Project Everest


[PROBLEM] Female Sanitation and Hygiene Malawi, July 2019

Lean phase: Problem Definition 

Aim: The aim of this post is to identify the most prevalent issues that Malawian women experience in relation to menstruation. 

The problem definition  is centered around three major pillars identified over the last month of research.

  1. Women lack access to affordable, hygienic sanitary products

  2. Current methods of MHM are inadequate and don't allow women to menstruate with dignity, hygiene and comfort

  3. Inadequate means to manage menstruation hinders women's social participation


Menstruation is a natural biological process and a key sign of reproductive health, yet women throughout the world are socially, economically and physically hindered due to inadequate means to manage it.  500 million women across the globe are significantly affected due to their inability to access adequate Menstrual Hygiene Management (MHM) facilities and materials. The detrimental impact it is having on female development aligns with many of the UN Sustainable Development Goals (SDG), specifically  1- No poverty, 5 - Gender inequality, 6 - Clean water and sanitation and 12- Responsible consumption and production, highlighting how influential it is and, if addressed, what positive impact it could bring to women and society.  

The continued silence around menstruation combined with limited access to information results in millions of women and girls with minimal knowledge on what they experience and more specifically how to manage it. In addition to persisting taboos, women and girls’ capacity to manage their periods is affected by a number of other factors, including limited access to affordable, hygienic sanitary materials and disposal options. This leaves many to manage their periods in an ineffective, uncomfortable and unhygienic ways. Such problems are further exacerbated by insufficient access to safe and private toilets and lack of clean water and soap for personal hygiene. As a result, menstruating girls and women often feel ashamed and embarrassed by their inadequate MHM, impacting their desire to attend work and school due to the fear of others knowing they are menstruating. Thus, menstruation acts as a barrier to women’s opportunities and aspirations, impacting their economic, social and independent development. In Malawi, the Female Sanitation team looks to remove this barrier in order to enable improved female sanitation practices and opportunities for all. 

Context of Malawi:

Within Malawi, menstruation impacts women's ability to participate freely within the community, hindering societal activity and capacity. The emotional and physical pain caused by current solutions for MHM, predominantly rags, isolates women though requiring regular maintenance, pain and discomfort. Over the month of July, the Female Sanitation Team has surveyed over 200 women on their experiences with menstrual hygiene management (MHM) to learn more about the struggles and pains they experience.

1) Access and Affordability:

Products such as disposable pads and tampons are almost solely available in urban hubs such as Blantyre city, and cost approximately 700 Kwacha per pack. Not only does this make it difficult to access sanitary products, but this price is unaffordable to most women. Of the women who did have access to disposable pads, many still identified cost as a barrier, expressing they could not afford to buy pads every month. Women in rural and isolated communities - making up 80% of the population - experience the barrier of physical as well as financial access. It is common for women to not even be aware of alternative MHM materials to rags as they simply cease to exist in remote regions of the country. 

Vast majority of the female population use rags to manage menstruation in Malawi, with the majority identifying they use this material because it is the only available and affordable option to them. Throughout qualitative research, the overwhelming consensus regarding what would enable girls to attend school through menstruation was access to sanitary materials. Of women who are aware of alternative MHM options such as pads, most expressed that they would prefer to use these if they were able to afford and access them. 

2) Inadequate Current Solution: 

As mentioned, the majority of women and girls in Malawi use rags to manage menstruation.  However 87% identified struggles and dissatisfaction with the material, including smelling, leaking, discomfort and chaffing / rashes. Fear of soiling themselves and bad odour when using rags impacts women’s ability to menstruate with dignity and comfort. School-girls shared that they were laughed at when their material leaked on their uniform, and women expressing embarrassment and shame when their material leaked in public (eg. on the minibus). Furthermore, many women develop chaffing and rashes from the material, particularly those who have to walk long distances to get to work and carry out their day. 

Further struggles identified with rags include their requirement for frequent washing and drying, causing regular disruption to daily activities. This is exacerbated by a lack of adequate washing and toilet facilities in schools and public places, along with scarcity of running water and access to soap. Furthermore, in light of the fact that menstruation is considered a highly sensitive and private topic, women are taught to keep their rags hidden at all times, leading many to dry their rags inside in the dark or even hanging on a rope tied around their waist. This clearly implicates the ability for women to use rags as a hygienic method of menstrual management. 

In truly isolated rural regions, there is a population of women who are unable to access rags as a means of MHM, instead reverting to cotton, mattress stuffing, blankets and natural fibres to absorb their period. Current methods of MHM are insufficient for most women in Malawi, impacting social and economic participation, comfort, hygiene and dignity on a wide scale. 

3) Impact on social participation

Menstruation prevents women in Malawi from participating in society to their full capacity and desire. Washing MHM materials such as rags causes regular disruption to daily activities. This, accompanied by frequent body washing, accounts for a significant amount of women’s day absorbed in MHM. Inability to travel to and from work has been highlighted as a significant block for female activity and participation. With inadequate materials and facilities for MHM in public and work spaces women are led to stay home through menstruation, particularly on days where they experience heavy flow. 

Girls miss on average 2 to 3 days of school per month due to menstruation, significantly impacting their ability to keep up in class and complete their education. This  enormously hinders women’s ability to escape the poverty cycle, have equal opportunity and achieve their aspirations. In speaking of missing school due to menstruation, women and girls of all ages identified emotions of pain, sadness and heartbreak.

External Factors:

Financial Context:

50% of the Malawian population live below the poverty line and 25% live in what is considered extreme poverty. Poverty and extreme poverty increases in rural communities, at 57% of the population, equating to approximately 14.3 million people living on less than $2 a day. This lack of access to finance impedes women’s openness and ability to purchase solutions to menstruation, education and productivity. 

Furthermore, it is a social custom for girls to leave the home of their direct family upon reaching menses, further financially disadvantaging them. This forces girls to approach male heads of house for the financial means for sanitary products and puts them in a highly vulnerable position. Studies have found this is linked to sexual abuse, with 2 out of every 3 pad users receiving them from a male sexual partner. 

Cultural Context:

Menstruation in Malawi holds high cultural significance and is strongly interlinked with women's behaviour and practices within the community. Traditionally when a woman begins menstruation, she undergoes a week-long initiation ceremony to welcome her into womanhood. Menses is symbolic of reaching childbearing age and is considered sacred and private, something that occurs on the ‘inside’ and not to be shared and spoken about with others. Female leaders and elderly women have expressed their concerns around increasingly fewer women undergoing the initiation ceremony, as they feel they are losing the passing down of their culture. The Female Sanitation team must ensure they work alongside female leaders to ensure no cultural damage is caused, and the proposed solution complements women’s beliefs and practices. 

Next Steps:

The Female Sanitation Team will move forward with ideating and currency testing a MVP within the early adopter customer segment. This will act as a means to validate that rural menstruating women in Malawi are willing to invest time, money or effort in a solution that allows them to menstruate with dignity and comfort.


edited on 24th July 2019, 19:07 by Gabriel Raubenheimer

Gabriel Raubenheimer 6 months ago

Status label added: Problem

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raichad0 5 months ago

Washing MHM materials such as rags causes regular disruption to daily activities. This, accompanied by frequent body washing, accounts for a significant amount of women’s day absorbed in MHM. basketball legends online

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