http://sheinnovates.com/our-work/.UNICEF(UnitedNationsChildren’sFund).2009.Bangladesh:TacklingMenstrualHygieneTaboos.

NewYork.———.2012.WASHinSchools:EmpowersGirls´Education.ProceedingsoftheMenstrualHygiene

ManagementinSchoolsVirtualConference2012.NewYork.http://www.unicef.org/wash/schools/files/WASH_in_Schools_Empowers_Girls_Education_Proceedings_of_Virtual_MHM_conferencepercent282percent29.pdf.

UniversityofOxfordHumanitarianInnovationProject.2013.MissionReport4.[[AU:URLdidn’twork.]

Women’sGlobalToolkit.2013.“PictureoftheWeek:SanitaryPads:NowThat’sLowTech!”June19.http://www.womensglobaltoolkit.com/2013/06/picture-of-week-sanitary-pads-now-thats.html.

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Profile:JayaashreeIndustriesFemalemicroentrepreneursproduceandsellpads,bringingsanitaryhygienetowomenandgirlsinvillagesChallengeOf the 355 million women ofreproductiveageinIndiain2011,88percent (312 million) did not usesanitary pads, resorting instead tounhygienic alternatives, such asashes,newspaper, sand,husks, anddried leaves to manage blood flowduring menstruation (Khan andGokhale 2013). Such alternativesincrease the risk of reproductivetractinfectionsby70percent(Sinha2011). Poor menstrual hygiene isalsoassociatedwithcervicalcancer,the second most common canceramongIndianwomen(InstitutCatalàd’Oncologia2014).Lackofsanitarypadshasalsobeenlinkedtopoorschoolattendanceanddrop-out.Accordingtoa2011studybyACNielsen,23percentofgirlsinIndiadropoutofschoolaftertheystartmenstruating(30percentinNorthernIndia)(Sinha2011).Girlswhoremaininschoolmissaboutfivedaysamonth,equivalentto20percentoftheschoolyear.Womenmissworkforthesamereason.Thebenefitsofprovidingwomenandgirlswithsanitarypadsarethusenormous.InnovationJayaashreeIndustries(JI,newinventions.in)developedtheworld´sfirstlocalsanitarypadproductionmachine.Thebusinessisbasedonawomen-to-womenmodel.Groupsof4–10womenacquireamachine,whichtheyusetoproducepadstheyselltootherwomen.Homesaleenableswomen’sgroupstocreateawarenessandallowsforanintimateinformationexchangeonmenstrualhygieneinanenvironmentthatfacilitatesprivacy.JIhassetup2,300manualorsemi-automatedmachinesinIndia.Eachmachinecanproduce1,000–3,000padsaday,usinglocallyavailablepinewoodfiberorotherabsorbentmaterials,suchasbamboofiber.Purchaseofamachine—includinginstallationandtraining—costsUSD2,300–3,800.Thewomenfinance their purchases through self-help group loans, loans from NGOs, banks, investmentorganizations,andgovernmentsocialschemes.JIempowerswomenandgivesthemasenseofownershipbyhavingthemchoosetheirownbrandnames.Since thesanitarypadsaremarketedonly locally, throughwordofmouth, thebenefitsofcreatingalocalproductoutweighthecreatinganationalbrand.TheEarnWhileYouLearnproject installed126machines inschools.Schoolgirlswhopurchase therequiredrawmaterialproducethepadsfortheirownuseandselltheirsurplusproductioninnearbyvillages.Corporatesocialresponsibilityprogramsorwealthydonorspaidforthemachines.ImpactIndiahasabout2,300machines,eachsupplyingabout3,000customers.Thus,theprogramprovides6.9milliongirlsandwomenwithaccesstosanitarypads.

Thesemicroentrepreneurs—picturedherewithcompanyfounderArunachalamMuruganantham—produceandsellsanitarypadsintheirvillages.

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Italsohassignificanteconomicandsocialimpact.Its21,000ruralmicroentrepreneursearnUSD46–99 amonth—two to three timeswhat the average farmworker earns and two to four times thepovertylineofUSD15amonth(Singh2014).JIreinvestsallprofitsfromthesaleofmachinesinthebusiness.Itincreaseditsproductioncapacity50-foldinthe11yearssinceitsfounding.ScalingUpJIbenefitsfromthedynamismofitsfounder,ArunachalamMuruganantham,oneofTimeMagazine’s100MostInfluentialPeople intheWorld in2014.HismissionistocreateonemillionemploymentopportunitiesandconvertIndiatoacountrywith100percentsanitarypaduse.Thecompany’sdecentralizedmodelfacilitateshorizontalexpansionanddeeppenetrationintoruralareas.Localproductionalsohastheadvantageofcuttingtransportationandstoragecosts(processedmaterialrequires10timesmorestoragespacethanunprocessedmaterial).Uptakeoftheproducthasbeenreinforcedbysettingupmachinesinschools—notleastbecauseyounggirlsaremorereceptivethanolderwomentousingsanitarypadsandoftenconvinceotherstodosoaswell.Cultural taboos associatedwithmenstruationmake it challenging to reachwomen in rural areas.Considerabletimeisrequiredtoreceivecommunitypermissiontotalktowomenanddissipatetheirdoubtsabouttheproduct.Installingthemachinesandtrainingpeopletooperatethetimetakestime.Marketdevelopmentisslow,andproducergroupsoftenfacelimitedeconomicviability.JI has received requests from several other countries, including Botswana and Côte d’Ivoire, forassistanceinreplicatingthemodel.Althoughthecompanyholdsapatentonthemachine,itprovidesopenaccesstothemodel,facilitatingreplication.Todate,morethan250machineshavebeensentto17countries,improvingthelivesofanestimated750,000people.ReferencesKhan,Natasha,andKetakiGokhale.2013.“NoMenstrualHygieneforIndianWomenHoldsEconomy

Back.”Bloomberg,July24.http://www.bloomberg.com/news/articles/2013-07-24/no-menstrual-hygiene-for-indian-women-holds-economy-back.

Sinha,Kounteya.2011.“70percentCan’tAffordSanitaryNapkins,RevealsStudy.”TimesofIndia,January23.http://timesofindia.indiatimes.com/india/70-cant-afford-sanitary-napkins-reveals-study/articleshow/7344998.cms.

InstitutCatalàd’Oncologia.2014.IndiaHumanPapillomavirusandRelatedCancers,FactSheet2014.InformationCentreonHPVandCancer.http://www.hpvcentre.net/statistics/reports/IND_FS.pdf

Singh,MahendraKumar.2014.“NewPovertyLine:Rs32inVillages,Rs47inCities.”TimesofIndia,July7.http://timesofindia.indiatimes.com/india/New-poverty-line-Rs-32-in-villages-Rs-47-in-cities/articleshow/37920441.cms.

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Profile:TechnologyforTomorrowLimitedInexpensive,locallyproducedpadsareprovidingwomenwithsafe,cleansanitarycareandprovidingdisadvantagedpeoplewithjobsChallengeLack of sanitary pads is a majorproblem in Africa, where millions ofgirlsandwomenhavenochoicebuttoresort to unhygienic and inadequatealternatives, such as newspaper, oldrugs,andashes,whichcausechafingandreproductivetractinfections.Oneoutof10Africanschoolgirlsdoesnotattend school during menstruation(UNESCO2014),andwomenlosefiveyears of unearned wages during alifetime because of work absencesduring menstruation (Nextbillion2013). One of the biggest unservedpopulations is female refugees,millionsofwhomlackaccesstopads.InnovationTechnology forTomorrowLimited (T4T),basedatMakerereUniversity inKampala,hasdevelopedseveral products to support low-income communities. Its Maka (Menstruation, Administration,Knowledge,andAffordability)sanitarypadsaremadeoflocalpapyrusandpaperwasteprovidedfromshreddedrecycledpaperprovidedbytheUnitedNationsHighCommissionerforRefugees(UNHCR).Thefourfactoriesthatproducethepadsemploymarginalizedgroups,includingpeoplelivingwithHIV,refugees, abductees of the Lord´s Resistance Army, and economically disadvantaged women inKampala.A10-padpackscostsUSD0.41–0.54,about50–75percentlessthancommerciallyavailableproducts.The pads disintegrate in a pit latrine within a year, overcoming the problem of waste. The littleelectricityneedtoproducethemcanbegeneratedbyasolarpanel.UNHCRdistributesabout90percentofallMakaPads,distributingtheminUgandanrefugeecamps.T4TalsoproducespadsfortwoNGOs,OneSchoolataTimeinUgandaandOneGirlinSierraLeone.Inadditiontothepads,T4Thasdevelopedspecialincineratorsforthedisposableofdegradablewastethatfunctionwithoutwoodorelectricity.Theyhavebeeninstalledatschools,hospitals,andclinics.ImpactMakaPadshaveimprovedthehealthandqualityoflifeof55,000refugeesinUganda,increasedfemaleschoolattendance,and reduced theenvironmentaldamagecausedby sanitarypads.T4Thasalsocreatedlivelihoodopportunitiesforabout250peoplefromvulnerablegroups,including65refugeesinitsfactoryattheKyakaIIcamp.EmployeesearnuptoUSD200amonth.ScalingUpT4Thasgrownoverthepastfewyears.MostofitsgrowthhasbeenfrombulkordersfromUNHCR,butthebusinesshasalsoexpandedtoSierraLeoneviaOneGirl.

Most of the pads thesewomen produce are distributed in refugeecamps.

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T4Tplanstoexpandfurtherbystrengtheningdirectdistributioninruralareasviasalesagents.It isalsoconsideringexpandingtoKenya,Sudan,andtheDemocraticRepublicoftheCongo,allcountriesinwhichUNHCRhasexpressedaninterestinsettingupfactoriesinrefugeecamps.T4T earns a profit, which it keeps low in order to achieve it social goals. The company is veryvulnerable, however, as 90 percent of its sales come from a single customer (UNHCR). Efforts todiversifythecustomerbasehaveonlyslowlybeenyieldingresults.TheUgandanMinistryofEducationdeclined to partnerwith the company, despite a successful pilot in 12 schools. The perception inUgandathatlocalproductsareinferiortoimportedonesalsoconstrainsgrowth.ReferencesNextbillion.2013.“TheFemaleSanitaryRevolution.”March8.

http://nextbillion.net/blogpost.aspx?blogid=3190.UNESCO(UnitedNationsEducational,ScientificandCulturalOrganization).2014.“PubertyEducation

&MenstrualHygieneManagement.”GoodPolicyandPracticeinHealthEducation.Booklet9.Paris:UNESCO.http://unesdoc.unesco.org/images/0022/002267/226792e.pdf.