By Rediet Seleshi, Marketing Associate Director, PSI Ethiopia
Ethiopia has a rapidly growing population of more than 100 million people, the majority of whom (84%) are agrarian and reside in rural areas. While females account for 51% of total population, there are 24.1 million women and girls of reproductive age (15-49 years) (DHS,2016). Yet the use of sanitary pads, according to Performance Monitoring and Accountability 2020 (PMA 2020), is reported to be 45% on average, 28.3% in rural and 78.9% in urban areas. It also states that failure to address the menstrual hygiene needs of women and girls can have far-reaching consequences for basic hygiene, sanitation and reproductive health. Menstrual Hygiene Management (MHM) refers to the practice of using clean materials to absorb menstrual blood that can be changed privately, safely, hygienically and as often as needed for the duration of the menstrual cycle.
Commercial MHM products are available in the Ethiopian market, but knowledge of and access to these products in periurban and rural areas is severely limited. This is mainly due to the cost of transportation for manufacturers and importers to make last-mile distribution in a low demand environment that requires investment in marketing. A few commercial brands are advertised on television, but these commercials are not tailored to resonate with girls living in rural areas. From PSI Ethiopia’s recent research on MHM, we understood that girls have a strong desire for more information on various topics including the biology of MHM, MHM product options, and pain management. PSI Ethiopia has identified that both demand-side and supply-side interventions are needed to improve access and knowledge about MHM across the country to spur the development of the market.
Market-Based Research and its importance in designing solutions
PSI Ethiopia’s research – carried out at the end of 2017 and the beginning of 2018 – identified more than fifteen commercial MHM brands available for purchase in the Ethiopian market. These products include mainly disposable sanitary pads. Reusable sanitary pads are generally sold by commercial companies directly to NGOs and UN organizations for free distribution to selected schools, refugee camps and other program areas. During this research, we identified six local disposable pad manufacturers producing eight different brands and nine imported brands. There are two reusable pad manufacturers and small women’s groups created by NGOs and UNICEF that produce such pads. Approximately 90% of product launches and significant distribution started within the last nine years, out of which 30% started operating in the last four years. The majority of disposable pads are sold in packs of ten while some of the imported brands are available in packs of four, seven, and eight.
PSI projects that the Ethiopian menstrual hygiene management market has a potential for growth to seven to eight billion pads, or US$600 million in revenues, if per capita consumption matches US, European and Chinese levels of consumption as incomes increase in Ethiopia’s rapidly growing economy. When the use of sanitary pads is compared with countries like Kenya, it shows that Kenya’s current use of sanitary pads (both reusable and disposable) is 87% percent compared to 45% in Ethiopian (PMA 2020). The current market (when the research was conducted) of approximately US $21.7 million in revenues (230 million units in 2016) is growing at 15% CAGR (Compound Annual Growth Rate).
PSI Ethiopia has played a significant role in sharing the learnings from the research completed in early 2018. These findings have been shared in different meetings like the celebration of Menstrual Hygiene Day, dinners organized for key ministries and different meetings. Participants include key stakeholders from the MoH; local and international NGOs; private sector players such as manufacturers, importers, and distributors; and Standard Agency. This helped in influencing advocacy around Menstrual Health and mainly sharing the consumer and market side information to a wider audience. This is the main reason why PSI’s consumer-focused market research helps establish a deeper understanding of the consumer and the market.
As part of PSI’s global strategy, PSI Ethiopia is working to “Reimagine Healthcare”, put the consumer at the center, and whenever possible, bring quality care to the front door. We achieve health impact in Ethiopia by working with both government and private partners while harvesting technology and innovation to bring quality care closer to communities, schools and homes. We empower consumers by including them in the design of healthcare interventions and solutions, offering them more choices and helping them have a voice in influencing national priorities. We work with all market actors in the health system to understand market failures, their needs, designing and delivering solutions so that market systems can sustainably serve consumers for the long term, helping to support the Government of Ethiopia in achieving Universal Health Coverage.
PSI Ethiopia understands that all target audiences exist within a complex ecosystem comprised of individuals and market players at the interpersonal, community and societal levels that all regularly interact. PSI brings a multi-disciplinary approach to understanding these challenges and to develop sustainable and scalable solutions that are contextualized to each target audience’s unique needs. PSI Ethiopia has systematically built its capacity to identify, understand and diagnose market failures and design interventions that achieve sustainable impact at scale and sustain our health impact beyond the life of donor-funded programs.