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Mapping the Menstrual Hygiene Market in Uganda
Market Research Executed by B-Space Ltd, July 2014
Research commissioned by: Uganda
MHM solutions BoP?
Introduction and Background to Assignment
The goal of SNV MHM project is improved school attendance of adolescent girls
SNV Menstrual Hygiene Management project has 5 major components:
1) Governance and evidence-based advocacy for improved menstrual hygiene
management in schools
2) Menstrual material supply chain development and informed choice
3) Behaviour change communication and empowerment
4) Improved hygienic access, collection, disposal and/or reuse
5) Performance monitoring, learning and dissemination.
The MHM project does not promote one particular menstrual hygiene product, but
promotes informed choice with consideration to consumer needs and preferences.
B-Space assignment
SNV asked B-Space
To map the market for MHM in Uganda, in order to understand business models and
market segmentation within the supply chain of menstrual pads;
Advise on the strategic choices SNV could make to maximize its added value for the
MHM market.
MHM solutions BoP?
Approach
Engaging with the market actors in the MHM sector in Uganda, in
order to understand:
a/ If and how they try to reach the reach the BoP; and
b/ How the development actors can facilitate the improvement
of the MHM sector at large
Primary sources interviewed:
Producers of disposable pads (Capstone, Technology4Tomorrow, Triple M
Hygiene Products Ltd)
Producers of re-usables (AFRIpads, Days for Girls Uganda)
Distributors (Kiboko Enterprises, Translink Ltd, visit Kikuubo)
WASH actors: Water for People
Social Marketing (Carbon Impact)
MHM School Initiatives (PEAS, Peace & Hope)
Sector bodies (Netwas)
We contacted 40 retail outlets across Uganda (in urban, semi-urban and
rural areas) and interviewed staff and pupils of a primary school in Mpigi.
Problem Statement
• Scope of Problem
• Culture & Myths around Menstruation
• Market & Product Segmentation
More girls than ever are attending primary school, but girls do not continue on to
secondary school at the same rates as boys do.
Secondary school net enrollment of girls is low at 24%1.
This is partly explained by the cultural and economic decisions triggered by a girl’s
first menstruation.
Retaining girls in school through the secondary level is desirable for many reasons,
but it is now understood to have far-reaching effects on national wellbeing as a
whole. Many of the benefits are related to the first years of sexual maturity—for
instance, fewer early pregnancies, lower HIV transmission, and reduced infant
mortality
According to 2012 census,
The population of women in Uganda is 18,124,684
24.5% of whom are adolescents, between 10-19 years (4,440,547).
84% of whom are rural and assumed to be unable to (sufficiently)
access and/or afford sanitary pads.
That is an estimate of 3.75 million girls living without proper sanitary care.
These numbers will keep increasing, as Uganda has the third highest fertility rate in the
world - averaging six children per HH in 2013.
Problem statement Uganda has a immense and fast growing demand for menstrual
care products
Scope of problem
1/ http://www.unicef.org/infobycountry/uganda_statistics.html
Although affordability is often mentioned as an obstacle to purchase any sanitary solution, it
appears that not so much price, but rather allocation of budget and gender power imbalance
within households play a big role. For illustration: a box of sanitary pads will last for a month
and can be purchased for less than UGX 2,500. Households typically spend many times that
much each week for the male head to have his drink.
Although menstruation is generally felt to be an intimate affair akin to sex, which should not
be discussed publically, it is crucial that girls get education about menstruation and are
provided with the means to deal with it privately already before their first period.
Menstruation is often a sign of womanhood, the end of their childhood, which…
For girls, is felt to set them apart from their peers. To remain accepted by peers, they
hide their menstrual experience and often withdraw from school / public life during that
time of the month;
Within (rural) families it can lead to pulling them out of school to get married;
For male community members sometimes means that a girl who experiences
menstruation, is a “fair game” for unwanted sexual advances.
Girls who do not know about menstruation in advance, inevitably reach out to an adult for
assistance when it happens, which effectively announces their puberty to the community,
which is for reasons mentioned above, not always desirable.
Other myths and cultural beliefs that effects menstruating girls:
A girl is physically and spiritually unclean during her periods (especially among Muslims);
Burning menstrual blood causes infertility, which can be a barrier to use disposable pads;
You can get be-witched if you touch blood, which can be a barrier to use re-usables.
A “one size fits all solution” might be tricky in Uganda, since it is the most ethnically mixed
country on the planet; home to more than 40 different indigenous ethnic groups all of which
have their own cultures and customs 2.
Problem statement Gender roles, education, taboo’s and myths are also important
aspects of MH related problems
Culture & Myths around
Menstruation
2/ http://www.dailymail.co.uk/news/article-2326136/Worlds-apart-Uganda-tops-list-ethnically-diverse-countries-Earth-South-Korea-comes-bottom.html
Long distances to school: an hour’s walk or more is not uncommon—and getting to and
from school often requires crossing difficult terrain. Solution that don’t provide support in
these matters are not a serious option (pads that don’t stay in place and/or have little
absorption capacity).
Challenges of washing and drying: cleaning of reusable pads is often done without soap or
with unclean water. Drying may be done indoors rather than in sunlight or open air, due to
social restrictions and taboos. This can cause bacteria to multiply. Not changing a pad when
it’s over soiled for too long causes rash.
Lack of privacy in sanitary practice at schools: latrines, if present at all, are cramped, too
few, open to view (no doors) and may be either shared with boys. Privacy is even more
important as boys outnumber the girls at secondary education with 2:1.
Disposal methods: communities collect rubbish in a common pile and do not always burn
the refuse. When the community does burn the rubbish, it is done in the open, often
incompletely, leaving wastage for dogs or children to pick out. For this reason, girls will
place used pads directly into the latrine, or bury their pads in the forest. Even in schools that
provide a central incinerator, the girls will put the pads down the latrines rather than be seen
walking to the incinerator with a used one. Moreover, local belief that burning menstrual
blood causes infertility make girls in some regions hesitant to use it.
No knickers many poor girls do not wear underwear.
Keeping clean throughout the day is at times a bigger problem than access to pads 3
Limited availability and choice in rural , hard-to-reach areas.
20-25% of a girls monthly allowance -on average allowance of UGX 10,000 - 12,500- goes
to purchase of sanitary pads 4.
Problem statement There are many challenges which rural school girls face when it
to comes to sanitary pad use
Menstrual solutions and
local context
3/ 5 Results from PEAS FGD among five rural secondary schools concerning pupils from impoverished areas 4/http://sbs-sancare.nsms.ox.ac.uk/wp-content/uploads/2013/11/UgandaPads-Rd4-v6.pdf
30%
3%
1%
0.5%
66%
Disposables: (Always, Secrets, Feathers)
Re-usables: (AFRIpads, DfG)
Biodegradables: (Makapads)
Tampons
Alternatives: own made cloth pads, cotton wool,
face towels
In 2009 about 18% of girls and women used sanitary pads, this number has gone up to
about 30%*
Sales at the big supermarkets chains in Kampala, only comprise about 6% of the total
national sales volume. Much of the market growth exists away from the current mainstream
in lower value BoP markets.
Re-usable pads are an improved, more hygienic version of cloth rags. There are several
RUMPS projects initiated at schools and women groups for “own consumption”. The exact
market seize of commercially produced re-usable pads is not known, but it is growing
strongly as MHM is on the radar of the donor community. AFRIpads is the largest producer.
Their sales for 2015 are forecasted to be more, than the combined sales of 2009 to 2014.
Ugandan’s are brand conscious and brand loyal. Always’ dominant role on the market
doesn’t seem to have anything to do with product design and quality that meet the needs of
the underserved rural population. It is mostly attributed to effective advertising campaigns
that target the youth, so that girls continue using the product into adult life. These holistic
“back to school’’ campaigns include building toilets, installing incinerators, educating
teachers, distributing free sanitary pads and expanding distribution.
1. Reusable pads most common among primary school girls.
2. Disposables mostly consumed by secondary school girls and middle to upper-class
women in urban areas.
3. Biodegradables mostly destined for refugees ( UNHCR)
4. Tampons only consumed in Kampala by western orientated, upper-class women
5. Menstrual cups are not present in Uganda
The sanitary pads market penetration is growing in Uganda, but
consumer uptake is still limited
Problem Statement
Market & Product
segmentation (estimates)
* Indicative figure, we could not get a hold of the most recent URA import statistics, but according to the MD of Capstone, the 30% is an estimated guess derived from comparing total national imports and local production with the women population.
• Manufacturers/ Importers
• Look & Feel of Imported & Local Brands
in Ugandan Market
• Wholesale/ Distribution
• Retail
• Consumer Insights
• Analysis of Pricing & Margins
Market & Distribution
Market & Distribution
Manufacturers/ Importers
Wholesale/
Distribution
Retail
Customers
Imports of sanitary pads are not taxed in Uganda.
The range of sanitary products available in Uganda has increased from 6 in 2010 to
around 30 products currently. Supply of inferior and counterfeits (fakes) increasing.
Main imported Brands & Importers
1. Always, a product from Procter & Gamble distributed by Kiboko Enterprises. Market
leader with 500,000 packs sold on a monthly basis in Kampala alone ( national sales
figures not shared). Targets school girls, positioned as an aspirational brand. Slowly
losing market share due to increased competition.
2. Feathers, a low cost sanitary pad, manufactured by Quanzhou Jiuan Sanitary Products
Co, distributed by Vision Impax.
3. Secrets, designed and distributed by Capstone Investments Ltd, a Ugandan company,
production through contract manufacturing in China. Positioned as a quality, high-end
brand. 200,000 pack sold / month
4. Stayfree pads, Energizer Holdings, distributed by Translink Uganda. Targeting the
Western oriented (ultra-thin), affluent urban consumer. 62,500 packs sold / month
5. Others: Eve Lady, NSB, Fantasy, Angel, Softex, Pink, Acti-eve… imported from China.
Little branding, quality disputable.
Main Local Brands & Manufacturers
1. Princess & True, locally manufactured by Triple M Hygiene Products Ltd.
2. Makapads, manufactured from papyrus reeds by Technology for Tomorrow Ltd, social,
cottage type enterprise targeting the BoP.
3. AFRIpads, producing washable pads made from imported fleece and cotton, social
enterprise, targeting the BoP.
>90% of all brands on market are imported, mostly from China
Market & Distribution
Manufacturers/ Importers
Wholesale/
Distribution
Retail
Customers
Look & feel of imported & local brands in local market
https://www.youtube.com/watch?v=dA_DviyhZwE
Always’ Local Marketing
Market & Distribution
Manufacturers/
Importers
Wholesale/
Distribution
Retail
Customers
Distribution highlights- disposable pads route-to-market:
1. Importing & distribution companies:
Kiboko Enterprises (UMA Show grounds) handles over 90% of the imported sanitary
pads. They are the sole distributer of P&G products.
Translink Uganda (Bugolobi), an FMG distributer of Multinational brands. Distribute
Tampons and Stayfree pads ( 62,500 pack / month)
Vision Impex (Industrial area) distributer of Feathers, a low-cost sanitary pad produced
in China.
Samba Logistics Uganda Ltd, distributing Essence, produced by Multibrands
International from the UK.
2. In-house distribution / direct sales :
Some local manufacturers with limited brand support resources (Capstone, Triple M
Hygiene) choose to bypass the wholesale distributors and supply directly to retail shops
(duka) with their own Vans. They are able to pass on higher margins to retailers.
3. Kibuuko
Kikuubo, which is a major wholesale shopping area in downtown Kampala, is used by
retailers from all parts of Uganda and neighbouring countries as a one-stop shop. This is
a key route for products destined for upcountry retail, and hard to reach areas.
Retailers in rural areas shop either directly in Kikuubo, from wholesalers in the towns or
wait for distribution trucks managed by distributors.
Coverage:
Distribution companies indicated there coverage reaches up to most provincial towns,
but little to no coverage up to rural towns in West Nile, Karamoja and upper north of
Uganda.
Market & Distribution
Manufacturers/
Importers
Wholesale/
Distribution
Retail
Customers
1. Sold to Last Mile Distributers at a cost-recovery price:
Marie Stopes -350 Blue Star Clinics- Living Goods, Brac for onward sales to BoP
consumers.
2. Sold to NGO’s & Emergency Relief at commercial price:
Plan, Care International, UNICEF, PEAS schools, SNV schools, UNCHR etc.
These distribute to schools at subsidized price and donate to refugee camps
PEAS* is running MHM pilot across 10 secondary schools to measure if access to
sanitary materials reduces retention rates. The girls are given AFRIpads and Days for
Girls kits. Attendance is their key performance indicator. The MHM intervention
reaches 3,000 marginalised girls.
3. Established as community run project
Knitting groups for “own consumption”, mostly made at Primary schools and women
coops (SNV, Peace & Hope Training Center). Women and girls are trained how to make
RUMPs, after which they source the material themselves.
RUMP making as a business- through micro franchise model (Days for Girls). The micro-
enterprises created are included in their supply chain. Local sourcing of material.
Coverage:
East and West Uganda are covered best.
Little to no presence in North Uganda (beyond Lira, incl West Nile and Karamoja) and
South western Uganda.
Hard to reach areas, only through one –off donations by Church Missions, (Peace Corps)
Volunteers, Rotary, NGO’s and “buy one give one’’ partnerships.
Re-usable pads route-to-market: no presence in the commercial retail
channels, distribution is marginal and supply erratic
* PEAS stands for Promoting Equality in African Schools, and is a UK-based charity / social enterprise hybrid. PEAS is running 24 secondary schools in Uganda. They built schools in rural, marginalised areas, where at least 250 children are leaving primary schools without being able to continue to secondary, because of high cost and low provision. Sustainability and affordability of schools should be ensured through their SmartAid model; after PEAS has fundraised for the buildings, all the running costs are covered locally through government subsidy, income generating activities (farmer field schools) and modest boarding student fees.
Market & Distribution
Manufacturers/
Importers
Wholesale/
Distribution
Retail
Customers
Last mile availability: distribution of the disposable pads goes out as far as medium-
sized towns where disposables are typically available at Indian run supermarkets, but
they are seldom for sale in duka’s in hard to reach, rural areas (West Nile, Karamoja).
Re-usables are not distributed via the mainstream distribution channels and availability
is limited and or erratic, hence hindering widespread consumer uptake.
Pricing out of control: retailers often ignore the recommended retail price. Local
manufacturers sighted that once you sell to a retailer in Kikuubo, pricing strategy is out
of your hand. P&G has the financial resources to supply its retailers with a lot of
branding material and free samples, so that they more closely adopt their
recommended retailer price.
Many middle-men: current supply models- that integrate several supply chain actors,
make it difficult to realize an affordable BoP price.
Advertising and market awareness are handled by distributors directly, who will either
outsource to marketing agencies or assemble own teams to travel countrywide; giving
out product samples in new markets, branding retail outlets with posters and sub-urban
signs, giving out flyers.
Target highly populated areas and especially secondary and primary schools with free
sanitary pads and feminine health booklets.
Experts in social marketing strategy and campaigns: Buzz (marketing for the youth)
Captiva, PSI, Carbon Impact.
Distribution highlights, key take outs:
Market Distribution
Manufacturers/
Importers
Wholesale/
Distribution
Retail
outlets
Customers
Menstrual care products are available at supermarkets, duka’s, local drug kiosks, Health
clinics, Pharmacies and Schools.
Consumers shop mostly at the duuka.
Re-usables and Makapads are NOT available in any of the commercial retail outlets. Hence,
consumer uptake is hindered by limited availability.
Entry of more players in the market have forced prices down.
A pack of 7-10 sanitary pads is priced between UHX 2,000 -UGX 5,000 with average retail
sales price being UGX 2,500.
Sanitary pad price difference between urban and rural is on average +7% price increase at
the rural retail outlets. Price difference across the different outlets –supermarket – duuka’s
pharmacy - within the urban or rural areas is small.
Pads with product features - wings, thick and/or extra long- are best sellers. Many women
believe they have a heavy flow and this makes them feel more secure and comfortable. Also,
it enables them to change pads less frequently.
Sales go up with 250% at onset of school terms.
Retail audit highlights* - characteristics that reinforce security
(Wings, thick and Xtra long) sell!
Most common brands and mostly sold across all retail outlets:
Brand Manufacturer Urban
UGX/ pack
Rural
UGX/ pack
Rural
Price increase
Urban
UGX/pc
Rural
UGX/ pc
1/ Always P&G 2,683 2,863 +7% 359 385
2/ Feathers Quanzhou Jiuan Sanitary 2,250 2,381 +6% 250 263
3/ Secrets Capstone Ltd 3,040 3,225 +6% 332 353
* Findings from retail audit, comprising 39 outlets in Kampala, semi urban and rural areas across Uganda. Reference is made to the Excellspreadsheet for more details
Market & Distribution
Manufacturers/
Importers
Wholesale/
Distribution
Retail
Customers
Hierarchy in choice for certain menstrual care product – according to the women:
Availability > Price > Absorption capacity / Safety > Convenience
Hierarchy in choice for certain menstrual care product – our findings:
Availability > Aspirational value > Absorption capacity / Safety > Familiarity
Product features valued: Natural, Wings, Extra Long, for Heavy Flow – reinforcing security.
Most of the women/ girls we spoke to not use one product: disposables are a treat and you wear
them ‘’if you want to feel nice’’. Re-usables are a rescue option when you are out of funds, or you
wear them at home.
Women interviewed said that night pads are preferred for heavy periods, but are considered costly.
Interesting to note is that thicker pads are actually cheaper to make, so the higher sales price is just a
marketing strategy of the manufacturers, and not a reflection of more cost incurred*.
No awareness about tampons or menstrual cups in the rural areas. Girls/women were very interested
when they heard cups can last for ten years. Insertion is not a cultural barrier in all regions of Uganda.
Menstrual cup trial across 31 girls in Kitgum indicated that 75% of the girls indicated the user
experience as very good 6
Several complaints were raised about Always pads, most frequently noted the high price, bad smell,
wings not sticking well and ''chemicals'', which irritates their skin. This is particularly the case with the
scented Always pads. We are not informed whether this is due to poor product quality, counterfeits
being on the market or wrong use (not changing pads frequently enough). Nevertheless, Always are
an aspirational brand and first preference of choice for most women. Branding seems to have a very
big impact, mostly its aspirational value and their first mover advantage, quality and pricing appears
to be of less importance.
Emotional motives have more weight in purchase decisions than
rational motives such as pricing and quality, even for the BoP
*Confirmed by MD of Capstone Ltd. 5/ Assessing acceptability and hygienic safety of menstrual cups as a menstrual management method for vulnerable young women in Uganda Red Cross Society’s Life Planning Skills Project – Womena, December 2012
Market & Distribution
The average gross margin for the downstream value chain from distributer to consumer is around
30%
Locally manufactured products are able to and seek to achieve a lower price point to the market.
Imported brands- perceived to have better quality are able to command price premiums on the
market
Always being the first mover and undisputed market leader, has hence determined the price
anchor, and all other suppliers benchmark prices against Always RRP.
Trade actors (wholesalers & retailers) have little respect for the RRP set by the manufacturers, and
will either focus on marketable brands (Always) or benchmark their sales prices close to “Always”
price.
Analysis of Pricing &
Margins
Always is undisputed leader, despite premium price positioning
Table below shows the Recommended Retail Price - set by the manufacturers/distributors (although
retail outlets tends to set own prices as shown in previous slide).
MHM solutions BoP?
• Making your own RUMP
• Pricing of RUMP’s
• Challenges faced by Social Enterprises, way forward
• Promising MHM initiatives targeting the BoP
• Case of AFRIpads
• Case of Days for Girls, Micro franchising programme
• Case of Makapads, locally made bio-degradable pad
• The case of Capstone Ltd, “Cheapy”’
• The case of Triple M Hygiene , a local manufacturer
of sanitary pads
• WASH interventions addressing MHM
MHM Solutions BOP
Sales price of RUMPs
Kit contains 1-2 shields and 7-8 liners
Community made RUMPS:
(example Mpigi Primary, Peace & Hope
Training Centre. Labour time not
capitalized and included)
Cost price of a kit: 15,867 UGX
Micro-enterprise made -Days for Girls
Consumer price BoP +/-10,000 UGX
Professionally made RUMPs – AFRIpads
Consumer price BoP +/- 8,000 UGX
What can we learn from this?
RUMPS made by the communities are much more
expensive, whilst providing less quality and
comfort!
Mental accounting: Mpigi teachers and pupils
believed their RUMPs were cheaper, as the
material could be locally sourced and everybody
contributes to the raw material needed, according
to what you can afford.
Even when we showed them the actual cost price
break down per pad and compared it to
AFRIpads which is cheaper, the understanding
remained that their pads were cheaper.
“cheaper is synonym for availability and flexible
pricing options’’
The fact that the girls (partially) create the
RUMP’s themselves can explain how they
appreciate self-made RUMP’s more than branded
RUMP’s. (IKEA effect, consumers place a
disproportionately high value on product they
partially created – labor leads to love).
MHM Solutions for BoP? Making your own RUMPs are felt to be cheaper than
professionally made, but actually are not
Price of RUMPs
Social enterprises typically include the
BoP in their production process, therefor
they face challenges in reaching efficiency
and economies of scale, needed for low
production costs.
Simultaneously they want to serve the
need of the BoP consumer by offering a
product at the lowest price possible.
So they compromise on their profit
margin to make their product affordable
and available for the BoP consumer, with
no marketing budget to operative with.
MHM Solutions for BoP? Serving the BoP is a High Gross Margin Business
Serving the BoP must be a high gross margin
business if it ever is to be sustainable. It is
challenging to cover high operational costs
with volume only, given the geographic
dispersion of the market and the required
village level marketing efforts.
The good news is that as long as marketeers
provide solutions that indeed appeal to the
consumer and improves their lives,
customers will be willing to pay and able to
afford the price that is needed for the
company that serve them to be sustainable
(the general consensus among several
publications by Hystra, BoPInc, Sida
Innovation Against Povery programme).
Challenges faced by social
enterprises
(Makapads, AFRIpads, Days
for Girls )
Social enterprises sell their product below
cost recovery price in the market
Whilst, high margins should
be applied
Cottage style production. In order to be able to enter the mainstream distribution channels and absorb the additional
margins applied whilst keeping a price in par with other sanitary products available, economies of scale and low
production cost are essential.
Positioning and branding, geared towards NGO’s and not appealing for direct sales. They struggle how to position
themselves in the market as an aspirational brand. The companies mentioned do not have professional marketing teams
and budget’s to work with.
Market cannibalization: the very fact that pads are being distributed at a subsidized price or for free undermines their
own commercial market. Therefore, it is advisable to create a different brand, instead of applying multiple prices (ex
factory, NGO’s, last mile distributers, donations) for one and the same product.
Their absence in the commercial retail outlet is explained by:
MHM Solutions for BoP?
To be discussed on the following slides
Promising MHM initiatives
targeting the BoP
Professionalizing RUMP’s
Makapads
bio-degradable pads made in
Uganda
Commercial companies targeting
the BoP:
Capstone Ltd
Triple M Hygiene
Wash interventions
Promising MHM initiatives
targeting the BoP
MHM Solutions for BoP?
About AFRIpads
AFRIpads incorporates the BoP as producer and consumer. Typically for such business models are
extremely low product margins and reaching volume is key for sustainability.
Their marketing budget is mostly covered through grant money, raised from challenge funds,
partnerships with NGO’s (like PLAN) and Embassies (French Embassy).
Made their market entrance in 2009 and they are now the largest producer. Their sales forecast for
2015 is more than the combined sales of 2009 to 2014.
Entering the mainstream retail channels with an aspirational product
Case of AFRIpads
Challenges current product:
Not an aspirational brand: pads have
rural (poor) image, suitable for primary
school girls with light flow.
Challenge of how to dry the pads
discretely and hygienically
High production costs due to importing
material via middle-men
Limited / erratic availability: AFRIpads is
not available in the mainstream
commercial distribution channels, as that is
being undermined by their NGO sales &
marketing strategy. The very fact that pads
are being distributed at a subsidized price
or for free undermines their own
commercial market.
Continuous improvement
Professionalization of manufacturing
AFRIpads has invested in a 2nd
factory
in Masaka town with semi-automated
production lines for increased efficiency and
output. Direct material import from China in
full container loads reduced production
costs significantly.
Continuous improving product design, to be
more absorbent, comfortable, quick drying.
Availability in the mainstream retail outlets
should improve access to product.
Improved, more hygienic version of cloth
rags.
Availability: all material can be sourced in
the village.
Flexible costs and tailor made solutions:
making pads is a community effort, all
contribute in the buying of raw material.
You contribute less / make less if you’re short
in money
The IKEA effect: to value something that you
made more, than something you buy ready-
made.
Making your own pads is an effective way
of sensitizing school boys and girls, teachers,
parents and breaking the silence
Learning a skill
MHM Solutions for BoP? Sensitization and buy-in effect through personal involvement but more
expensive and lower quality alternative than professional re-usables.
No quality control. Girls and teachers use
whatever is at hand, which sometimes has
little to do anymore with the original
product design (such as soft cotton layer
and impermeable core).
Discomfort: plastic layer makes sound of
diaper, poor absorption, Velcro hurts.
Social stigma against cloth use in
secondary schools: disposable pads are
modern, while cloth pads are associated
with rural poverty. Teenagers everywhere
are sensitive to such judgments
Lack of proper and gender friendly WASH
facilities challenge the use of reusable
pads.
More expensive than professional made
re-usables.
Making your own RUMP
Disadvantages: Advantages:
Tailor made solution make your own knickers
MHM Solutions for BoP?
‘’
Days for Girls (DfG) Uganda is piloting a micro-franchising programme (launched May
2014). They train rural women to become a re-usable menstrual health kit producer. The
women are equipped with (i) a seed package with raw material for 65 kits. (Dying of the
liners and pre-cutting is done in Kampala, as it requires slightly more advanced tools) (ii)
sowing skills manual (iii) reproductive health manual (iv) business skills manual.
The difference with other RUMP (school) projects (SNV, Peace & Hope) is that the micro
enterprises that are created will be included in the supply chain of DfG Uganda, ensuring
control over quality of raw material used whilst being able to negotiate better prices when
buying in bulk.
The micro franchisee can (re)order their stock by phone and pay by mobile money. DfG
does not provide credit or delivers on consignment. Distribution is done via public
transport.
DfG is supposed to make a small profit on the supply to ensure sustainability of the
programme.
Can the production of RUMPs be set up as a business?
Whether RUMPS are accepted by the communities when they need to pay for the kits is too
early to tell. Up to now, DfG is mostly a philanthropic driven project, and the seed packages
have been granted to the community. Therefore, it is advisable to monitor the progress and
results of their program, to analyse whether their approach could be a market based
solution for MHM challenges.
DfG approach towards entering the BoP market is entirely driven by functionality and
keeping cost to a minimum. Little attention is paid to creating a brand. Supporting DfG in
creating a more desirable brand based on rich consumer insights, could be beneficial in
triggering product acceptance and uptake.
Is there business in making RUMP’s as a micro franchisee?
Case of Days for Girls
Micro franchising
programme
MHM Solutions for BoP? A case of great BoP innovation, but weak business practices
Case of Technology for
Tomorrow Ltd
Makapads, a locally made
bio-degradable pad
Creation of employment: Makapads are the only
trademarked, biodegradable sanitary pads made
in Uganda. Invented by Technology for
Tomorrow Ltd (T4T), a company specialised in
developing pro-poor technology and product
design for the BoP in Uganda.
The pads are primarily made from papyrus reeds,
which are biodegradable- hence providing a
solution to the disposable problem.
85% of the material is locally sourced.
Lowest production costs of all disposable pads
available in the Uganda market, which allows for
a low consumer price, if they were to be
available in the retail chains.
They are planning to launch an 3pc pack to the
market, aiming at retail price of 500shs,
providing an affordability solution for emergency
days / special confusions in which a sanitary pad
is most needed.
Positive consumer feedback: 6 month trial
among 402 school girls indicated that 57%liked
Makapads better than other commercial
available alternatives 6.
Up to 95% of produce is sold to one client
only: UNHCR, for onward distributed to
Refugees and Internally Displaced people. This
makes them very dependent and vulnerable
and the business would collapse if UNHR
orders stop.
Despite potential as an innovative BoP
solution, Makapads have no presence in retail
outlets.
Key constraints hampering the entering of
mainstream markets are (i) lack of production
capacity to supply beyond UNHCR orders (ii)
Production inefficiencies-out of reliance on BoP
labour and ‘’cottage -style’’ manufacturing (iii)
T4T is essentially an R&D Company, with
insufficient in-house expertise needed to fuel
widespread Makapad uptake.
significant business development support
will be required in core business areas such as
process optimisation, Marketing & Strategy
and Sales & Distribution to enable T4T’s
innovation to widely tap into the BoP
market
Advantages: Weaknesses & challenges:
6/ Sanitary Pad Acceptability and Sustainability Study in Uganda, October 2013, University of Oxford
RUMPs generally have a bad reputation among secondary school girls
but this changes after trial 7
MHM Solutions for BoP?
Acceptability of Makapads
and re-usables among
secondary school girls
Findings from Oxford Study, N=402,
day & boarding, Rural town, Western
Uganda.
Usage of disposable pads among secondary school girls widespread: close to 93% were
regularly using commercially available disposable pads.
Sanitary pads are considered a basic need: when asked what they would give up last if
faced with a sudden financial emergency, girls said sanitary pads (75.7%).
Awareness about RUMPs is high (75%). Usage is low.
9
89
Preferes
Disposable Pads
Preferes Re-usable
Cloth pads
% o
f respo
ndents
78% Because do not leak
67% No washing needed
51% Easier to dispose
60% Last longer
16% Because don’t leak
Oxford researchers assessed the acceptability of Makapads and reusables among primary and
secondary school girls in in Uganda.At start of trial, girls were given Makapads and Reusable
pads (AFRIpads and community made) to use during 6 month period.
4654
35
Preferes
Disposable
Pads
Continue
Using
Disposables
Switch to
Using Re-
Usables
% o
f respo
ndents
Post Trial (6 months) Pre Trial
6/ Sanitary Pad Acceptability and Sustainability Study in Uganda, October 2013, University of Oxford
RUMP usage positively correlated with lower monthly allowance 7 MHM Solutions for BoP?
Acceptability of Makapads
and re-usables among
secondary school girls
Findings from Oxford Study, N=402,
day & boarding, Rural town, Western
Uganda.
73
53
Girls who received
free AFRIpads
Girls who received
free community
made RUMPS
% o
f respo
ndents
After the 6 month trail, more than half of the secondary school girls continued buying
disposable pads, even though they were given reusable for free.
Post Trial (6 months) Post Trial (6 months)
Consumer acceptability of locally made
disposables:
Girls who were still using cloth pads, had
monthly allowances smaller than girls who
used disposable pads.
Graph indicates that secondary school girls
like to use different products and/or
disposables are preferred.
Girls that continued buying disposables during
six month trial:
57
5
% o
f re
spondents
Makapads better than
commercial available
pads
I like Makapads very
much
This suggests that the MakaPads, if they
could be made available, could substitute
for the pads that are currently for sale in
the area, which is important not only
because they are more environmentally-
friendly, but also cheaper.
6/ Sanitary Pad Acceptability and Sustainability Study in Uganda, October 2013, University of Oxford
Among primary school girls, usage of disposable pads is very low, and
RUMPS are considered an improvement of their customary methods.
MHM Solutions for BoP?
Acceptability of Makapads
and re-usables among
primary school girls
Findings from Oxford Study, N=110, day
& boarding, Rural town, Western
Uganda.
Most menstruating girls who participated in the Oxford MHM test, were using cotton
wool (bought by the mother, or pulled from their matrasses).
All girls at the primary schools reported that the cloth pads they had been given
(AFRIpads and locally made), were more reliable and stable than their customary
methods.
Secondary schools—which are usually boarding facilities in Uganda—increasingly
require parents to provide pads (or the funds to buy pads) for female students.
Consequently, the attitude has arisen that sanitary pads are something for the rare girl
who goes off to continue her education, but are an unnecessary luxury for girls still in
primary school.
Oxford researchers found that at the nearby secondary school, more than half the girls
who came from villages had used disposable pads in primary school. whereas
disposable pads use among primary Ugandan school girls is generally very low. This
dramatic suggestion of a connection between pads use in primary school and
participation in secondary school may be important and merits further study.
MHM Solutions for BoP?
About Capstone Ltd
Capstone is a Ugandan company, producing sanitary pads through contract manufacturing
arrangements in China. Product design, packaging, marketing and distribution is done by Capstone.
The brand Secrets, appreciated in the market by the middle to high end, urban consumer.
Contract manufacturing is preferred over local manufacturing, because of (i) limited incentive
resulting from zero import tariffs on sanitary pads), (ii) the size of the Ugandan market is to small to
make investing in a local manufacturing plant feasible (iii) efficiencies, quality and economies of scale
by Chinese manufacturers. As such, Capstone is able to provide a high quality and relatively affordable
product for the Ugandan market
Nevertheless, Capstone is often out of stock. It is not easy to switch to other supplier/manufacturers of
sanitary pads, as the size of the Ugandan market is not so interesting for large Chinese manufactures.
Initial aggressive market growth which was driven in part through delivering on consignment, but the
company stopped doing this due to significant losses accruing from bad debts.
Targeting the BoP with an affordable, high quality disposable pad
The case of Capstone Ltd
“Cheapy”’- working title
Launching a new product
destined for the BoP
Capstone recognises the BoP is an important and neglected growth area for their business
Reaching the BoP through product redesign: the company is working on the design of a sanitary
pad, that would be priced around UGX 1,000 / for a pack of six.
Project ‘’Cheapy’’is in initial stages and significant R&D costs will be required, particularly in the
development of the unique mould (approx. $20,000) to be used by the contract manufacturer.
Asian consumer’s like thin and small pads, whereas Ugandans prefer thick and extra long.
Companies’ approach towards entering the BoP market is focused on achieving lower product cost
through product design and contract manufacturing, rather than achieving cheaper price points by
reducing quantities/ pack ( common strategy adopted by others).
MHM Solutions for BoP? A local manufacturer, with the capacity to produce for the BoP?
The case of Triple M
Hygiene
A local manufacturer of
Princess & True pads
Creation of employment: Triple M
Hygiene is the only local company
manufacturing disposable sanitary pads in
Uganda. All material is imported though.
The consumer brand is Princess and True
and UNBS certified, allowing distribution
and sales across the EAC market.
Market share is very small, but they do
have presence in the mainstream retail
outlets.
The factory located at Nvumwa near
Mukono, has an installed capacity of up to
400 pieces a minute. However, only a
small percentage of this capacity is being
utilised.
The untapped, local production capacity
could present an opportunity for
collaboration in locally innovating BoP
solutions to better utilise unused capacity.
Triple M has expressed interest for further
discussion.
Whereas the company targets an RRP of
between 1,700 and 2,000, the retail
outlets have benchmarked pricing with
Always, selling at between 2,500 to
3,000 shs / pack
Triple M tries to control pricing by
supplying directly to retail outlets,
bypassing middlemen, and in this way is
able to provide competitive margins.
However, sales volumes are small.
We are not informed as to whether True
and Princess command good consumer
reviews.
The company would require substantial
business development support in the
areas of process optimization, product
design and branding, if order to reach
lower production costs and improve
sales.
Advantages & opportunities Weaknesses & challenges
Gates Foundation – reinventing the toilet campaign. Goal is to bring sustainable and
affordable sanitation services to urban slum neighbourhoods in low-income countries with
a toilet that has to recover all resources, operates grid-free , with usage costs no more than
$0.05 pp / day. One of the award winners is the Blue Diversion Toilet. The toilet
successfully passed field tests in Kampala and is ready for mass production. Their business
model relies on a franchising approach. An established private or public organization will
act as a franchisor, responsible for branding, promotion, assembling, and installation of the
toilet, the collection of the weekly service fees, procurement and installation of the
treatment technology, as well as branding and marketing the end products. Local
entrepreneurs will have the business opportunity to become franchisees and sell the toilet
service agreements to sanitation entrepreneurs, landlords, and tenant households, collect
the urine and faeces
From building more pit latrines ( for free) to provision of sanitation services by local
sanitation entrepreneurs. Water for People and GIZ launched a new waste removal
technology -gulper- to empty pit latrines. Captiva provides BDS and Marketing and
Awareness campaign.
PEAS: is running MHM pilot across 10 secondary schools to measure if access to sanitary
materials reduces retention rates. The MHM intervention reaches 3,000 marginalised girls.
They are given re-usable pads (DfG and AFRIpads). PEAS has developed a mini curriculum
and ToT module compiled from different sources, as they found that MHM reader from
the MoE has many shortcomings. The MHM module will be integrated in their Citizen
Education Curriculum across all schools.
Impact Carbon is doing a mapping the school exercise of all private and government run
schools in Uganda for their clean drinking water project.
MHM Solutions for BoP?
Drivers and innovators in the WASH Space:
WASH interventions
addressing MHM
7/ http://www.gatesfoundation.org/What-We-Do/Global-Development/Reinvent-the-Toilet-Challenge
PSI.org embraces the total market
approach a system in which all sectors -
public, socially marketed, and commercial
- work together to deliver health choices
for all population NGO’s should crowd in
the private sector instead of crowd out.
Those in the poorest communities receive
free products, those with slightly greater
resources benefit from partially subsidized
products, and those with a greater ability
to pay should purchase their products
from the commercial sector.
Current thinking in social marketing:
Community Led Total Sanitation (CLTS) :
merely providing toilets does not
guarantee their use, nor result in improved
sanitation and hygiene. CLTS focuses on
the behavioural change needed to ensure
sustainable improvements –using shame as
driver of behavioural change. Their
website, managed by IDS, aims to be a
global network sharing hub for CLTS
research & interventions.
Plan International: I am a girl campaign
A good example of a successful awareness and
fund raising campaign which appeals to many
of us, as it engaging, refreshing and fun.
Market potential for menstrual care products is promising, as sanitary pad penetration
is increasing – but it is a competitive market. The range of sanitary products available
in Uganda has increased from 6 in 2010 to around 30 products currently. Supply of
inferior and counterfeits has increased,
>90% of the brands available on the market are imported. The size of the Ugandan
market is too small to make investment in an own manufacturing plant feasible.
Competitors compete with one another on price, free samples and branding material
for retailers. Less focus is given to product quality for competitive advantage.
First mover advantage is massive in Uganda, exemplified by the dominance of Always.
Always set the anchor in pricing, against which the retailer and consumers benchmark.
Consumer are loyal and not so inclined to experiment.
Prices of same sanitary products are fairly homogeneous across the various retail
segments. Sanitary pad price difference between urban and rural is on average +7%
price increase at the rural retail outlets.
Much of the market growth exists away from the current mainstream, in lower value
BoP markets for which distribution is key. Distribution models that eliminate the
avoidable middlemen (such as Kikuubo wholesalers) enable lower costs to be achieved,
and higher margins to be passed on to final retailers.
Makapads and AFRIpads are not available in the mainstream commercial distribution
channels, as that is being undermined by their NGO sales & marketing strategy. The
very fact that pads are being distributed at a subsidized price or for free, undermines
their own commercial market.
Insights & lessons learnt First mover advantage is massive in Uganda, but market potential for more
menstrual care products is promising, in particular at the underserved BoP
Market & distribution
The obstacle to purchase any sanitary solution is not price, but the gender power imbalance
within households and limited availability in remote areas.
P&G does not create a separate BoP product, but instead focuses on (latent) demand creation,
wide availability, customer loyalty and creation of an aspirational brand.
On the contrary, the entire branding of Makapads, AFRIpads and Days for Girls, that wish to
provide a solution for BoP girls, is geared towards NGO’s and appeals less for direct sales.
“Made in Uganda”’ has a bad consumer perception. ‘’Proudly Ugandan’’ does not (yet) apply
for sanitary pads.
A sanitary pad/towel that is “Natural, Wings, Extra Long, for heavy flow’’ – is a guaranteed
success!
A women or girl does not use one product: disposables are a treat and you wear them ‘’if you
want to feel nice’’. Re-usables are a rescue option when you are out of funds, or you use them
at home.
The “IKEA’’ effect, flexible costs and the mental accounting principle in the community effort all
bearing the costs, are in favour of RUMPs.
At the secondary school level, disposable pads are favoured and will most likely be chosen by
most girls, even when reusable pads are provided for free.
There is a social stigma against cloth use in the secondary schools: disposable pads are
modern, while cloth pads are associated with rural poverty. Teenagers everywhere are
sensitive to such judgments
Lack of proper and gender friendly WASH facilities as earlier explained, challenge the use
of reusable pads .
Insights & lessons learnt
Consumer Insights
It is important for the international development community to give more
attention to the intimate conditions that give rise to these choices, rather than
relative importance of price or environmental impact when it comes to
sanitary care.
Given the strong preference for disposable pads, it is important to focus on providing less expensive pads with a
better environment profile.
Key take outs:
1) Continue with sensitization & awareness drives
2) Focus on professionally made, wide availability of RUMPs
in parallel with WASH interventions
i. Join Days for Girls in their micro franchise program
ii. Support Afripads to commercialize for the mainstream market
iii. Champion UNBS certification for RUMPS
iv. Support WASH initiatives that embed the adoption of use of
RUMPS
3) Explore support options for commercial entities that are
targeting BoP consumers
i. Supporting the development and design process of -“Cheapy”-
a BoP product by Capstone Ltd
ii. Provide BDS support to T4T to allow BoP product -
MAKAPADS -profitably access mainstream market
iii. Partnering to facilitate Triple M, a UNBS certified local
manufacturer to produce for the BoP
MHM solutions BoP?
Suggested Interventions
All stakeholders interviewed targeting the BoP, welcome awareness rising and evidence
based advocacy campaigns like the Menstrual Hygiene Day, so keep up the good work! It
boosts their sales, get to know other stakeholders and create partnerships opportunities,
Continue & increased liaison with the Ugandan Parliament, including the Speaker RT.
HON. Rebecca Alitwala Kadaga, and Minister of Finance Margret Kiwanuka, among
others, to apply gender-responsive budgeting as part of the educational funding.
Use role models, such as Jennet Museveni but also an influential, popular male figure.
Governments should only donate for temporary period of time (e.g. 1 year); this is an
effective behavioural change tool. Once the girl experiences the convenience of pads/ re-
usables, she or her parent will be willing to spend money on it.
Continuous sensitization and educating of parents, community, head teachers and boys. It
is a cost burden for menstrual care distributers to also take up the role of “ village health
worker’’.
Donating does not go with building the market. NGO’s should be educated in impactful
donations: only donate pads with knickers in the poorest, hard to reach regions where
pads are not commercially available.
Girls’ school uniforms should have pockets.
Establish an online platform / multi stakeholder group for WASH and MMH, with a
contact database, access to documentation and calendar of events and news updates.
Stakeholder interviewed stressed the lack of sharing and centralizing information readily
available about MHM.
Set up Health Clubs as a community service rural primary and secondary schools are often
located in close vicinity. The girls from the PEAS secondary health clubs can sensitize the
upper primary school girls. Educating girls about menstruation and providing the means to
deal with it privately, should happen before their first period
Suggested interventions for SNV The obstacle to purchase any sanitary solution is not price, but the
gender power imbalance within households
Strategic choices for SNV to
make ?
Continue with Sensitization
&
Awareness raising!
Facilitate Days for Girls micro franchisee programme, as it is not easy to set up your own RUMP
making project as a business, given it took DfG a year to launch their micro-franchise program. By
investing in and partnering with DFG, SNV could ensure that
The micro- franchising program becomes more embedded as a market based solution for MHM, by
strengthening distribution and focusing on economies of scale (athe programme has just been launched
and it is only NGO’s that have bought the seed package and provided it to the women as a donation);
The product design which is currently driven by functionality and cost optimisation, further benefits from
brand building considerations, that will increase consumer acceptance and uptake.
That SNV considers Business Development Support services to AFRIpads to reorient their
products for the commercial Ugandan market. Specific support suggested should include:
Marketing and Brand Building advisory services as Afripad products are currently geared towards NGO
customers.
Capacity building on how to tap into the mainstream retail outlets.
That SNV argues for UNBS certification for re-usable sanitary pads:
In Uganda, there is no distinction made in certification between re-suable and disposable pads.
The standard is being developed in Kenya and could be replicated for Uganda.
That SNV supports gender friendly WASH interventions:
Price is not the main roadblock in usage of RUMPs at schools, but inadequate gender friendly sanitary
facilities. One could think of ‘’back to school partnerships’’ in which DfG and AFRIpads make effort to
sell their kits in rural schools, and SNV supports interventions in sensitization, education and WASH
improvements,
Explore mechanisms within the community that can trigger savings for sensible products, like
VSLA’s.SNV could play a brokering role between the VSLA’s and producers of RUMPs.
Suggested interventions for SNV Towards supporting RUMPS initiatives, we would recommend SNV not to
reinvent the wheel but facilitate existing, successful market-based initiatives, like:
Strategic choices for SNV to
make ?
RUMPs
Providing a one off R&D related financial grant to Capstone Ltd
To facilitate the investment in a mould and sanitary pad that is designed for the BoP
priced around UGX 1,000 / for a pack of six.
Whereas other stakeholder trying to target the BoP with a mainstream product
(AFRIpads, Makapads) have no much experience in supplying commercial
distributers and retailers, Capstone does.
Business development Support services for Technology 4 Tomorrow, geared toward
upscaling production and improving availability of Makapads
T4T is an R&D Company, having developed a product with great potential to
service the BoP market. But they are not well equipped with the skills and resources
to bring their business to the next stage (diversify from UNHCR & NGO market to
mainstream market). Tailor made business development support, in the areas of
process optimisation, Marketing & Distribution are essential for T4TS to successfully
enter the commercial retail outlets penetrate the BoP market.
A partnership that leverages Triple M’s manufacturing capacity, and willingness to produce
and innovate for the BoP
How to do so, requires more follow up research.
Suggested interventions for SNV To support local private sector initiatives, SNV could consider…
Strategic choices for SNV to
make ?
Disposable pads
Interviews:
AFRIpads Ltd, Sophia Klumpp- Founding Director, Helen Walker - Communication and Liaison
Officer, Ingrid Beuzekom –COO.
Capstone Ltd, Mr Robert Katuntu - Managing Director
Carbon Impact, Tim Neville – COO
Days for Girls Uganda, Mrs Eliza Chard - Managing Director
Kiboko Enterprises Ltd, Mr Mbalwa Nelson - Manager Demand Planning and Quality Assurance,
Mr Simon Mwangi, Country Representative Proctor and Gamble
Netwas, Ms Helen Obuya and Ms Linda Lillian
PEAS, Lucy Philpott -Education and Gender equality Officer
Technology4Tomorrow, Julie Nakibuule - Operational Manager
Translink Ltd, Mr Raj Thakara - Managing Director
Triple M Hygiene Products Ltd, Mr Jackson Twinamatsiko- Operations Manager
Retailers visited: 39 outlets in Kampala, semi urban and rural areas across Uganda. Reference is made
to the Excell spreadsheet for the details.
Site visit: Peace & Hope Training Centre, Olivia Sserabira- Director. Mpigi Primary School visit
Interviews
& Market visits
Quoted
1/ http://www.unicef.org/infobycountry/uganda_statistics.html
2/ http://www.dailymail.co.uk/news/article-2326136/Worlds-apart-Uganda-tops-list-ethnically-diverse-
countries-Earth-South-Korea-comes-bottom.html
3/ 5 Results from PEAS FGD among five rural secondary schools concerning pupils from impoverished
areas
4/ http://sbs-sancare.nsms.ox.ac.uk/wp-content/uploads/2013/11/UgandaPads-Rd4-v6.pdf
5/ Assessing acceptability and hygienic safety of menstrual cups as a menstrual management method for
vulnerable young women in Uganda Red Cross Society’s Life Planning Skills Project – Womena,
December 2012
6/ Sanitary Pad Acceptability and Sustainability Study in Uganda, October 2013, University of Oxford
7/ http://www.gatesfoundation.org/What-We-Do/Global-Development/Reinvent-the-Toilet-Challenge
Other
Assessing acceptability and hygienic safety of menstrual cups as a menstrual management method for
vulnerable young women in Uganda Red Cross Society’s Life Planning Skills Project – Womena,
December 2012;
Hystra Consulting, Marketing Innovative Devices for the Base of the Pyramid, March 2013
Puberty Education and Menstrual Hygiene Management, UNESCO
unesdoc.unesco.org/images/0022/002267/226792e.pdf
http://www.doublexeconomy.com/publications-projects-2/sanitary-care-and-girls-education/
Study on Menstrual Hygiene Management in Uganda, by SNV and IRC
https://www.google.com/search?q=Study+on+Menstrual+Hygiene+Management+in+Uganda&oq=Stu
dy+on+Menstrual+Hygiene+Management+in+Uganda&aqs=chrome..69i57.710j0j7&sourceid=chrome
&es_sm=93&ie=UTF-8
http://www.communityledtotalsanitation.org/
http://www.bluediversiontoilet.com/
http://sanitation.captivaafrica.com/
http://plan-international.org/girls/
Literature
MHM solutions BoP?
Contact us
Stanley Musiime Associate Consultant – Inclusive Business Advisor
+256 772 449 590
Femke de Kort Associate Consultant – Market & Consumer Intelligence
+256 787 079 794
Laura van Dijk Management Consultant
+256 788 925 799