Access, Availability, & Use Challenges Associated with Menstrual Products
In low-income communities in developing countries, menstrual product access often falls short due the the following factors:
Families living in poverty often do not have the disposable income to buy commercial sanitary products. Even for those that might be able to afford enough disposable pads on a monthly basis, the much higher up-front costs associated with buying a supply of reusable products is often difficult or impossible to pay, even though that investment would result in savings relative to purchasing disposable products in the long run.
Affordability X Low Status of Girls
Even for families that might have money to spare beyond that required to survive, the needs and preferences of girls are often overlooked in favor of goods targeted for use by male and/or older family members. Especially in families where menstruation is not openly discussed, sanitary product needs often never make it on the list of family financial priorities whenever money is limited.
In families where mothers and grandmothers have always used traditional menstrual solutions (old rags, pieces of old mattresses, newspapers, leaves, mud, sand, etc.), new menstruators are sometimes told by their elders that they should be able to make do with free options themselves. In cases when girls have been educated about the range of alternatives and when traditional methods meet sufficient health and safety thresholds, then its use by girl who prefers it can be seen as a positive outcome. But generational conflict on these issues can sometimes push girls towards using homemade products that they would prefer not to use, and that can present challenges to the comfort and empowerment of girls.
Low-quality menstrual products are often sold at a (somewhat) more affordable price point; however, some of the lowest-priced pads in some markets have quality-control issues that can lead to leaks or discomfort that higher-quality products often avoid. That said, quality and cost are not always directly related, and producers in this sector have been able to sell some high-quality products at impressively low price points.
Disposable menstrual products tend to be available in most cities around the world. The primary question in urban areas tends to be whether an individual person can afford to buy a product, and whether reusable products might be available at all. In rural villages, however, commercial sanitary products are often not stocked at all, especially when too few women in a given community can afford to buy them on a regular basis. Even when money might allow a sanitary product purchase by an individual menstruator in a given month, it may not be an option in practice.
Trash disposal challenges
While not always effective and/or safe, one advantage of traditional/free menstrual solutions tends to be that most have minimal negative effects on the environment. When traditional methods use natural materials (i.e., leaves, mud, sand, etc.) or repurposed materials (i.e., old mattresses, old newspapers, old rags), the materials 1) are not adding environmental costs from production; 2) most would have required disposal anyway, so do not add to trash challenges; 3) many may be safely burned. In contrast, most standard commercial disposable pads typically cannot be safely burned, so they either add to community landfill challenges where landfills options exist, or else have to be buried on a family’s land. Reusable pads and menstrual cups help to avoid many of these challenges; however, they tend to require high up-front costs to users, and tend to require a good deal of education and/or advertising in order to appeal to users.
Embarrassment about purchases
In places where shop keepers tend to be male and menstrual taboos tend to be strong, buying commercial menstrual products can feel deeply uncomfortable for many women. Even without cost constraints, some women in those situations may prefer to use homemade products simply to avoid the embarrassment of buying them in shops.
Lack of underwear
Many women in developing countries do not wear underwear, often (although not always) due to cost constraints. Without underwear, standard menstrual pad designs do not typically work, since there is nothing to which to attach the pad. However, some traditional solutions (often belts and pads made of clothes tied together) function without the additional cost of underwear. For menstruators without underwear, moving towards commercial menstrual products requires one of the following to be in place: 1) affordable underwear needs to be made accessible to them, or 2) menstrual products need to be designed to function without underwear (i.e., menstrual cups, reusable pads designed for stand-alone use, period panties, or tampons.) The former is expensive, and the latter is still relatively rare in most places.
Inadequate washing facilities
School and home bathrooms in the developing world often lack basic sanitary features (such as having no sinks, running water, warm water, soap, trash receptacles, inadequate lighting etc.). School bathrooms often lack privacy from other girls (i.e., often no doors on stalls, sinks for washing are out in the open, nowhere to change clothes privately, etc.). Some bathrooms even in public locations lack privacy from passersby (i.e., no walls and/or roof, unsafe location, fear of sexual harassment or attack, dangerous wildlife, etc.) For some reusable menstrual products, limited water and washing or drying options can be a deterrent to their use. But regardless of product, many working on general sanitation issues argue that adequate bathrooms in schools, homes, and public areas are necessary precursors to being able to facilitate healthy and comfortable menstrual hygiene practices.