Why companies, NGOs struggle to increase the use of menstrual products
Despite the presence of large conglomerates like Square Toiletries and ACI, as well as innovative solutions such as menstrual cups and reusable pads, the use of period products remain worryingly low
During fieldwork in Khulna in 2018, studying salinity intrusion, I met 14-year-old Sumita Rani Saha. She was from the Chila Union of Mongla, Bagerhat.
Sumita had just learned about sanitary pads, courtesy of a non-profit organisation that visited her school and distributed packets of pads. Previously, she had been using discarded clothes during her menstruation.
"The packet contained 10 separate pads. I have only used two so far, saving the rest for important days when I need to go out during my period," Sumita said excitedly.
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Sumita's family, like many in the Chilla Union, are marginalised. Her father is a fisherman like every other breadwinner of that village.
"These pads are [common] products for urban dwellers. Me, my mother, and everyone before used plain clothes. We weren't even allowed to dry them in the open after washing. Always kept the cloth piece under a dress to dry them," explained Baishakhi Saha, Sumita's mother.
"During pre-monsoon, when the salinity level is highest, we take pills to stop our menstruation," she added.
Chilla Union, located by the east bank of the Passur River and the north part of Sundarban, faces rising salinity intrusion in groundwater. Washing period clothes in salty water and improperly drying them in the sun make women susceptible to a range of menstrual problems. This includes but is not limited to damage to reproductive organs, infertility and cervical cancer.
"Even last year, a woman from our community died from some sort of cancer," Baishakhi added. It was later revealed to be cervical cancer.
A 2020 report from Bangabandhu Sheikh Mujib Medical University Hospital reveals that over 50% of women in coastal areas suffer from pre-cervical cancer symptoms. Infections in the uterus and vagina are common among women in the area — and poor menstrual practices (such as using discarded clothes during menstruation) are key in driving this health trend.
The 2014 Bangladesh National Hygiene Baseline Survey showed that sanitary napkins that are available in the market, ranging between Tk60 to Tk200, are only used by 10% of the female population. The number soared to around 29%, according to the National Hygiene Survey 2018 conducted by the Bangladesh Bureau of Statistics.
According to another 2018 study by the World Bank, 77% of Bangladeshi women have no proper access to appropriate menstrual materials. No further data was found after 2018.
On this year's World Menstrual Hygiene Day (28 May), The Business Standard took stock of the country's overall menstrual hygiene.
Why sanitary pads don't reach everyone
Square Toiletries Ltd is one of the leading manufacturers of toiletries and hygiene products in Bangladesh. The company was founded in 1988 and has grown into a large enterprise with a myriad of products under its umbrella.
One of these products is sanitary napkins. Square Toiletries is the first-ever company in Bangladesh that started local manufacturing of Sanitary pads under the brand name "Senora", in 1989.
ACI started its journey in period products in 2008 under the brand name "Savlon Freedom Sanitary Napkin." On the other hand, SMC started manufacturing similar products in 2014 under the brand name "Joya Sanitary Napkin." Big companies, like Bashundhara, also entered the market in recent years.
Despite the presence of numerous brands offering sanitary pads in Bangladesh, their usage remains low in rural areas.
"Beyond the price point, the main reason is taboo and not having proper awareness. In collaboration with the Netherlands, we ran a project named 'Go Bangladesh' where we gave free sanitary pads to rural school girls. Even after having it for free, many refused to use it," said Dr Jesmin Zaman, Head of Marketing, Square Toiletries Limited.
In the budget for FY2019-20, the government exempted a 45% supplementary duty on raw-material imports of sanitary napkins and diapers to protect the local industries.
"After that, we could stabilise the price of sanitary pads and our products have not gone through any price hike," she added.
This initiative led the company to launch a new product line named "Femina" – the most affordable pad in the market. A packet of Femina containing eight pads is priced at Tk45. However, sales in rural areas remain very low.
"One of the major reasons why girls refuse to adopt pads in their lifestyle is the difficulty of buying them. They believe it is quite embarrassing for them to buy it themselves. Also, [the women and girls] are not comfortable with male members of their families buying it as well.
Proper education is a crying need now. Not just for the women, but also for the male members of the families," explained Dr Zaman.
Samia Aboni, a former employee of Unicef, who worked in the WASH sector at the Rohingya refugee camp, made similar observations.
"The stigma they have is beyond imagination. They simply won't use the pads and will be at home and sit in a particular spot during the time of menstruation," she said. Later, Unicef started providing them with sanitary fabrics.
Affordable alternatives
During the implementation of "Bhasha," a project under CIPRB (Centre for Injury Prevention and Research, Bangladesh) where women teach other women how to swim, an interesting finding surfaced. Many trainers felt uncomfortable conducting classes while menstruating.
To address this, CIPRB introduced menstrual cups to the 64 trainers. This resulted in a positive outcome – 93% of them adopted the cups into their routine and encouraged others to do the same. Later, they continued using the cups after the project ended.
Nahid Akther, Communications manager & Researcher, CIPRB firmly believes that menstrual cups could be a long-term and more affordable solution for menstrual health.
"The average cost of menstrual cups in the country ranges between Tk1,000 to Tk4,000. If maintained properly, a cup can be used for eight to 10 years. Despite the initial investment, menstrual cups are a much more economical choice than sanitary pads," she explained.
Through her Facebook page, "Roop Mohol," Nahid sells imported menstrual cups to women in Bangladesh. Currently, she offers Sirona cups from India, priced at Tk1,000 each.
Since Bangladesh has yet to begin manufacturing menstrual cups, Nahid and other vendors are compelled to import them, incurring high duties and taxes. This significantly raises the cost for consumers, making an already challenging situation more difficult for those seeking affordable menstrual health solutions.
A Bangladesh Customs portal reveals that a 127.72% tax is imposed on Sanitary towels (pads) and tampons, napkins and napkin liners for babies and similar products.
"Period products are considered luxury goods, hence the excessive tax. This is the second highest duty import item after luxury cars, as far as I understand," Nahid remarked.
Over the past few years, a few non-profit organisations have been producing washable, reusable sanitary pads that have gained acceptance among women. Shaathi Bangladesh Ltd and Safepad Bangladesh are notable organisations promoting their use.
Shaathi Bangladesh Ltd empowers women in the Korail slum by teaching them how to make reusable sanitary napkins, providing them with a new skill set to achieve financial independence.
"By providing reusable pads to 25,000 women and girls [across the country], we have not only addressed immediate menstrual hygiene needs but also promoted long-term health benefits and environmental sustainability," said Mifrah Zahir, the founder and chairperson of Shaathi Bangladesh Ltd.
A single pad by Shaathi is priced at Tk60. The organisation recommends three pads to tackle a single cycle. With each pad lasting a year, the total annual cost for menstrual health is just Tk180. Shaathi has installed pad banks in 50 schools.
Starting in 2019, Safepad™ is making similar products using anti-microbial technology. Their pad has three layers – a top layer of fuchsia-coloured microfiber fabric, the core has three layers of white microfiber fabric and the bottom is an anti-leak security layer made of polyurethane laminate.
Safepad offers two sizes designed for heavy flow and regular flow. The pads are packed into a bright recycled fuchsia paper pack. The economy pack has two pads [1 heavy flow and 1 normal flow] which cost Tk190, and the regular pack has four pads [1 heavy flow and 3 normal flow], which cost Tk360.
"Given the fact that using fabrics during menstruation is a generational practice, these products are more acceptable to the girls and women in rural areas," Aboni said.
