Menstruating Tanzanians cannot easily get commercial disposable sanitary pads with popular brands such as Always or HC because of these products' price. According to studies by the World Bank and SNV, these pads can cost up to TZS 3,500 while around three-fifths (60%) of parents in Sengerema, Chato, Siha, Babati, Karatu, Njombe, and Mufindi districts would be willing to pay no more than TZS 800 for their daughters who attend schools to access these pads.
The Price Barrier
Thus, the price of sanitary pads is over four times (4x) larger than parents' ability to pay.
Moreover, many women and girls report using commercial disposable sanitary pads and that the lack of access to these pads may limit their ability to attend school, for menstruating school girls.
# Real Stories from the Field
Beneficiary from Tabora, quoted saying, "there is a shortage of water in our village, during menstruation, we don't go to school. The only source we are using, Is the one we are sharing with cattles down the valley. You can Imagine, the level of itching and fungus we are getting."
A Girl from Arusha who is enrolled as beneficiary of our project quoted saying, "Among our pastoralist community in Arusha, girls use cow manure as a sanitary material during their menstrual periods."
Another one from Arusha, quoted "many places in our pastoral societies have scarcity of water, hence Girls are forced to use cow's urine to clean themselves."
Research Evidence
According to a 2021 survey by Tanzania's National Institute for Medical Research (NIMR) and UNICEF, half (52%) of the menstruating students regularly use commercial disposable sanitary pads. Further, about 1 out of 6 (16.8%) of all school girls surveyed missed school during menstruation.
Of these, 42% cite the lack of menstrual materials, such as commercial disposable sanitary pads as a reason for their absence in school during menstruation. Only pain and discomfort are cited as a reason by more girls (74%).
# Study Scope
The survey asked about menstruation, among other things, to 8,012 menstruating adolescent school girls across Tanzania's 16 regions in Arusha, Dar es Salaam, Dodoma, Iringa, Kagera, Kigoma, Kilimanjaro, Mara, Mbeya, Mtwara, Pemba, Ruvuma, Shinyanga, Tabora, Tanga, and Zanzibar.
Policy Advocacy and Government Response
The Tanzanian government must legislate and implement policies that increase girls' and women's access to sanitary pads including, but not limited to, reducing the price of these pads. The government has indeed repeatedly acknowledged the limitations of price on access to these pads.
# Tax Policy Changes
To help reduce the price of these pads, they first removed the value added tax (VAT) on sanitary pad products in 2018 before reinstating it a year later. In scrapping the exemption, the government observed that the price of these products in the year after the VAT exemption did not decrease.
Understanding the Full Cost Structure
Discussions among stakeholders girls, schools, producers, importers, NGOs, international donors, local and national governments highlighted the contribution of other non-VAT costs in determining the final price of commercial disposable sanitary pads sold by retailers.
A 2023 analysis by the Tanzania Menstrual Health and Hygiene Coalition finds that manufacturers have to pay several taxes and fees to the government. Such costs include, but are not limited to:
- Import duty (10%-35%)
- Custom processing fee (0.6%)
- Railway development levy (1.5%)
Recent Policy Victory
Acknowledging this issue of cost, the government has once again removed taxation on sanitary pads. Specifically, on June 13th, 2024 during parliamentary budget sessions, Tanzania's Minister of Finance, Hon. Dr. Mwigulu Nchemba announced removing import duties on input materials that are used to produce sanitary pads.
This announcement comes after lobbying and advocacy by many individuals and institutions including, but not limited to, the Msichana Initiative (MI).
Key Lessons for Future Advocacy
Drawing lessons from both the yet-accomplished fight to equalize the minimum age for marriage among boys and girls in Tanzania and our successful fight to reduce tax costs on commercial disposable sanitary pads, we conclude with three key points for future engagements between government and stakeholders:
# 1. Collective Advocacy Works
First, we would like to commend the efforts of many stakeholders who continue to advocate for girls' and women's welfare. These individuals and institutions, both locally and abroad, are too numerous to name but we nevertheless acknowledge them, wholesale, here. Relatedly, we want to appreciate the government's continued goodwill to ensure that we are implementing policies that will not harm girls and women.
# 2. The Importance of Rigorous Impact Evaluation
Penultimately, we want to emphasize the need for rigorous impact evaluation in adjudicating between policies to implement. Failing to do so may provide incorrect conclusions. For instance, the government assumed that the tax exemption had zero impact on price because they observed the price not falling after the tax exemption was implemented.
This counterfactual thinking what would have happened to the price of sanitary pads in the absence of the tax exemption could easily have been resolved by rigorous impact evaluation that would have provided the evidence necessary to identify whether the tax exemption had indeed helped slow inflationary pressures that would have raised the price even more than observed.
# 3. The Role of Social Norms
Finally, social norms are very important in achieving even greater impact than just what fiscal policy alone can deliver. Social norms, which can be defined as not just what one thinks they should do but what they think others think they should do, are important in understanding how society can move away from child marriages but also reduce the costs related to menstruation.
Indeed, much of the research, including those cited in this article, shows that if there are norms against changing behavior that would allow girls to be supported during menstruation including being given information about their menstrual and reproductive health, it becomes very difficult to achieve maximum impact.
We thus implore all Tanzanians, but especially those who are religious, community, and other social leaders to work toward changing norms toward the direction that ensures improved welfare among girls but also equality among boys and girls.
---
- This article was authored by Ms. Lucy Gidamis, Ms. Furahini Mlekang'ombe, Jacob Maduki and Mr. Francis Shao are Officers at Msichana Initiative (MI). Mr. Constantine Manda is co-Founder and Director of the Impact Evaluation Lab at Tanzania's Economic & Social Research Foundation (ESRF). Mr. Manda is also an Assistant Professor in the Department of Political Science at the University of California, Irvine (UCI). All views expressed in this article do not necessarily represent views by Staff, Board and Trustees of MI, ESRF, and UCI.*
