Girls hold up sanitary pads from AFRIPads. Photo by: AFRIPads / Business Call to Action / CC BY-NC-ND

OGUN, Nigeria — In April, South Africa removed its 15% value-added tax from sanitary products, such as pads and tampons, in a move that was praised by advocates as a win in the fight against “period poverty.”

"Zero-rating these products targets low-income households and restores the dignity of our people," said finance minister Tito Mboweni when the move was announced.

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Period poverty is a problem worldwide. When women and girls cannot afford proper sanitary products or do not have the information and facilities to use them correctly, it can put their health, education, and well-being at risk as they turn to unsafe substitutes such as rags, newspaper, and feathers.

It is estimated that 1 in 10 girls in Africa misses school when they are on their period, and others run the risk of infection from using unhygienic products, or not changing them often enough.

Experts in menstrual hygiene management emphasize that access to products alone is not enough to end period poverty, and that education and infrastructure are just as important.

“Organizations that are distributing free pads will always need more funds and donations to sustain the model ... When such funds stop, the project dies.”

— Ibukun Babarinde, founder, Mentor Missy

But the issue of cost has gained attention in recent years, as campaigners from the United Kingdom to Malaysia have urged their governments to remove the so-called “tampon tax.”

Despite the VAT relief, advocates in South Africa say sanitary products remain expensive, and that more is needed to ensure universal access.

“Removing VAT on menstrual hygiene products is a kind gesture, but it will not make the prices … fall to the level where everyone will be able to afford them without any government or donor support,” explained African Development and Empowerment Foundation team lead, Dr. Victoria Feyikemi.

The debate is following a similar path elsewhere in Africa. Several countries have removed VAT, including Mauritania and Tanzania. Kenya, a global pioneer on the issue, removed the tax in 2004, and budgets about $3 million annually for the distribution of free sanitary pads to girls in low-income communities.

Yet even there, about 65% of women and girls cannot afford pads. So what else can be done?

Free pads

While some girls in Kenya receive free pads from the government — at least in theory — elsewhere on the continent, local NGOs are stepping in to fill the gap.

They include the Mentor Missy Project in Nigeria; Days for Girls in Ghana; and ZanaAfrica in Kenya, supporting the government’s efforts with their own small-scale distribution programs.

Although such initiatives are growing, coverage remains low. The Kenyan government has experienced roadblocks in its distribution scheme, including the diversion of goods, regular stock-outs, and reports of suppliers lowering quality too far because of the price paid.

The need to constantly replenish disposable supplies means that sustainability is a concern.

Ibukun Babarinde, founder of Mentor Missy, argued that in the long-term, sanitary products must become commercially accessible.

“Organizations that are distributing free pads will always need more funds and donations to sustain the model ... When such funds stop, the project dies,” she said.

Reusable options

One solution to sustainability concerns is reusable options, such as washable pads and menstrual cups, which can last for a year or more.

For example, the AFRIpads social enterprise, launched almost a decade ago to produce reusable pads in Uganda, sells to consumers and NGOs across Africa. ActionAid UK runs a scheme training women to make their own cloth pads; and through Grace Pads, charity givers can buy reusable pads and soap for girls in Malawi.

Reusable products are still not widely available. Although they are more cost-effective in the long-run, they involve a higher upfront cost, putting them out of reach for many commercially.

They also need to be washed and dried regularly and properly, which may be problematic for women and girls in some contexts — for example, where access to water is an issue, or where they cannot leave the pads outside in the sun to kill bacteria. For many health experts, disposable pads remain a safer option.

"Even though they are really popular on the global scene and in the hygiene innovation space, the major problem facing the adoption of reusable pads is hygiene,” Feyikemi explained.

“This concern was what led to the introduction of the disposable pads in the first place,” she said, adding that if not taken care of properly, reusable pads are no more hygienic than rags.

Reducing the cost

Amid the challenges facing reusable pads and free distribution schemes, the attention for many campaigners has shifted back to governments to find ways of making basic products more affordable.

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The common emphasis on sanitary pads and materials, and not education regarding menstruation, needs to be rethought, experts say.

Some see VAT relief as primarily benefiting retailers, and other taxes have become a key target. In South Africa and Ghana, for example, sanitary pads face a 20% import tax. Importing materials to produce pads locally also incurs a cost.

J Initiative, an advocacy group in Ghana, is urging the Revenue Authority to review the import tax. “A lasting solution must be [found] by removing or drastically reducing the 20% import tax ... to make that essential product available and affordable for all girls,” the initiative said in a statement.

Babarinde talked about the need to restructure supply chains. “At the moment, we have to go through several middlemen, thus raising the cost unjustly,” she explained.

Those involved in manufacturing pads also recommended redesigning products to remove unnecessary costs. A former production line officer for a major sanitary pad brand in Nigeria estimated that brand designs printed onto pads add about 15% to the cost, even though the pad “will still work well without it.” Branding is used to create a more premium product and push the price point up, he said.

Ultimately, advocates said a combination of localized and targeted methods is likely to be the answer. But many advocates say African governments need to do more with the options available.

“Intentional or unintentional, there is a systemic discrimination against women and girls in Africa. Removing VAT but keeping import duties intact, and not working with the manufacturers to reduce cost ... could be regarded as hypocrisy,” Feyikemi argued.

About the author

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    Paul Adepoju

    Paul Adepoju is a Nigeria-based freelance journalist, academic, and author. He covers health and tech in Africa for leading local and international media outlets including CNN, Quartz, and The Guardian. He's also the founder of healthnews.africa. He is completing a doctorate in cell biology and genetics and holds several reporting awards in health and tech.

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