Reusable Sanitary Pads – A Pilot Trial That Lets Girls Tell Us What They Think

Many girls, in countries considered both developed and developing, cannot afford to buy sanitary pads. Consequently, when they hit puberty, periods often prevent adolescent girls from attending school.

In a bid to encourage girls to go to school and stay there during their menses, an organization known as Days for Girls International introduced the reusable sanitary kit that makes it possible for a girl to purchase a one-time kit that is supposed to last about three years, or 36 menstrual cycles, thereby reducing the cost of supplies.

Patti Law, a Presbyterian Minister from Stratford, Connecticut, arranged through the Days for Girls Accra office to donate thirty-six kits to the Women’s Health to Wealth, allowing us to undertake a study on the purchase and use of resusable pads with members of the Women’s Health to Wealth Girls’ Clubs.

The study included teenage girls in three districts in the Ashanti region where we operate the WomenStrong International Girls’ Clubs. It focused on menstruation and menstrual hygiene, allowing us to better understand and document the issues related to the purchase and use of sanitary material by teenagers in the peri-urban districts.

After discussions with 11 focus group that included 99 girls ages 12 – 18, 25 girls volunteered to use the kits for a year, during which time we would collect feedback quarterly on the use of the kits. The feedback was to be used to determine whether to promote and more broadly supply kits to girls in school who have difficulty purchasing regular sanitary pads.

Findings

The kits were distributed between late August and early September 2015. Of the 25 volunteers, 22 who received the kits provided feedback for all four quarters of 2016. In February 2017, the feedback was collated and analyzed. Here is what we found:

Three out of the 25 girls who passed out of Junior High School and into Senior High School and entered boarding schools in September 2015 had stopped using the kit within four months, by December 2015. They did not provide feedback.

As for the rest, the initial euphoria of owning a kit in a beautiful, colorful bag wore off by the end of fourth month of owning the kit, leaving the girl to face a variety of practical and social challenges.

For the remaining 22 girls in the pilot, water posed the most important challenge to using the washable pads. High schools in Ghana, as in other parts of Africa, are boarding schools, overcrowded and often lacking adequate water for bathing and washing. So, girls had trouble having enough water to wash the pads.

In addition, school bathrooms are usually long rooms with many showers but only a single entrance door. Shower cubicles are open to the room, so girls have no privacy when bathing, and washing activities that are private in other circumstances are open to full view in schools. Drying lines also are in the open where others can see the washed pads drying for follow-up use.

The pads themselves are multi-color, rather than the white of a disposable pad, and so when girls were seen using them they were sometimes subject to teasing by their peers for using a product outside the norm.

During the day, until they could find a way to wash their pads, girls were forced to keep soiled pads in Ziploc plastic bags. This compromised the life span of the Ziploc bag, and WHW had to replace the bags at the end of each quarter.

There were also some quality issues with the pads themselves. By the third wash, the flannel pad started fading and by the end of six or eight months, lost its attractive appearance, although it continued to serve its purpose. For a teenage girl the appearance of the flannel proved important.

By the end of the year, December 2016, only seven out of the original 25 girls, or slightly less than one-third, were consistently using the kit at all times for all their monthly periods, day and night.
– Eleven additional girls were using the reusable pad in the evenings at home and on weekends when there was no school, but used disposable pads or toilet tissue during the day at school. They reported that normal pads and toilet paper were easier to dispose of in the pit latrines at school if they needed to change them.
– Three girls used the pads rarely, and usually only when they ran out of the disposable ones.

Of the girls who used the pads most often, several expressed doubt over whether the flannel could actually last 36 cycles, considering the condition of the product after 15 cycles of use. However, the shield which provides a protective layer between the flannel pad and the panty appeared quite robust and was likely to last another 12 cycles.

Recommendations

The twenty-two girls who used the product made the following recommendations:
1. The idea of a reusable pad is good but disposable pads make more sense in circumstances where water is scarce and there is a lack of school bathrooms and privacy. All of these are critical issues in the success of reusable pads.
2. The material (flannel) used in the manufacture of the reusable pad should be replaced with something more durable that can truly withstand frequent washings. Or, the number of flannels in a kit should be doubled from 8 to 16.
3. The number of Ziploc bags for storage of rinsed used pads before they are finally washed should be increased from 1 to 4 per kit.
4. The initial cost of the kit should not be more than GHs 10 or $2.50 U.S., so that “we, the poor girls, can buy and use it.”

Conclusion

The idea of a reusable kit is laudable and has the potential to help in maintaining proper menstrual hygiene among teenagers, especially schoolgirls. However, the initial cost is prohibitively expensive for those who really need it.

Additionally, it is important to consider the environmental variables that are the context for use, including the presence of adequate water, bathroom facilities, and private spaces.

Finally, distribution and promotion of the pads needs to be preceded by effective education on the use and, especially, the benefits of reusable pads. Such education can help increase the likelihood that teenage girls will actively try the pads and continue to use them in the peri-urban and rural areas of Ghana – and beyond.