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Affordable sanitary pads for all women and Girls

Every month millions of women and girls around the world face the impossible challenge of managing their menstrual blood without clean, convenient, comfortable sanitary products. In Tanzania estimates suggest 85% of girls resort to unhygienic solutions, most commonly strips of cloth, which are difficult to keep clean and more likely to spread, fungi and infection or leak blood onto the user’s clothes. The potential humiliation that results, plus inadequate water and sanitation facilities in schools, results in thousands of school girls missing classes due to menstruation. The trial doesn’t end when a girl leaves school: women are regularly forced to stay at home during their period, their ability to travel and work severely diminished.

Global campaigns to improve menstrual hygiene management (MHM) have gathered pace in recent years but policy changes by national governments have been slow in coming. In 2018 Tanzanian activists and development organisations united to call for the abolition of tax on sanitary pads. Their campaign succeeded: on the 14th June 2018 the Government of Tanzania exempted sanitary pads from VAT in their 2018/19 budget bringing millions of girls and women closer to clean, dignified menstrual management as products become more affordable. 

So what made this campaign so successful so quickly? 

As far back as 2009, work started to address the multiple challenges Tanzanian women and girls face: inadequate sanitation facilities, limited distribution channels for sanitary pads, social taboos which prevent fathers and husbands understanding the need to spend money on menstrual hygiene products. Celebrations for 2016 International Menstrual Hygiene Day helped raise awareness of the issue and encouraged public discussion of a problem that for so long has remained a lonely, private battle. 

In 2017 the Kenyan government introduced free pads for girls in primary school, raising the bar for political intervention. Development bodies and campaign groups in Tanzania were already training MPs on issues surrounding MHM and those parliamentarians, including the Minister of Health, spoke publicly about the need to address the problem. In early 2018 opposition MP Upendo Peneza ran a social media campaign and tabled a private motion in parliament calling for free sanitary pads in schools. It was rejected as unaffordable but there was cross-party support for the wider issue, especially within the Tanzania Women’s Parliamentary Group. Enthusiasm was plentiful but years of work had yielded little concrete change.

Determined to move the campaign forward, the Tanzanian Gender Networking Programme (TGNP) saw an opportunity to launch a fresh campaign to further galvanise support for MHM with parliamentarians and policy makers. .  TGNP in turn called upon experts at Institutions 4 Inclusive Development (I4ID) for technical support on the advocacy strategy. I4ID is a governance programme funded by UKAid and IrishAid.

“Despite TGNP doing a lot of work at a local level, which resulted in budget allocation for MHM in some Local Government Authorities, we needed to influence the debate at a national level,” says Grace Kisetu, TGNP Head of Programme. "That’s why we brought in I4ID. Because of this partnership, MHM is now a national agenda for both government and non state actors, especially private sector.”

I4ID’s strategy was to broaden the scope of the campaign to examine wider policies and market changes that could improve access to menstrual health products for women and girls. As Sachin Gupta, Team Leader at I4ID explains, improvements to the whole market system would be more sustainable and far-reaching:

“After conversations with activists in Kenya we felt a policy change based around free pads at schools would be difficult to implement and monitor, particularly in the context of an education system where many schools struggle to provide even basic things like textbooks and stationary. 

Reducing VAT, however, might drop the price point for everyone. And other market changes could make an even bigger difference to access - smaller pack sizes, increasing distribution networks, encouraging competition among importers and suppliers and marketing activity to change social norms. 

These sorts of changes to the overall market system could have a wider impact for many more people, including out-of-school girls, young women and the rural poor. Plus, such changes are more easily implemented and sustained by market systems on their own.”

I4ID was invited to chair an informal coalition of UN agencies, state and non-state actors all working on different aspects of MHM, from water and sanitation in schools to education and behaviour change. Informal feedback from government showed interest in granting VAT exemption. A more focused, tactical approach was agreed, focusing on this policy goal, and concentrating advocacy activity around one event with parliamentarians in Dodoma on International Menstrual Hygiene Day in May 2018 .

Formal and informal diplomacy and brokering ensued, harnessing the momentum and support that historic training and awareness-raising efforts had created. The I4ID team engaged with parliamentarians, civil servants and development partners and equipped MPs with exact information about the cost and potential impact of the new policy. BBC Media Action, one of I4ID’s main partners, produced two radio programmes focused entirely on MHM. During the broadcast of one programme, Niambie, the Deputy Minister for Health committed to exempting pads from VAT in the Budget Speech, less than a month away. 

By the time International Menstrual Hygiene Day (MHD) arrived support was far-reaching.  A social media campaign had hundreds of thousands of supporters.  More than 45 MPs, plus a handful of Tanzania’s most senior politicians, attended the MHD celebrations in Dodoma. When Upendo Peneza raised the issue in parliament again a few days later, this time requesting the VAT exemption at Prime Minister’s Questions, she was granted a meeting at the Ministry for Finance and Planning, which she attended with NGOs and the Tanzanian Women’s Parliamentary Group. The following week the Minister for Finance announced the removal of VAT on sanitary pads during his 2018/ 19 budget speech. 

The cost of some brands of sanitary pads immediately fell and further price reductions are expected as markets adjust, demand rises and distribution channels improve. I4ID is working with product companies to invest in marketing and distribution, to improve access, affordability and product awareness, and ensure lower prices are implemented by retailers. 

Significant barriers to safe menstrual hygiene management remain, including the need for improved sanitation facilities and education around menstrual health and sanitary products: in a recent small survey of women and girls in urban and rural parts of Tanzania the vast majority of recipients expressed a desire for more information sent directly to their mobile phones. But the success of the VAT campaign has demonstrated MPs’ responsiveness to inclusive campaigning and focused advocacy and campaigners are hopeful that their commitment will yield further concrete policy changes that help women manage their periods safely and with dignity.