Millions still lack access to safe menstrual products, but community-led manufacturing and sales models offer a sustainable, market-driven solution to a critical human rights issue, according to a comprehensive 2025 design guide released by the UNICEF, WaterAid UK, and Menstrual Health Action for Impact (MHAI)
Nilambar Rath
Menstrual health is not merely a matter of basic hygiene; it is a fundamental health priority and a profound matter of human rights. Achieving optimal menstrual health requires a comprehensive approach that guarantees access to accurate information, supportive health services, adequate water, sanitation and hygiene (WASH) facilities, and critically, a choice of affordable and quality products. Yet, across low- and middle-income countries (LMICs), the structural mechanisms to deliver these essentials frequently fall short.
The scale of the crisis outlined in the latest UNICEF and WaterAid report is staggering. Across LMICs, approximately 1.72 billion girls, women, and others menstruate. Within this demographic, an estimated 613 million individuals face an unmet need for safe and effective menstrual products. Driven by economic necessity and a sheer lack of availability, some are forced to manage their periods using unsafe materials like old rags and tissue paper.
While commercial markets remain the primary channel for menstrual product access globally, they consistently fail to reach certain populations, often those who face severe socio-economic vulnerabilities and marginalization. Conversely, while free distribution programmes remain popular interventions, they are financially unsustainable in the long term to continuously meet the ongoing needs of all menstruators.
Decentralizing the Supply Chain
To address these persistent delivery failures, decentralized models have emerged to fill critical last-mile gaps in menstrual product access. Dr. Pratibha Singh of UNICEF (India) captures the fundamental essence of this pivot, noting that decentralized models emerged from the point of accessibility and affordability—making low-cost and good quality products available to girls as close to their homes as possible.
But what exactly does a decentralized model look like in practice? These models locate salient aspects of the product value chain directly within or near the communities they serve. This approach involves the critical redistribution of resources, implementation capacity, and decision-making power to community-based and community-led groups.
These local setups do not aim to replace established commercial markets; rather, they serve as complementary market-based mechanisms that fill access gaps where fragmented or inefficient supply chains fail.
The design guide identifies three primary archetypes for these models:
- Archetype A: Local manufacturing of single-use pads.
- Archetype B: Local manufacturing of reusable pads and period underwear.
- Archetype C: Community-led sales and distribution of menstrual products.
Driving Socio-Economic Impact and Ownership
The socio-economic implications of a well-executed decentralized model extend far beyond the logistics of product delivery. Decentralized models seek to achieve sustained access to affordable, quality products while simultaneously generating local livelihoods and creating decent jobs, especially for women. By bringing the means of production and distribution into the community ecosystem, these models foster vital community ownership over menstrual health, help dismantle enduring stigmas, and serve as hubs for spreading awareness and health education.
Achieving these broader socio-cultural outcomes necessitates a dedicated focus on grassroots engagement and sustained behavioural intervention. Organizations deeply rooted in the community are vital to this mission. For instance, the IFI Foundation, an Official Partner of the Global MH Day Campaign from India, has been actively advocating outreach on MH Education and Behaviour Change by hosting an annual campaign ‘Let’s Talk Periods’. Working alongside other partners, the foundation promotes sustained access to quality menstrual products and the adoption of sustainable practices. Integrating these robust educational initiatives alongside product access is essential for any comprehensive menstrual health strategy.
Overcoming Roadblocks: Blended Finance and Intermediaries
Despite their highly transformative potential, community-based models face structural and operational constraints. Decentralized initiatives grapple with high operating costs, limited economies of scale, inconsistent product quality, weak regulatory alignment, and stiff competition from low-cost commercial products. Most concerning is their heavy reliance on donor support, which raises serious questions regarding their long-term financial viability.
To ensure these models can survive and scale, the strategic design guide emphasizes that financing must evolve beyond traditional grants. A “blended finance” approach—which combines development grants with commercial capital—is essential. Under this dynamic framework, grants are strategically utilized to support the initial setup and target social outcomes (like advocacy and awareness), while subsidized debt and equity can be leveraged to fund core business operations.
Furthermore, the success of these community enterprises relies heavily on the critical support of “intermediaries”. These intermediary organizations step in to address operational challenges by providing technical support, negotiating pooled procurement, assisting with financing, ensuring rigorous quality assurance, and driving training and advocacy. Ultimately, intermediaries enable these decentralized models to sustain.
When carefully calibrated—ensuring model selection is context-driven, quality-focused, and seamlessly linked to broader menstrual health strategies —decentralized supply chains possess the profound capability to expand choice, advance equity, and empower the last mile. However, strategic design is only the first step; these models must also ensure the rigorous evaluation of priority outcomes to truly measure their impact on the ground. By measuring what works, we can refine these local blueprints and scale a sustainable, market-driven end to period poverty.
Read the full report at: https://knowledge.unicef.org/resource/strengthening-decentralized-menstrual-product-access-models
(About the Author: Nilambar Rath is a senior journalist, communication specialist, and public health advocate based in Bhubaneswar, India. With a deep background in mass media, strategic and development communication, he is the Founder & CEO of OdishaLIVE and aml Communications. He also serves as the Co-founder and Mentor of the IFI Foundation, where he actively drives high-impact campaigns focused on public health awareness, non-communicable diseases, and behaviour change communication etc.)