In Kenya, one million girls miss school every year because they lack access to sanitary pads and reproductive health education. This lack of access leads to unnecessary shame, preventable illnesses, and unplanned pregnancies that keep women and girls home from school and work, and consequently from achieving their full potential in life. ZanaAfrica Group is a Nairobi based hybrid social enterprise working to solve this challenge by manufacturing, selling, and donating sanitary pads and underwear, while offering easy access to critical health information.
ZanaAfrica Group Founder and CEO Megan White Mukuria first presented her solution to the SOCAP audience last year as a SOCAP15 Scholarship Entrepreneur. In March of 2016, ZanaAfrica Group was awarded a $2.6M Grand Challenges Grant from the Bill & Melinda Gates Foundation. This four-year grant, given under the Putting Women and Girls at the Center of Development (WGCD) initiative, will fund a groundbreaking new impact study. I recently spoke with Megan about the award and other exciting developments in her enterprise and her field of impact.
You had been living and working in Kenya for several years before you founded ZanaAfrica. What opened your eyes to this challenge?
Megan White Mukuria: Back in 2002, when I was working with street children, I put together a cost-per-child budget, and then I further segmented it out by gender. I found that sanitary pads were girls’ second biggest cost, after bread, which was just stunning. I came to understand this expense competes with food. Women and girls often have to choose between buying pads and having dinner. Families are already reducing from three meals to two or two meals to one. Poverty means that you are hungry. When I asked girls what they did when they didn’t have pads, they said time and again “I stay home from school.” I found this unacceptable.
“I found that sanitary pads were girls’ second biggest cost, after bread, which was just stunning. I came to understand this expense competes with food.”
I was like a mom to those 200 girls, and they would talk to me. I couldn’t allow these girls who are like my daughters to go through this. So it was really responsive compassion and love. I had already started a village bakery and several other businesses, and it just made sense to try to start selling sanitary pads. That turned out to be a much bigger undertaking, but one that had the potential to help eradicate poverty.
Meanwhile, I also witnessed how so many organizations had such limited ability to talk to girls about reproductive health because they were limited by their own religious values or lack of comfort around the topic. And so girls were getting unintentionally pregnant and were unable to negotiate sex on their own terms. I thought that was appalling. I wanted to see how I could solve this problem not just for my 200 girls, but for how many? Could I create a sustainable model to serve two million? 20 million? How many commas can we add in there? And when I realized that nobody was going to do anything to sustainably solve these dual challenges of pads and related health education, I decided to step up. So that’s what I’ve done and am still doing.
“… when I realized that nobody was going to do anything to sustainably solve these dual challenges of pads and related health education, I decided to step up.”
Can you describe the WGCD Grand Challenge initiative and the ways that ZanaAfrica’s work fits that program?
Melinda Gates launched the Putting Women and Girls at the Center of Development initiative at the Grand Challenges conference in 2014. Melinda Gates has really been looking at how putting women and girls’ voices and needs at the center of development initiatives can lead to stronger long term outcomes.
The Gates Foundation has taken increasing interest in menstrual health. This is our third Grand Challenges award. We’re one of the longer-term grantees in the Grand Challenges community on the African continent, having been a part of the program since 2011. At the Grand Challenges Africa launch, the Gates Foundation spoke of our work as an example of a project that started out with one type of innovation, the material science innovation of sanitary pads, and through that journey transitioned to a new type of innovation, namely leveraging sanitary pad brands to deliver reproductive health education through engaging, girl-centered comics and a magazine that is anchored in the UNESCO sexuality education curriculum.They also highlighted it as an example of an innovation that was at the fringe and has moved towards the center of their work.
The Gates Foundation and WGCD grantees are together thinking deeply about how to measure “empowerment.” We 19 grantees are really at the epicenter of a movement that is thinking through questions of what empowerment means and how to measure it, including the role of qualitative metrics to capture empowerment indicators. At a recent Monitoring and Evaluation workshop for the initiative, there were a lot of discussions about the importance of qualitative data when it comes to measuring the success of more nuanced gender-based work. That is huge because important projects are too often shelved because funders say, “it’s not measurable.”
Please describe the impact study the grant will fund.
The study is going to be a six-armed randomized controlled trial conducted by Population Council, an international research organization, that will elucidate the role of sanitary pad provision and different health education delivery methods on girls’ educational attainment and well-being. It is a rather large trial–we will be tracking approximately 7,000 seventh grade girls in 120 schools over two years–so as to provide statistically rigorous longer-term results. One of the key areas we will be assessing is whether and how reproductive health education delivered through our magazine and text message-based (SMS) service compares to reproductive health education delivered by a facilitator (someone standing up in a classroom and talking). The latter is the “go-to” approach for health education in Kenya and most countries, but can at times pose challenges when it comes to maintaining not only the quality of content, but also cost-efficiency at scale. ZanaAfrica’s combined magazine and SMS tool offers girls a referable resource that is rooted in their real questions, as well as UNESCO’s technical guidance on sexuality education.
“ZanaAfrica’s combined magazine and SMS tool offers girls a referable resource that is rooted in their real questions, as well as UNESCO’s technical guidance on sexuality education.”
In the menstrual health space, much attention has been paid to the returns of menstrual health management and reproductive health education on girls’ school attendance. From our work on the ground over the past eight years, we’ve learned that oftentimes, even when girls attend school during their periods, they may become withdrawn in class due to shame or discomfort. Over our two-year evaluation we will be examining other aspects of educational attainment in addition to attendance, such as matriculation into eighth grade, scores on national exams, and advancement to secondary school. We will also evaluate other factors such as self-efficacy and self-confidence. Assessing these broader areas of potential impact will be of vital importance to global education and health research.
“Over our two-year evaluation we will be examining other aspects of educational attainment in addition to attendance, such as matriculation into eighth grade, scores on national exams, and advancement to secondary school. We will also evaluate other factors such as self-efficacy and self-confidence. Assessing these broader areas of potential impact will be of vital importance to global education and health research.”
What do you hope will be the ultimate outcome of this impact data?
I hope that it will help organizations, whether large UN entities, small development organizations, or governments, pay attention to this link between menstrual health management and reproductive health education and be able to normalize that intervention across their girl-focused programs. We believe that girls deserve to manage their bodies with dignity because menstrual health management is a basic human right. We also recognize that data is fundamental to large-scale systems change.
“We believe that girls deserve to manage their bodies with dignity because menstrual health management is a basic human right.”
The onset of puberty and the provision of pads is an amazing opportunity to speak to girls about a range of issue that will affect them and to help them be in the driver’s seat of their own destinies. Hopefully governments and organizations that work with girls around the world will begin providing feminine hygiene products such as pads alongside comprehensive sexuality education rooted in girls’ real questions and experiences. That is not currently happening in many parts of the world, including in the US. And to be honest, I think reproductive health education is the next frontier in women’s rights. We deserve to know what is going on with our bodies and the choices and rights we have.
For instance, in Kenya, right now about 45% of girls’ first sexual encounters are unwanted—they are coerced, forced, or transactional. That is stunning and awful and we can and must change this. Answering girls’ basic questions about health, rights, and sexuality, while providing them with pads and tampons can help reduce this dynamic. While the focus of this WGCD trial is not to get statistically significant data to prove this kind of intervention reduces incidences of such trauma, I believe we are going to contribute to a growing evidence base that eventually will answer such questions.
What call to action would you offer the SOCAP Community?
To any organization that works with girls, I would ask you to consider how you are coming to understand girls’ needs around menstrual and reproductive health. To think about how your organization could leverage that understanding. One of the most powerful ways to engage with girls is to give honest answers to their real questions. The first step is offering a listening ear to whatever they feel the need to say or ask.
I would also add that the field of menstrual health management, tampons and pads, is a $13B global industry with an $85M market in East Africa alone. I think, coming from both a human rights perspective and from a business perspective, we should be asking how can we be innovating products that meet the needs of women and girls who are locked out of the market in a responsible way without being completely extractive.
ZanaAfrica Group is looking at a “buy one–give one” type model locally, where a percentage of the revenue would go back towards giving out free products for girls whose families can’t afford them through our nonprofit arm ZanaAfrica Foundation. This would be the first of its kind that directs sales from within a low-income country to serve needs of girls in that country, which inherently gives greater dignity to consumers, and creates a movement that enhances brand equity. Such a model would require more patient capital. If we are taking out, say, 5% of every product sold to give back to girls that could take slightly longer to repay.
Right now ZanaAfrica Foundation supports 10,000 girls a year throughout Kenya by delivering reproductive health education, sanitary pads, and reusable cotton underwear through a network of 21 community based organizations, while also collecting data on each of those girls every term. While the Foundation receives some institutional support, we also rely on a strong network of grassroots donors to help fund our programs. A donation of $10 can help provide a girl with the tools she needs to stay in school for an entire academic year. I encourage the SOCAP community to support our Foundation’s work or just learn more about how this issue is affecting so many girls in Kenya (and around the world).
For those interested in supporting the work that ZanaAfrica is doing on the manufacturing and product development side, we are going to be opening a new round of investments soon. Menstrual health management–real, comprehensive MHM–is a field that can sometimes fall through the cracks when it comes to investment, because this work cannot be classified only as education, or health, or sanitation, or even gender. I urge impact investors to think about broadening the ways at which they are looking at health and education. Educate Global Fund is a fabulous fund out of London that is expanding the definition of educational investment beyond brick and mortars or teachers to include all the educational inputs that school children need, including menstrual products, sanitation, and more. I think taking a more integrative and ecosystem approach is where this space is heading and where it should be heading.
“Menstrual health management–real, comprehensive MHM–is a field that can sometimes fall through the cracks when it comes to investment, because this work cannot be classified only as education, or health, or sanitation, or even gender. I urge impact investors to think about broadening the ways at which they are looking at health and education.”
We are also currently in the process of looking for a CFO for the business, and welcome inquiries about that.
Can you tell us about other developments that have taken place for your enterprise since SOCAP15?
On the company side, it’s been an epic couple of months for us. We’ve introduced our second-generation product design and rebranded our Nia pad products with a new look, as well as sourced a new producer. Also our sales closed last year at $90K and we are serving about 20,000 customers in the market. We’ve experienced 10X growth in sales from 2014, as we have launched into commercial markets to meet the BOP where they want to shop.
On our Foundation side, we’ve really formalized our Accelerator Program. We have five amazing Community Based Organizations that are getting a much deeper dive in terms of basic leadership skills, fundraising, and organizational capacity building. Because we recognize that change comes from within communities, we want to equip existing organizations that are already on the ground to be agents of change from within their own communities.
Also, on the policy side, our team in the US at ZanaAfrica Foundation has been collaborating with advocates in New York who are working to eliminate the “tampon tax” and provide free pads for girls in public schools. As you may know, across the US and the UK, bills are being put forward with advocates and politicians clamoring to end what’s called the “tampon tax,” which is an antiquated tax code on feminine hygiene products that unfairly penalizes women and girls. In some states in the US, prescription drugs like Viagra are not taxed, but tampons are. There is simply no way to justify that.
“… Kenya was actually the first nation to eliminate a tax on tampons in 2004, ended an import duty on pads in 2011, and through our organization’s advocacy efforts, Kenya became the first nation in the world to provide pads for girls in schools. Now we can help to leverage that expertise to help advocate for girls in New York and other states.”
This has been very exciting–to see the Menstrual Health movement really take off in the United States. What many do not know is that Kenya was actually the first nation to eliminate a tax on tampons in 2004, ended an import duty on pads in 2011, and through our organization’s advocacy efforts, Kenya became the first nation in the world to provide pads for girls in schools. Now we can help to leverage that expertise to help advocate for girls in New York and other states. That is a great example of innovation happening in Africa that we believe America and other countries desperately need. We are committed to helping make that happen, not just in the US, but for girls globally.
What is inspiring you in your work right now? What gives you hope?
I have a strong faith and I think that really helps. I’m also inspired every day by our team. We have such incredible people! On the company side, our brand tagline is Live Your Purpose and I think every one of my team members really is living her or his purpose. They are so smart in their areas of expertise and so passionate about listening to girls and women. With the right people, it is inspiring to see the ideas that I’ve had come to life even better than I originally imagined them. And then the girls themselves inspire me daily. There is nothing more inspiring than seeing girls believe in their inherent value and dignity, and thrive.