OpenIDEO is an open innovation platform. Join our global community to solve big challenges for social good. Sign up, Login or Learn more

Menstrual Cup Market Accessibility Model (MCMAM) Scale up - Increasing Youth’s Access to Sustainable Menstrual Health Management

Scaling up menstrual cup sales through trusted community networks to provide sustainable access to effective menstrual management in Uganda

Photo of WoMena Uganda
15 11

Written by

Tell us about your vision for this project: Share one sentence about the impact you would like to see from this project in five years

By 2020 we aim to have supported the growth of an independent market for menstrual cups with private and public sector involvement, reaching 10,000 girls and women in Uganda through different channels.

Who will implement this idea? Or what’s your strategy to implement in the next 6-18 months?

WoMena (3 staff): coordinate project & market advocacy activities & facilitate human-centered design activities (with support from HUE). Design team will include sales agents and MC Users. Partners: Integrate sales into their existing programmatic activities and do M&E. • Q1: Ideation & prototyping workshops, secure MCs & refresher training for current partners & development of Market Advocacy Strategy • Q2: Roll out sales toolkit prototypes to partners, launch demand activities, initiate procurement mechanisms & on-board 2-3 new distribution partners • Q 3-6 continued activities, partner led M&E of sales refresher training & feedback

How has your idea changed based on feedback?

We have already changed pricing levels across models, pivoted from rural to urban savings groups and simplified ICT materials. We learnt that we need more refresher training, a more robust & relevant sales toolkit, broader marketing activities and better sales tracking. We need to invest in more targeted activities for youth. This project aims to integrate all these elements and together with sales agents and MC users develop an optimal approach.

Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?

WoMena is a learning organisation. We will employ a continued feedback loop to ensure we receive and act upon feedback on the developed prototypes. We already have a cohort of MC users and sales agents who will be integral members of our design team. We will also regularly engage our partners in feedback sessions and address supply and demand related issues and pivot activities where needed. We do not have set implementation models, we build on the success of existing ones and integrate.

How long have you been working on the project?

1

What year was your organization or group started?

2012

How many full time staff are needed to implement your idea?

3

What most attracted you to the UNFPA Young People's Sexual and Reproductive Health Challenge?

We are excited about the success we have had with MC sales but more importantly we want to learn from what has/hasn't worked. Applying a human-centered design approach is the ideal opportunity to make use of these lessons learnt. The UNFPA has been instrumental in MHM programming and plays an important role in global product related policy and distribution. A partnership with the UNFPA would be particularly advantageous for national and regional scale up.

Share the URL for your Business Model Canvas Here

https://canvanizer.com/canvas/rG984Oggovutu

Opportunity Areas – Select those that apply

  • Last Mile Sexual and Reproductive Health Commodities
  • Other

What specific problem(s) are you trying to address? (300 character limit)

In Uganda, girls and young women lack access to preferred MHM methods. But donations are not sustainable or sufficient to meet demand. Scaling up tested, cost effective models to sell menstrual cups (MCs) directly to users could provide access to a long lasting MHM solution for millions of Ugandans.

What are some of your unanswered questions about the problem(s) you are working to address? (500 character limit)

Our work has shown that with the right inputs, MCs are an accepted and often preferred solution for MHM in Uganda. We also know that MCs can be sold; over 1000 cups have been sold at community level through our recent Menstrual Cup Accessibility Project (MCMAP) pilot. But how can we scale up to ensure national coverage, continued stock and ensure safe use on a wider scale? And what tools do we need to effectively build demand and disseminate information?

Who are your end users? (1000 character limit)

Our primary end users are young Ugandan girls and women, aged 15-30 years in both rural and peri-urban areas, who lack adequate access to and knowledge of sustainable menstrual management methods. We have interviewed girls and women that have received MCs with our support; they report feeling more free and secure and saving money. By securing their menstrual management needs, girls and young women can concentrate on the things that matter; going to school, taking part in social activities and building their future prospects. Selling MCs can also provide an additional income to our partners "sales agents" and provide a pathway to discuss menstrual health and continued support to girls and women in their communities. By expanding access through increased # of sales points, creating mechanisms for procurement of larger MC volumes & building demand, we expect to reach at least 10’000 girls and women with MCs within two years, and potentially millions beyond the duration of the project.

Explain your idea. (500 character limit)

Based on our experience of selling MCs using different pricing/distribution models through our partners (incl. feedback from 45 interviews with MC users and sales agents), this scale up project aims to: 1. Design, with partners, sales agents and existing MC users a "sales toolkit" to meet the needs of sales agents and demand creation activities. 2. Scale up sales through tested & new partner models 3. Develop supply chain mechanism & scalable training model for increased MC sale

What is your value proposition? (500 character limit)

Many Ugandan girls & women lack access to appropriate MHM methods, having implications for their physical, social & mental well-being. Reusable menstrual cups are a 10-year solution & have been found acceptable in Uganda. But supply & distribution is a challenge due to lack of awareness & unsustainable supply. Using human-centered design, we aim to optimise existing distribution/demand creation networks, build local training/support structures & encourage sustainable supply chains in Uganda.

What's different about your idea compared to current solutions? (500 character limit)

Most MC interventions in low-income contexts are donation based. We are applying a human centered design approach (sales toolkit), several types of sales agents and a total market approach (NGO, private & public) to work towards a sustainable sales network expanding across the country utilizing existing structures. We have partners who are already selling MCs, over 100 trained community facilitators & sales agents, pilot experience & over 3000 MC users to draw ideas and inspiration from.

What are the key reasons why end users would turn to your organization over another?

  • Convenience / Accessibility: Making products accessible

What would success look like for your end users? (500 character limit)

1. Access to product: Promoted sales models ensures 10,000 girls and women have accessed MCs conveniently, and models are sustained after the end of the project, 2. Access to information: By training sales agents across partners we also expand knowledge networks increasing girls and women's access to MHM knowledge and support, 3. Generating demand: By using a sales toolkit we will increase trust in the MC and increase demand and sales.

How would you measure the impact your idea has on your end user(s) ? How will you measure the success of your program? (500 character limit)

The scale up project will utilise partners existing M&E frameworks to gather data noted above through routine sales data, which will measure reach and cost recovery. However capturing user experience is not fully covered by their routine M&E procedures. Together with partners we will develop a process that fits better into their existing data collection methodologies. Lending from a project in Kenya, we may look at integrating a "customer incentive" scheme to encourage direct user feedback.

What strategies will/are you testing to acquire end users? (300 character limit)

Our partners have community-based agents with established promotion networks, as well as youth volunteers. The sales toolkit will incorporate marketing materials to support agents in creating community demand. A radio & social media campaign will be developed as part of the sales toolkit process.

Key partnerships - Who will you partner with to make your idea work? (500 character limit)

We are working with Marie Stopes Uganda & Welthungerhilfe/WHH on the MCMAP pilot. As part of the MCMAM project we will include 2-3 additional partners with wide distribution networks. Pharmacy-based models will be explored regarding MC distribution through private sector. MC suppliers producing cheaper MC brands will also be involved. Lastly, we will also continue to consult with the Ministries of Education and Health, about providing MCs through the public sector.

What is your organization’s name? (150 character limit)

WoMena Uganda

Tell us more about you: (750 character limit)

WoMena is an NGO focusing on implementation of reproductive health innovations. We have an office in Uganda as well as a virtual office in Denmark & a number of successful MC research and projects under our belt working with e.g. DanChurchAid, WHH, London School of Hygiene & Tropical Medicine and Mbarara University. Our mission since 2012 has been to pilot innovations and taking them to scale and we have MCs successfully introduced MCs in +30 sites across Uganda. To find out more about our work across Uganda, check out our interactive map: https://www.google.com/maps/d/viewer?mid=1oMROqJIXlHjRhXtgA7du_Mkyv_k&ll=1.7081855641809434%2C31.612354554101557&z=7

Organizational Characteristics

  • Women-led organization
  • International/global organization

Where will your idea be implemented? (200 character limit)

Through MCMAP, MCs are currently sold in 9 out of 111 Ugandan districts: Moroto, Arua, Gulu, Kabale, Tororo, Wakiso, Masaka, Mbarara and Kampala. We aim to scale up to minimum of 30 districts.

What do you need to get started? (500 character limit)

HR: Full time project manager, project officer and admin assistant, part time finance officer and general program support. Financial: Full/partial funding for the project budget (one of our donors is potentially interested to co-finance). Physical: Laptops, data collection tools and means of transportation to facilitate the geographical scope of the project. Technical: Inputs on supply chain aspects (Reproductive Health Supplies Coalition who funded the pilot project will be consulted).

What is the current scale of your proposed innovation?

  • National - expansive reach within one country

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • I've worked in a sector related to my idea for more than a year.

Organization Location (200 character limit)

WoMena Uganda is based and registered as an NGO in Kampala, Uganda. We are supported by WoMena, which is a registered NGO in Denmark and international volunteers from +30 countries.

What is your organizational status?

  • We are a registered non-profit, charity, NGO, or community-based organization.

What is the maturity of your innovation?

  • Roll-out/Ready to Scale: I have completed a pilot and am ready or in the process of expanding.

Website

WoMena: www.womena.dk HUE Experiential: http://hueexperiential.com/ WHH: https://www.welthungerhilfe.de/en/home-en.html Marie Stopes Uganda: http://mariestopes.or.ug/

Attachments (1)

15 comments

Join the conversation:

Comment
Photo of Laura
Team

Many young people lack adequate sexual health knowledge. Thirty-two per cent of young people responding to the Tellus 4 survey (NFER 2010) either found the information they had received on sex and relationships unhelpful, or had received no such information at all.
Laura, https://www.classyessays.com

Photo of Lunette Projects Lune Group
Team

Dear all WoMena Uganda , we appreciate the approach and find your videos are so inspiring. We hope we can be part of supporting this idea!

Photo of WoMena Uganda
Team

Thank you @Lunette Projects Lune Group! It is so great to see so many menstrual health related projects taking innovative approach to increasing access to menstrual health information and products. You .Hub concept is very exciting as well and in fact exactly the type of network that we would want to work with collaboratively as part of our scale up model in Uganda!

Photo of OpenIDEO
Team

Hi WoMena Uganda and Team,

We’re excited to share feedback and questions with you from a set of experts that are supporting this Challenge.

We encourage you to think about this feedback as you continue to improve your idea, whether that’s refining it or adding more context. You are welcome to respond in the comments section and/or to incorporate feedback into the text of your idea. Your idea and all associated comments will all be reviewed during the final review process, but we recommend putting all critical information in the body of your contribution somewhere. It's also ok if you don't have all the answers, we know teams are at different stages and we are excited to learn how you are thinking about the complex problems teams in this space face.

Experts were excited about:
1) One strength is focusing on a sustainable way to make MC's more accessible.
2) This idea is designed to address a clear public health need with strategies that have been proven to be preferred to other alternatives

Questions experts had:

Product and Service:
1) Esther Ndagire brings up a great point, can you provide more clarity to the exact problems you are solving and how this fits into your broader theory of change?
2) Why hasn't existed up to now? Regulation? Financial? Social/cultural? Access (i.e., geographic constraints, etc? and how can your team uniquely tackle some of these barriers?
3) Would be helpful to better understand your pilot or program to-date, what’s worked well what would you like to improve or iterate on? How do you recruit and support women as entrepreneurs in this process? Is this a livable income or supplemental? What’s in the sales toolkit and training?

Resources and Recommendations Shared:
I would look at social marketing schemes of SRHR that might already exist in Uganda before identifying this as a gap. Check out Healthy Entrepreneurs, PSI and Triggerise. https://www.healthyentrepreneurs.nl/ http://www.psi.org/research/evidence/psi-social-marketing-evidence-base/ https://triggerise.org/

In case you missed it, check out this Storytelling Toolkit (ideo.to/OZznV4) for inspiration on crafting strong and compelling stories. Storytelling is an incredibly useful tool to articulate an idea and make it come to life for those reading it. Don’t forget - the last day to make changes to your contribution on the OpenIDEO platform is December 10 at 5:00PM PST.

Have questions? Email us at youthsrh@ideo.org

We look forward to reading more, and thank you for the important work that you are doing!

Photo of WoMena Uganda
Team

Thank you OpenIdeo Team for your insightful comments and questions. We are also excited about the potential to scale for sustainability.

There are so many projects and solutions to take inspiration from, thank you for pointing us towards a couple. We have actually already looked into the Health Entrepreneurs model, met with the team and hope to continue discussions for potential collaboration. Healthy Entrepreneurs is a perfect example of the type of organization we aim to bring on board, to add menstrual cups to their basket of goods. They have an established distribution structure, robust and trained sales team and innovative knowledge dissemination and motivational structures. As this project is about scaling up and building the right tools to support scale up, we are leaning in and integrating into our current and new partners’ experience in demand creation, knowledge dissemination and supply chains. The aim is to have more and more organizations, both public and private, including cup sales in their existing structures.

In terms of demand creation and social marketing, our aim is to look at the existing frameworks of our partners. Combined with insights from sales agents and menstrual cups users, we will design demand creation activities/materials specific to menstrual cups that can be slotted into our partners’ existing demand creation processes at a local level or national level.

During our pilot project we collaborated with HUE Experiential, a marketing agency specializing in bottom of the line marketing, to create prototypes of marketing materials. We will build on these existing prototypes, but also look at diversifying our approach to meet the needs of all sales agents and contexts.

We are also happy to note that Marie Stopes Uganda, our partner on this project is an existing Triggerise partner. Although we have not included Triggerise in our current project design, this is a great example of the various ways we can utilize the expertise and existing frameworks in place to promote menstrual cup sales.

Photo of WoMena Uganda
Team

2) Why hasn't existed up to now? Regulation? Financial? Social/cultural? Access (i.e., geographic constraints, etc? and how can your team uniquely tackle some of these barriers?

Womena was born out of an identified need to address the lack of menstrual knowledge and adequate menstrual management methods for girls and women in Uganda. The menstrual cup is still a new product on the Ugandan market. Although Womena has worked with partners to distribute over 3000 menstrual cups in Uganda, expanding to a market based solution is new. Until now menstrual cups are not readily available in Uganda, due to; high commercial price, limited suppliers, lack of registration as a medical product at a national level, low public awareness about the product and lacking SRH knowledge dissemination & education.

Lack of awareness and demand: Although awareness is growing, there is little knowledge of the menstrual cup as an accepted choice for menstrual management in Uganda. As we have noted, as the menstrual cup is a vaginally inserted product, there are some perceived social/cultural barriers related to this. The menstrual cup is also often related to family planning methods and the misconceptions and fears around infertility and cervical cancer that accompany family planning methods often also apply to menstrual cups. Through our work with the menstrual cup in Uganda, we have developed and tested a sensitization and training model to tackle these perceived issues and have distributed menstrual cups through partner organizations successfully across the in a variety of context. We also have established partners who have community based sales agents and facilitators, many of whom are menstrual cup users themselves. Based on information received in training, they are able deliver messages about the comfort and safety of menstrual cups in a contextually relevant way. Our growing cohort of menstrual cup users also contribute to debunking myths and misconceptions by sharing their experiences. We will also leverage the local knowledge of existing sales agents, community facilitators and menstrual cup users to create a sales toolkit that helps our sales agents address these issues.

Lack of supply and high sales cost: There is currently one commercial importer of menstrual cups in Uganda however import volumes are low, the supply network has been limited to pharmacies in Kampala and the sales price is often considered too high. The menstrual cup is sold commercially at 18 – 22 USD. Due to low levels of awareness about the menstrual cup, this sales price is not conducive to increased sales, at the moment. We do expect that with the right market segmentation and increased demand for the menstrual cup, these price levels can be achieved on the long run.

We have already established acceptable sales prices through our pilot project. In order to achieve these prices and maintain momentum build by the pilot, we will look at stopgap subsidization until the commercial price of menstrual cups can be achieved through higher import volumes and diversity on brands available on the market.

Currently the import volumes of menstrual cups are low, this raises the unit price of the cup. We aim to address this by building a better understanding of procurement and import options as part of the project to find optimal import conditions. We also know that cheaper cups do exist on the market, this project aims to create demand and thus a more inviting environment for more menstrual cup brands to enter the market. As we are not tied to a single brand or provider, we are ideally positioned to find solutions that work across partners.

Regulation: The menstrual cup is not currently registered as a medical product in Uganda. As such distribution through public channels is not possible. Through our Market Advocacy approach we will continue to engage the Ministries of Health and Education to solidify support as well as continue our current work in achieving product registration. We have already achieved a tax exemption for menstrual cups which is positively contributing to a more favorable regulatory environment.

Photo of WoMena Uganda
Team

3) Would be helpful to better understand your pilot or program to-date, what’s worked well what would you like to improve or iterate on? How do you recruit and support women as entrepreneurs in this process? Is this a livable income or supplemental? What’s in the sales toolkit and training?

With funding from the Reproductive Health Supplies Coalition, the MCMAP project evaluated the efficacy of six MC pricing, distribution & payment models for delivering menstrual cups in urban and rural settings in order to scale up availability of menstrual cups to youth (aged 15-30 years) at point of access in Uganda and to promote a policy environment conducive to effective supply and distribution.

Six models were implemented in partnership with Marie Stopes Uganda (MSU), Welthungerhilfe (WHH) & private pharmacies supplied by Ruby Cup Uganda by integrating menstrual cup sales into our partners existing service delivery channels from November 2016 to October 2017. The project resulted in the distribution of 1605 menstrual cups, training of relevant staff within the partner organisations, provision of ICT and marketing materials, stakeholder engagement, local level demand creation activities, continued monitoring and evaluation of sales and activities was well as a policy assessment. The project aimed to sell 285 menstrual cups across the different models, this has been superseded largely due to the success of two sales models, the WHH “Goat and Cup for work scheme” and MS Ladies Model. Sales in MS Clinics, among savings groups and in pharmacies did not take off, however the project has proven that with the right inputs and acceptable pricing, menstrual cup sales are possible.

79% of all menstrual cup sales reached girls and women between the ages of 15 and 30. 34% menstrual cups were sold to girls and young women aged of 15-24. Very encouragingly across the two successful sales models, a number of cups were sold to mothers and grand-mothers to provide cups to daughters and granddaughters.

A key success factor for the two best performing models has been the presence of trusted and motivated community based sales agents and promoters. As a new product, shared experiences from fellow community members has been crucial to building trust in the product. Through community level sensitization and demand creation, we have also seen a marked change in male attitudes. We will now look to build on these experiences for a sales toolkit that can be used across partners. We will also look at increasing cup sales to adolescents through parents and adult relatives, building on the sales strategies employed by successful MS Ladies.


Recruitment of sales agents:
We work in partnership with organizations that have existing distribution channels, as such the sales agents or entrepreneurs are recruited by partners according to their existing mechanisms. In terms of income to sales agents, this will also depend on how the model is implemented by our partners and the level of subsidization or reductions in cup costs achieved during the project. For example, MS Ladies currently purchase cups from Marie Stopes for 10,000UGX and sell the cups at a price capped at 25,000UGX. MS Ladies who have built demand are now selling most of their cups at 25,000UGX and report being happy with the profits made and are regularly restocking. We aim for the menstrual cups to be a product among other goods and thus the income would be supplemental to other sales.

Sales Toolkit:
As part of the MCMAP project we have prototyped different training approaches and ICT and marketing materials. We aim to combine these into a consolidated sales toolkit to support sales agents across partners to deliver information about menstrual cups, build demand and provide continued support. We expect the toolkit to include a refined training session, a set of user friendly, portable ICT materials to aid in knowledge dissemination and a set of marketing materials that sales agents can use. However as this will be developed using a human-centered design approach and in collaboration with partners to fit into their existing training and support processes, the contents and design of the toolkit will be shaped by feedback from partners, sales agents, MC users and potential customers’ and may end up being radically different to our current expectations.

Photo of Nina Nayana
Team

I love the Menstrual Cup and I think it's a great invention. I sue it myself. What I have heard from my colleagues from Africa is there's a bit hesitance to use the cup as you need to "put it in there" and apparently women do not feel comfortable with it. I also notice that keeping it clean is a must and for the cup, you need special soap or to boil it in water regularly. Could the maintenance of the cup while using it remains hygienic in the context as yours?

Photo of WoMena Uganda
Team

Thank you for your question Nina. This is something that we have considered carefully and continue to monitor and research. As noted in our response to ABMS above, the fact that the menstrual cup is worn in the body and is vaginally inserted is often the first issue that is raised when we introduce menstrual cups to communities. We also recognize that this is a solution that requires a higher upfront investment in terms of time and resources to work through some of these concerns. We ensure that our educational approach addresses understandings of virginity and educates women about their own anatomy.

Across our projects, we have found that it can take girls and women between 2 to 6 months to decide to try the menstrual cups. Sometimes the first time they try is because they do not have any other method available and often it is once they have heard about positive experiences from their peers. Through our pilot work we have been able to build a growing cohort of community level menstrual cup users who can share their own experiences of using a menstrual cup. Many girls and women report initial issues getting used to the cup, but once they get used to it they find it comfortable.

The menstrual cup is however one choice in managing menstruation among others, and we have also found, for example that in refugee settings, that women choose to use different menstrual management methods interchangeably dependent on environmental and social constraints. Hygiene is essential to all menstrual methods, and each has its challenges. Reusable pads for example need to be soaked, washed with soap and preferably hung out to dry in the sunshine to completely dry them and avoid infection. This requires access to both soap and water, as well as a discreet place to dry, and studies indicate these are some of the main barriers faced. Disposable pads are often poor quality and worn too long, leading to irritation and have significant impact on waste management.

As you note, the menstrual cup should be to be boiled once a month and making sure you have clean hands when inserting and removing the cup is very important. Learning from user experiences, we have adapted our safe use and care guidelines to meet contextual challenges, for example one of our early projects showed that school girls were not able to access a pot to boil the menstrual cup in. Instead they poured boiling water over the cup several times, in a container they were able to access. We now also recommend this method if other boiling facilities are not available. Women and girls we have worked with actually report needing less water and soap when using the menstrual cup than when using other methods, this is for both washing the product compared to reusable pads and cloth but also for washing themselves. In Karamoja, North-east Uganda, girls and women using menstrual cups have reported feeling and being perceived as cleaner due to using the menstrual cup. They even developed a marketing slogan for cups in Karamoja emphasizing this (Menstrual Cup: A clean lady every month) which we now use for marketing materials in the region.

An important part of our project is to ensure menstrual cup users have access to support via community based sales agents and facilitators as well as a toll free hotline that provides information in 16 different languages. Through a human-centered approach this project aims to strengthen existing support structures and potentially develop new ones based on feedback for both sales agents, menstrual cup users and community members to ensure cup users get adequate information to be able to use their purchased cups safely.

Photo of ABMS
Team

Thank you for sharing this interesting idea. What are the different barriers for young girls to use the menstrual cup? And how about the pricing?

Photo of WoMena Uganda
Team

Thank you for your question ABMS. WoMena has been working with menstrual cups in Uganda for over four years and in this time we have seen our fair share of perceived barriers. The menstrual cup is often a new, unheard of product and as such raises a number of concerns when first introduced to communities. Girls and adult women alike often share fears about loss of virginity and stretching of the vagina due to the menstrual cup being vaginally inserted. In communities where there are misconceptions and fears about family planning, such as infertility and cervical cancer, we find similar concerns about the menstrual cup. We do not however consider these perceptions as barriers. Our approach centers around community sensitization, training and continued support. As part of our pilot project for menstrual cup market accessibility, we have worked closely with partners to ensure that information about menstrual cups is delivered by trusted community members and peers. We have leveraged the experiences of existing menstrual cup users to provide examples of safe and comfortable use to build trust in the product.

Finding the right price point for sales is crucial. We have been testing different sales prices (ranging between 4 and 22 USD), and will continue doing so throughout this project, based on user feedback. We have received feedback that even at a subsidised price, younger girls cannot afford menstrual cups. Direct sales are however not the only way to reach young girls. Through the MS Ladies model, we have had success in reaching adolescent girls with menstrual cups with targeted sales to parents and older relatives. We have seen grandmothers work to provide a menstrual cups to their granddaughters.

To this end we hope to build on these experiences by employing a human centered approach to better design sales models, including flexible pricing to reach younger girls.

Photo of Esther Ndagire
Team

Hello, congratulations on making it this far! A few points for clarification;

1) Your problem statement seems a bit broad. Do all girls and young women in Uganda lack access to preferred MHM methods? If not, what are some of the statistics backing your problem statement? Is there any other specific information that could prove the problem?

Photo of WoMena Uganda
Team

Esther, thank you for your question. The field of menstrual health, although gathering momentum, is still fairly new and under-researched. In the last five years more evidence has been mounting. Most research concentrates on school girls, so we still lack robust evidence in relation to out-of-school girls and adult women.

Based on the existing evidence, what we do know is that studies show that girls consistently report missing school, or feeling uncomfortable while attending school, fearing to stand up to answer questions, that they will be teased, or have concerns about odour. A study from Uganda showed 90.5% of girls reporting such issues (Hennegan 2016). Another study in rural Uganda showed that girls receiving free pads were 17.1% less likely to dropout of school than those who did not (Montgomery et 2016). A study by the Ministry of Health among adolescents in Uganda also found that transactional sex was common (26.9%) especially among 10-14 year old females. Around 25% of school girls have been absent from school at least 2 times a term due to MHM issues (pain, lack of products, fear that the class would make fun of them). There is less effect for better-off families. (MoE Uganda 2016).

There are more studies from Kenya than from Uganda. One issue which repeatedly comes up is that girls resort to transactional sex to be able to buy pads (e.g. Oruko 2015), and the poorer and younger the girls, the higher the risk, e.g. 10% of the girls aged less than 15 years in one rural area of Kenya (Phillips-Howard 2015). One study indicated that, when MHM products were provided for one year free of charge, those receiving the free products were less likely to develop sexually transmitted infections than those who did not receive free products (7.7% 4.2/4.5%) (Phillips-Howard, 2015).

We know there is an issue, and the evidence to date suggests that providing comprehensive information about menstruation and acceptable, comfortable menstrual health management products can make a difference to girls menstrual experiences. There is less evidence on how to do this sustainably and cost-effectively. Free distribution of products is amazing, but we also know that donations need to be supported by market approuches. Our pilot project (Menstrual Cups Market Accessibility Project) in Uganda has shown that menstrual cups, given the right inputs and pricing, can be sold. This project is about scaling up our pilot sales models and optimizing existing distribution networks and discovering new ways to reach younger menstruators.

Photo of Iliriana Kacaniku
Team

Hey WoMena Uganda 

As the deadline to refinement phase is only 4 days away, we look forward to reading your refined idea afterwards. To this end, we highly encourage you to respond to the experts’ feedback in the comments part and upload the completed business model canvas as a separate document. The template for the canvass is available in the following link: https://d3gxp3iknbs7bs.cloudfront.net/attachments/11ed3970-7b4b-4168-95e4-42f44cf1bf72.pdf?utm_source=UNFPA+Shortlist+Announcement+%28To+Shortlisted+Ideas%29&utm_campaign=35344cc5a0-EMAIL_CAMPAIGN_2017_11_14&utm_medium=email&utm_term=0_19296933e1-35344cc5a0-

Should you have any question regarding the canvass, please feel free to reach out to us and we’ll make sure to respond to you timely.

Best regards,
Iliriana

Photo of Ashley Tillman
Team

Hi Laura, Thanks for your contribution! Important reminder, don't forget to have your Idea finalized, answer all the questions and published by November 5, 2017 at 5pm PST to be considered for the Challenge.

You can publish it by hitting the "Publish" button at the top of your post. You can also update your post by clicking on the "Edit Contribution" on top. We're looking forward to seeing your contribution in this challenge.