Last August, Sandra,* 18, suffered a vaginal yeast infection that caused itchiness and discomfort. Sandra, who lives in Djichami, Boyo division, in northwest Cameroon, developed the infection after using unsanitary menstrual products.

"I used to use a toilet roll instead of a pad at times, because my mother, whom I live with, could not afford to buy me a sanitary pad most of the time," she says.

In Cameroon, a proper sanitary pad costs approximately 600 to 800 Central African francs (CFA franc) ($0.99 to $1.31). In a country where the monthly minimum wage is 41,875 CFA franc ($68.70) and most people live below the poverty line ($2.15 per day), it is difficult for many to afford basic necessities, including sanitary menstrual products.

In December 2023, Ndum Charlotte Ayeah, a girls' rights advocate, convened seven of her peers between 21 and 25 years old to form a nonprofit group—the National Movement of Adolescent Girls and Young Women (AGYW)—to confront period-poverty and reproductive health ignorance in poverty-stricken rural communities.

When word of the first education program made its way across villages, young women trooped out to attend the sessions.

There they learned about sexual health, the female reproductive health system, and how to use cost-effective reusable menstrual pads. After each session, individuals were offered a free pack of sanitary pads.

The use of improper materials for menstrual products can potentially have several negative effects on a female's reproductive health
Habiba Jibo, sexual reproductive health consultant

"Before the program, I was ignorant about my body as a young woman," Sandra remembers.

Between December 2023 and April 2024, AGYW helped prevent genital infections in 350 adolescent girls living in vulnerable communities in the northwest region.

"The use of improper materials for menstrual products can potentially have several negative effects on a female's reproductive health," says Habiba Jibo, a Cameroon-based sexual reproductive health consultant.

"Poor-quality or unhygienic materials can create an environment conducive to the growth of bacteria. This increases the risk of developing bacterial infections, such as bacterial vaginosis or urinary tract infections (UTIs) among others," she says.

The Seven-Volunteers Group

According to Ayeah, the founding of AGYW was inspired by UN Sustainable Development Goal 3, which centers around good health and well-being of the reproductive system, adolescents, and newborns, as well as other well-being factors. She believes the residents in underserved communities tend to lack health-care services.

"[The] high cost of pads and the inability of adolescent girls in rural communities to afford them have prevented them from participating fully in economic and social life due to their low self-esteem when menstruating, probably because of the alternatives they use," she says.

Pushing for a solution to costly menstrual pads, Ayeah created a social media page on X, to launch a campaign for tax-free pads.

"We are carrying out an advocacy campaign which we launched in May last year. The campaign is dubbed #TaxFreePadCmr," Ayeah tells Think Global Health. "[It's] pushing for the total removal of taxes on pads in Cameroon to make pads more affordable and available for adolescent girls and young women."

She also wrote an online petition to the government to remove taxes on menstrual pads. This, she believes, would break the financial barriers and make sanitary menstrual products affordable for all.

Ayeah says that although the lack of clean water in many rural parts of the country does not permit the effective use of reusable pads, it is preferable to using inappropriate materials.

An outreach effort in the Momo Division of the Mbengwi community, in Cameroon. Photo courtesy of Ndum Charlotte Ayeah and Abdullahi Jimoh

Addressing Stigma

The fear of bleeding through clothes caused Linda,* 15, in Mbengwi village to miss school because she always felt uncomfortable when she had her period. She worried that the boys in class would mock her if they caught a glimpse of her blood-stained uniform on the backside.

"I always feel ashamed whenever menses come, especially while in school, fearing that everyone is looking at me," she recalls.

Like Sandra and other women, Linda uses unsanitary products in place of a pad, often leading to yeast infections.

Fortunately for Sandra and Linda, they were able to use AGYW as an avenue to shed light on their plight and the duo was able to use that momentum to speak with medical practitioners who gave them hygiene tips to prevent yeast infections.

Now, I'm empowered and knowledgeable about my body and rights
Linda, participant in AGYW

"I was taught that, as long as I maintain proper hygiene, I should not be ashamed when on my period. Now, I'm empowered and knowledgeable about my body and rights. I'm more comfortable when menstruating, for I understand that it's a natural occurrence and the pride of every woman. After maintaining the hygiene, I'm now free of discomfort," Linda said delightedly.

Jibo affirmed that consulting a service provider could be a lasting solution.

"If somebody is experiencing persistent discomfort, irritation, or any unusual symptoms while using inapt menstrual products, consulting a health-care professional is the best. They can provide personalized advice and recommendations based on the specific needs and medical history," she says.

The Obstacles

Ayeah noted that financing the nonprofit is one of the challenges they encounter along with the economic insecurity and deeply rooted religious beliefs in some communities.

"All the resources we have been utilizing thus far come from in-house contributions, individual donations, and sometimes local organizations. This largely limits our scope and the number of girls we can reach," she says.

AGYW could only reach English-speaking villages in the northwest region due to language barriers with the French-speaking side, and internal conflict.

"We are working in a war zone and sometimes risk being targeted, shot, or kidnapped by secessionist fighters," she adds.

But for many women like Sandra, AGYW's education on menstrual health hygiene allowed her to live comfortably and shame-free.

"Through the sensitization [education], I understood the dangers of using inapt pieces to cover menstruation on my system, and the packs of pads given to me helped," she says. "After attending the outreach, I am confident I know my reproductive health, and I can now make informed decisions about my sexual health."

Reusable sanitary pads are displayed inside a factory at Bonda Women Craft Centre. — Reusable sanitary pads are displayed inside a factory, at Bonda Women Craft Centre, in Mutare, Zimbabwe, on July 13, 2022. REUTERS/Philimon Bulawayo

EDITOR'S NOTE: Last names have been omitted to protect privacy.

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