For Dr. Ugochi Odinakachi Ohajoruka, period poverty has never been simply about the inability to afford a sanitary pad. It is a much larger problem—one tied to health, education, dignity, sanitation, economic opportunity and gender equality.
“Period poverty is much bigger than an inability to afford sanitary pads. It’s a systemic gender equity issue,” Dr. Ugochi explains.
As Founder and CEO of the Health Aid for All Initiative (HAFAI), Dr. Ugochi has spent more than a decade developing solutions that look beyond the immediate need for menstrual products and address the conditions that make period poverty persist.
Globally, approximately 1.8 billion people menstruate, yet millions still lack the resources needed to manage menstruation safely and with dignity. The World Bank estimates that about 500 million people do not have adequate access to menstrual products and facilities.
For Dr. Ugochi, menstrual health must therefore mean more than having access to a pad. It includes affordable and appropriate menstrual materials, clean water and soap, safe and private toilets, facilities for changing and disposing of menstrual materials, accurate information, access to healthcare, and freedom from shame and discrimination.
In Nigeria, the consequences are particularly visible among girls and young women. About 23 percent of girls have missed school because of their periods.
The challenge is not only economic. Cultural beliefs and stigma continue to influence how menstruation is understood and experienced. In some communities, girls are still expected to avoid being around men and boys while menstruating.
For Dr. Ugochi, these realities make menstrual health a gender-equity issue that Nigeria must confront at both community and policy levels.
Nigeria held its first menstrual health summit last year, providing a platform for stakeholders to discuss menstrual health and hygiene management. But for Dr. Ugochi, conversations must ultimately translate into sustained action.
HAFAI began tackling the issue 11 years ago through the Red Diamond Project, an initiative that combined school health clubs, girl-child mentorship, hygiene education and the local production of reusable sanitary pads.
Through the project, more than 6,000 reusable pads were distributed, with each pad designed to last approximately three years.
But the pads were only part of the solution.
HAFAI created community enterprise groups where women were trained to hygienically produce reusable pads. Participants received sewing machines and locally produced fabrics, giving them the ability to manufacture and sell the products within their communities.
The approach created a two-way impact: women could generate income while communities gained greater access to affordable menstrual products and more opportunities to discuss menstruation, reproductive health and the stigma surrounding periods.
One beneficiary, Saloma, developed significant sewing skills through the initiative and later secured a local contract to produce school uniforms. She went on to train other women in pad production and expand her business, creating additional economic opportunities within her community.
For HAFAI, Saloma’s journey illustrates what can happen when women are not treated simply as beneficiaries of development interventions, but are positioned as producers, entrepreneurs and leaders of solutions.
“Period poverty shouldn’t just be about giving access to products,” Dr. Ugochi says. “It should be about engaging women to produce, distribute, own, and lead solutions within their own communities.”
The model also demonstrated potential for wider scale.
According to Dr. Ugochi, one sewing machine can empower a cohort of five women, while community-based production can simultaneously strengthen local supply and create economic opportunities.
The use of reusable products also helps reduce menstrual waste, while local production gives communities greater ownership of the solutions designed to address their needs.
However, Dr. Ugochi believes that scaling menstrual health interventions requires more than the efforts of one organization.
Community leaders, teachers, health professionals, women’s groups, adolescent girls and government institutions all have important roles to play.
Health professionals contribute evidence and technical knowledge. Teachers can help girls remain in school. Community leaders can challenge harmful beliefs and create acceptance. Women’s groups can produce and distribute affordable menstrual products. Government institutions can provide the policies, infrastructure and systems required to sustain progress.
Men and community leaders must also be included in the conversation.
Before recruiting women into the Red Diamond enterprise groups, HAFAI engaged community leaders, most of whom were men. That engagement helped create space for communities to move away from treating menstruation as something girls should hide and toward understanding it as a normal biological process that deserves support.
“Periods should be an open conversation,” Dr. Ugochi says. “It’s a normal biologic function after all.”
For her, the larger challenge is ensuring that menstrual health interventions do not remain isolated projects that disappear when funding ends.
Nigeria already has policies addressing aspects of women’s and girls’ health, but implementation remains a critical challenge.
A girl missing school because she cannot adequately manage her period is not facing an isolated personal problem. A mother struggling to provide menstrual products for her daughter is not dealing with an issue confined to her household. And when women are unable to participate fully in education, employment or community life because of menstrual health challenges, the consequences extend far beyond the individual.
That is why Dr. Ugochi believes local governments, schools, primary healthcare centres and other institutions must help translate policy into practical and sustainable action.
HAFAI’s experience also demonstrates the importance of designing sustainability into programmes from the beginning.
Three years after the Red Diamond Project ended, an evaluation found that 82 percent of beneficiaries had been upskilled.
For Dr. Ugochi, the result reinforces the importance of building interventions around local ownership rather than dependence on external support.
A sustainable approach could combine government support, community-based production, affordable sales, social enterprise and targeted subsidies for marginalized communities.
It could also bring public health leaders, women’s health innovators, entrepreneurs and communities into the design process from the outset.
Each stakeholder brings something different: evidence and policy expertise, innovation and technology, financing and business strategy, and lived experience.
The real measure of success, however, goes beyond the number of products distributed.
Are girls missing fewer days of school? Are menstrual products consistently available and affordable? Are women earning income? Are they participating more consistently in work? Are community attitudes changing? And can programmes continue after external funding ends?
These questions help determine whether an intervention is simply delivering assistance or actually changing the conditions that created the problem.
“The ultimate goal should be to move from projects to systems,” Dr. Ugochi says.
Today, HAFAI has distributed more than 130,000 reusable pads in Nigeria while empowering women and girls with the skills and tools to produce them.
The organization’s work focuses on maternal, child and adolescent health and the intersections between health, gender equality, education, environmental sustainability and economic empowerment.
Dr. Ugochi, a medical doctor, public health practitioner and author, believes collaboration will be central to achieving lasting progress.
Across Nigeria, organizations are addressing period poverty through different approaches, from product distribution and education to advocacy and policy engagement. The opportunity now is to connect these efforts and create systems capable of delivering lasting change.
At the heart of that transformation is a simple but powerful shift: women should not merely receive solutions to problems affecting their lives. They should have the opportunity to design, produce, lead, own and sustain those solutions.
“We must ensure women’s voices and solutions are part of the history being written,” Dr. Ugochi says. “If we don’t tell our stories, others will redefine reality for us.”
The fight against period poverty, therefore, is about far more than putting a pad in a girl’s hand. It is about creating communities and systems where no girl has to choose between her dignity and her education, where women can participate fully in society, and where the people most affected by a problem are empowered to lead the solutions.
