International Consultant formative Market Study on Reusable Menstrual Health Hygiene Products in Cameroon, WASH, 90 days (Yaoundé including fieldwork)

Each month, over two billion people menstruate globally, yet persistent stigma, taboos and mockery limit the understanding/acceptance, accessibility, and availability of menstrual health hygiene products (MHH) worldwide. In Cameroon, Menstrual Hygiene Management has rarely been integrated into national demographic and health surveys, resulting in a critical lack of data to inform policy and interventions.

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A study by UN Women and the Water Supply and Sanitation Collaborative Council (WSSCC) highlighted that the limited awareness among target populations about menstrual hygiene issues, insufficient access to affordable menstrual products, and the prevalence of cultural practices impede effective menstrual hygiene management.  A recent study conducted in the Southwest region from March to May 2024 highlights several key points. The findings show that 60.95% of participants use disposable menstrual hygiene materials, 19.03% use tampons, 17.54% use cloth pads, and 4.96% use menstrual cups. Notably, only 1.09% of adolescents use reusable menstrual hygiene materials. Additionally, 41.2% of the population in the study considers the available menstrual products to be affordable.
The two studies underscore the critical need for targeted interventions to improve menstrual health awareness, product accessibility and affordability, mainly for reusable menstrual hygiene materials in Cameroon. In response, the Ministry of Women's Empowerment, and the Family (MINPROFF) and UNICEF aim to mobilize stakeholders across the private sector, civil society, and development agencies to scale up access to washable, reusable eco-friendly menstrual hygiene products for one million adolescent girls by 2025. This study will be instrumental in identifying and overcoming the key supply and demand barriers to achieving this goal.
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1. Background and Rationale

Each month, over two billion people menstruate globally, yet persistent stigma, taboos and mockery limit the understanding/acceptance, accessibility, and availability of menstrual health hygiene products (MHH) worldwide. In Cameroon, Menstrual Hygiene Management has rarely been integrated into national demographic and health surveys, resulting in a critical lack of data to inform policy and interventions.

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A study by UN Women and the Water Supply and Sanitation Collaborative Council (WSSCC) highlighted that the limited awareness among target populations about menstrual hygiene issues, insufficient access to affordable menstrual products, and the prevalence of cultural practices impede effective menstrual hygiene management.  A recent study conducted in the Southwest region from March to May 2024 highlights several key points. The findings show that 60.95% of participants use disposable menstrual hygiene materials, 19.03% use tampons, 17.54% use cloth pads, and 4.96% use menstrual cups. Notably, only 1.09% of adolescents use reusable menstrual hygiene materials. Additionally, 41.2% of the population in the study considers the available menstrual products to be affordable.
The two studies underscore the critical need for targeted interventions to improve menstrual health awareness, product accessibility and affordability, mainly for reusable menstrual hygiene materials in Cameroon. In response, the Ministry of Women's Empowerment, and the Family (MINPROFF) and UNICEF aim to mobilize stakeholders across the private sector, civil society, and development agencies to scale up access to washable, reusable eco-friendly menstrual hygiene products for one million adolescent girls by 2025. This study will be instrumental in identifying and overcoming the key supply and demand barriers to achieving this goal.

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The study will be conducted in six specific areas characterized by high levels of vulnerability:
Far North Region: Known for its arid climate and high poverty rates, the Far North faces unique challenges in menstrual health management due to limited access to water, sanitation, and hygiene (WASH) facilities, impacting adolescent girls' ability to manage menstruation effectively.
Northwest and Southwest Regions: These regions are affected by socio-political instability and displacement, making it difficult for residents to access essential services, including menstrual hygiene products.

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East Region: Adolescents in the region often face barriers related to WASH infrastructure, limited health and hygiene resources.
Urban Areas (Douala and Yaoundé): Rapid urbanization, overcrowding, and economic inequality create complex challenges for menstrual health management. Vulnerable populations in these cities often struggle with limited access to affordable hygiene products and face infrastructural constraints that can hinder access to adequate sanitation facilities.

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Purpose and Objectives of the Study

The main purpose of this formative study is to provide a comprehensive understanding of the reusable eco-friendly menstrual health hygiene products market in Cameroon. By examining both the supply and demand constraints, the study aims to identify evidence-based strategies to stimulate demand, reduce production costs, and improve sustainable access to reusable eco-friendly menstrual hygiene materials, particularly for vulnerable adolescent girls.

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2. Specific Objectives:
Conduct a comprehensive inventory of reusable menstrual hygiene materials in Cameroon, assessing pricing, distribution channels, and regional availability.
Identify and analyze cultural, social, and financial barriers limiting the adoption of reusable menstrual hygiene materials among adolescents and their caregivers.
Assess supply-side constraints such as cost drivers affecting small and medium enterprises (SMEs) producing reusable menstrual hygiene materials and identify feasible approaches to reduce production costs.
Compare the market dynamics of disposable and reusable menstrual hygiene materials to support advocacy for reusable products.
Develop a sustainable marketing strategy and business model to increase access to affordable reusable menstrual hygiene materials for one million adolescent girls by 2025.

3.  Methodology:
The study will employ a mixed-methods approach, integrating both qualitative and quantitative research methodologies to deliver a comprehensive analysis of the reusable menstrual health hygiene (MHH) product market in Cameroon. This approach will provide insight into both supply and demand dimensions, offering valuable data to guide improvements in accessibility and affordability for reusable menstrual hygiene materials.
In terms of sampling, the study will ensure effective participation of adolescent girls and their caregivers, vulnerable groups, households in economically disadvantaged areas, hard-to-reach populations, small medium enterprise producers and partners. The methodology will be participatory and inclusive, prioritizing meaningful engagement with key stakeholders who are impacted by issues of menstrual health access and affordability.
The sampling will include targeting adolescent girls, caregivers, and other stakeholders in the five localities of Cameroon, particularly in areas with limited access to reusable sanitary products. The study will capture a representative sample across different socio-economic backgrounds, geographical regions, and will provide an accurate assessment of the menstrual health product market landscape, including access barriers and socio-economic factors.

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Research questions:
Market Inventory and Accessibility

What reusable menstrual hygiene materials are currently available in different regions of Cameroon?
How are reusable menstrual hygiene materials priced across regions, and what are the main distribution channels?
Which areas in Cameroon have limited or no access to reusable menstrual hygiene materials, and what factors contribute to this lack of accessibility?

Demand-Side Barriers and Adoption

What cultural, social, and financial factors limit the adoption of reusable menstrual hygiene materials among adolescents and their caregivers?
How do perceptions, preferences, and challenges of adolescents influence their willingness to use reusable menstrual hygiene materials?
To what extent do household financial constraints impact purchasing power and willingness to pay for reusable menstrual hygiene materials?

Supply-Side Constraints for Small Medium Enterprises (SMEs)

What are the main cost drivers impacting the production of reusable menstrual hygiene materials for SMEs in Cameroon?
What feasible approaches could reduce production costs for SMEs, and how might these impact the pricing and affordability of reusable menstrual hygiene materials?
What financing options and gaps exist for SMEs, and how do these affect their ability to scale up production?

Comparative Market Dynamics and Consumer Preferences

How do consumer preferences and perceptions of reusable menstrual hygiene materials compare to disposable options?
What are the key strengths, weaknesses, opportunities, and threats for both reusable and disposable menstrual hygiene materials in the Cameroonian market?
What data can support advocacy for reusable menstrual hygiene materials based on their sustainability, cost-effectiveness, and other benefits?

Sustainable Marketing Strategy and Business Model Development

What are the critical components of a marketing strategy to increase accessibility and acceptance of reusable menstrual hygiene materials among adolescent girls?
How can partnerships with stakeholders contribute to developing a sustainable business model for expanding reusable sanitary pad access?