Mapping the Menstrual Hygiene Market in Uganda - B...

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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.

Contents

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


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


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




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.


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.


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


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


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


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


‘’

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


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


RUMP usage positively correlated with lower monthly allowance 7 MHM Solutions for BoP?



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.


Among primary school girls, usage of disposable pads is very low, and

RUMPS are considered an improvement of their customary methods.




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.


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.


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 & distribution

• Consumer Insights

MHM solutions BoP?

Insights & Lessons learnt

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:


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…


make ?

Disposable pads

MHM solutions BoP?

Sources used

• Interviews

• Market visits

• Literature

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


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

[email protected]

Femke de Kort Associate Consultant – Market & Consumer Intelligence

+256 787 079 794

[email protected]

Laura van Dijk Management Consultant

+256 788 925 799

[email protected]

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