The Tampon Taboo

Sign in Indonesia, Source: Flikr Creative Commons

For girls everywhere menstruation is a rite of passage. Menstruation is a healthy, normal bodily function that affects half of our population -- the overwhelming majority of our women, at some point in time. But for too many girls worldwide this shared experience is a source of shame, restriction and if badly managed -- illness. Menstruation is an age-old phenomenon and across the developed world we’ve built awareness, products and systems to manage menstrual hygiene to enable women to live their lives seamlessly. Even with such support we can still argue that menstruation is something we’d rather not talk about in the developed world  -- but in the developing world, the stigma around menstruation has led to an invisibility around it that can really hold our girls and women back.

According to the Geneva-based Water Supply & Sanitation Collaborative Council (WSSCC), even sectors such as water and sanitation which “routinely deal with unmentionables such as excreta, ignore girl’s and women’s need for safe spaces to manage menstrual hygiene and mechanisms for safe disposal of materials used to absorb menstrual blood.” As we all know, ignoring a problem -- or menstruation -- does not make it go away. NGO Plan International and A C Nielsen conducted a study and estimated that there are 355 million menstruating women in India -- but only 12% of them use sanitary napkins. The study even found that 23% of Indian girls drop out of school after reaching puberty, with irreversible effects on their health, well-being and participation in society. Millions of girls and women instead rely on old rags, dried leaves and grass, ash, sand or newspaper to manage their monthly menstrual flows -- shrouded by shame and disgust on a vital bodily function.

Columbia University,  Millennium Promise and the social enterprise, Be Girl also hosted pilots for menstrual hygiene products and one of their participants, Patience, a 15-year-old girl from Ruhiira, Uganda told them “you suffer a lot; in case you stamp [stain] the boys can make fun of you which causes you to lose your self-esteem […] it’s embarrassing when you are washing your soiled clothes. It makes you not even want to go to school.” The washing of stained rags or clothing can also bring shame, especially in areas of water scarcity. Be Girl reports that in rural Africa, 40% of school girls miss up to 5 school days a month, or 30% of the school year. WaterAid found that 82% of their surveyed girls in Malawi did now know about menstruation before it started; girls across their surveyed countries were found to be excluded from water sources during menstruation, and even prohibited from washing and bathing in some communities making what is often a difficult week even more difficult to bear.

Source: WaterAid

Given the success of feminine hygiene and menstruation products, and the important role it has played in women's empowerment history, it would appear that the private sector could have significant market opportunity if they can break this taboo for women and girls -- who are expected to require the products for more tham 50 years. Sanitary products must be designed to be affordable; disposable tampons and sanitary towels are often priced out of reach of low- and even middle-income families if supply is scarce. Euromonitor International found that women in India, with average earnings of US $750 per annum earns below the $1,000 per annum deemed necessary to easily purchase disposable menstruation products. Moreover, systems to support menstrual hygiene are necessary, products alone aren’t the solution: appropriately designed and managed community spaces and importantly education on female reproductive health.

To make this happen, WSSCC believes that breaking the silence around the taboo of menstruation is a crucial first step. Girls should be informed and encouraged to talk and discuss menstruation in an informed and positive manner to prepare them emotionally and physically for the onset of menstruation and their monthly menstrual periods. Families need the education to support their girls and women. WaterAid has also compiled a phenomenal guide, Menstrual Hygiene Matters, with nine modules and tool kits -- an essential resource -- to improve menstrual hygienic for women and girls in lower and middle-income countries.

WaterAid found that well designed and appropriate water, sanitation and hygiene facilities that address menstrual hygiene can make a significant difference to the schooling experience of adolescent girls
(Photo: WaterAid/ASM Shafiqur Rahman) 

As WSSCC spokesperson, Archana Patkar,  powerfully argues: “Women are the progenitors of the human race […] Menstruation is therefore something of which they can and should be proud, so each and every one of us should work to improve the lives and life chances for women who do not have access to clean materials, water and safe disposal facilities; who cannot talk about their experiences; or are never asked if they can help define a solution.”

What I Talk About When I Talk About Money

Source: Flickr Creative Commons

“Money is never just about money” argues a leading financial services designer, James Moed, over a dinner attended by financial inclusion professionals hosted by Women Advancing Microfinance UK. "Instead," he explains, "it’s pretty much always about something else." In conversation with James, who has over 11 years of experience in helping innovation leaders and design teams understand people’s complex behaviours around money, we learnt how we can use Human Centered Design (HCD) to promote global financial inclusion -- an issue particularly pertinent to the world’s women.  According to the UNDP, 6 out of 10 of the world’s poorest people are women; women may comprise more than 50% of the world’s population but only own 1% of the world’s wealth. Some 75% of the world’s women are without access to bank loans as they have unpaid or insecure jobs and are not entitled to property ownership.

This blog will share some of the insights from James’ experiences having advised companies, governments, startups, and social enterprises, most recently as the Director for Financial Service Design at the London office of IDEO, a global innovation consultancy.

First, what is human-centered design (HCD)?

HCD applies the design process to create innovative solutions based on observations on humans. The HCD process begins by examining the needs, dreams and behaviours of people relevant to a prospective solution. A solution can be a product, a service, an environment, an organization or a mode of interaction. HCD focuses on desirability (what do people desire?), feasibility (what is technically and organizationally feasible?) and viability (what is financially possible?). It is an iterative process -- borrowing from the designer who observes, prototypes, tests and then repeats until an appropriate solution is reached. James describes the approach as "building to learn," creating imperfect examples of solutions to be tested by user experience instead of aiming to launch the perfectly formed solution straightaway.

Original Invitation for the HCD event with WAM UK

How can HCD help promote women in financial inclusion?

HCD depends on human observation and often women and girls have been ignored in the design of financial products and services. Even if they haven’t been explicitly ignored, then perhaps not enough nuance to their culture could have supported their financial exclusion. Such as failing to pay attention to what women and girls feel like they can and cannot say in interviews and surveys. Moreover, there is a big difference between what people say they will do, and what they actually do -- especially when it comes to money. HCD promotes user insight, so adopting an approach to always consider gender in the target user group is vital and can be extremely telling. Designing solutions with women’s behaviours, aspirations and needs specifically in mind can lead to women-inclusive financial solutions.

What kind of HCD insights on women do we have?

Investing in women has a multiplier effect

One of the major observations in microfinance -- the provision of financial service to the under and unbanked -- is based on gender. Women’s World Banking found that, "when a woman generates her own income -- and this holds true no matter what the  country -- she re-invests her profits in ways that  can make long-term, inter-generational change: the  education of her children, health care for her family and improving the quality of her family’s housing”. As James highlighted in our conversation, time and time again in his fieldwork, he saw that for women "finances are less about her own interests, but for others." Financial inclusion for women does not only empower the woman user, but often has positive impact on her wider community.

Source: Flickr Creative Commons

For some women illiquidity is attractive

Mind boggling at first, especially when we consider the gender discrimination that has led to three quarters of the world’s women unbanked, women may actually prefer access to financial services with features of illiquidity in some circumstances. Liquid cash could be dangerous to a woman’s wealth if socially she is obligated to financially help out family members and friends if they ask. It may be hard for a woman to not hand over her cash to her husband for example or her friend in financial difficulty -- it could bring stigma, perhaps attack if she says no. However a savings account with fixed non-withdrawal periods, or other features to lock funds away, could provide a socially acceptable excuse. In providing illiquidity in formal financial services, it could attract women who otherwise would prefer to store their wealth in more illiquid forms such as gold and livestock or hidden away in difficult to reach places. Illiquidity could not only protect wealth from the saver’s own impulses, and the demands of those around her.

Women experience high emotional return for good financial management

A recurring theme in James’ work saw that the rewards for good financial management were beyond financial for women -- this applies to women across the economic spectrum. Juntos Finazas, which was borne out of a class project from the Stanford Design School, helps Spanish speakers save via SMS. The founders saw that SMS was the right technology to help low-income Latinos as they tend to use mobile devices more than other groups and are substantial SMS users. Around 72% of successful Juntos Finazas savers said at sign up that they had never saved successfully before. Importantly, in feedback, users cite that using the tool to help them save has made them feel like better mothers, better daughters -- the return is more than extra money leftover in an account.

In consultation with IDEO, the successful Keep the Change savings program from Bank of America originated from the observation that women were more satisfied by the act of saving than the interest rates offered on savings itself. The program was therefore designed to emphasize the action of saving rather than focusing on the potential reward. Keep the Change automatically rounds up purchases on the Bank of America debit card and transfers the difference to a savings account, building up a savings balance subtly over time. Since its launch in 2005, the program has led to 12 million new customers building up an additional $3.1 billion of savings.

Financial planning can save lives

Having a financial plan in place affords protection for life’s shocks, and in some cases can make the difference between life and death. Although still imperfect, there are now maternity saving programs to help women save money over time to access skilled maternal care. In Kenya, where only 43% of births occur in health facilities and many Kenyans still lack access to basic maternity care and health insurance, medical payment can be a life-threatening barrier for mother and child. Changamka, established in 2008, developed a smartcard program which allows women to set saving goals and save via the mobile payments service, M-PESA. The program is a dedicated maternal savings program which locks the deposited funds for maternity expenses only. USAID has written up a case study on this project, which can be accessed here.

With financial technology advancing globally the practice of HCD, people are placed back in the center of experience to build lasting solutions. With 75% of women worldwide without access to financial services -- and importantly, the lack of understanding and emphasis upon their needs as cause and effect of their exclusion -- HCD can provide an attractive framework to unlock their considerable potential.

For more information on the topic connect with @jamesmoed, @WAM_UK, and @lisavwong on Twitter. Other interesting links on HCD and financial inclusion include:

• A CGAP video on bringing savings products to market
• The HCD toolkit by IDEO
• Free online course on HCD by +Acumen and IDEO.