Sitting on the edge of her bed in a dimly lit cramped room, Peace (not her real name) darted her eyes around, too embarrassed to share her memories. The electricity went off and the whirr of the old ceiling fan went down, both offering her some form of safety and a silent urge to speak. Her shoulders relaxed for the first time as she grabbed a cup of water next to the bed, gulping hastily. “It’s okay, just take a deep breath and shake it off,” Comfort Tanko, her friend, sat on a three-legged stool across the room, and cheered her on. Peace nodded in agreement and began to speak.  “I have not really had a lot of awkward experiences in life. Maybe that’s why that Sunday decided to teach me a lesson. Whenever I am on my period, I always use a rag to control my bleeding. So, that day, I wore it and went to church as usual. The pastor was preaching and he asked everyone to stand up. I felt uncomfortable but I could not immediately tell why,” the 22-year-old said in a tone above a whisper. “You know when you feel like people are staring so hard at you. I knew something was wrong and I decided to turn back and look around; that was when I saw blood on my seat. I wished the ground would swallow me at that moment,” she added as the bed creaked while she adjusted her weight. She brushed her hand over the section of the mattress she shifted from, wiping an imaginary stain off the sheets. Soon, the lights came back on and she broke into a nervous smile. “My friend had to take her head tie off and gave me to tie around my waist. Luckily, I had a handkerchief with me which I used to wipe my seat,” she continued. “I went into the bathroom and never returned.” Tanko, her 24-year-old friend, said she has never had such an embarrassing experience, but she wondered what it would feel like to consistently use a sanitary pad.  Tanko and Peace moved to Abuja, Nigeria’s capital, in 2016 in search of better economic fortunes. Prior to their move, they had never used a pad because they could not afford it. Now, their meagre income coupled with the demands from home and the cost of living does not permit them to use a pad as often as they would like to. Tanko, who works as an assistant operator in a water bottling company, said she only buys sanitary pads once in a while — either as a birthday present or to celebrate a special event in her life. Once, she saw a movie where a character was instructed to gather used sanitary pads for diabolical reasons and she found an extra reason to stick to using rags. “I don’t understand the way this country is moving. The price of everything is just increasing, but I feel there are some things that are not supposed to increase,” Tanko said while wiping a bead of sweat of her face. “When I think of all the bills I have to pay, buying a pad is the last thing on my mind.”

Despite VAT exemption from sanitary pads, economic woes push more women into period poverty

Comfort Tanko, outside Peace’s house, came to cheer her friend up but also needs relief from period poverty. Photo credit: Claire Mom/TheCable

THE REAL SITUATION In a junior secondary school in Gwarinpa, 17-year-old Ene (not real name) opts for tissue paper when she’s on her period. In the first three days of her five-day cycle, she trades school for an opportunity to bleed without being embarrassed by a stain in public. She would reduce the number of sanitary pads she uses to save costs if she could, but her period is dramatically heavy. “Sometimes, I use cloth or tissue paper, but I mostly stick with tissue because I don’t have many wrappers and I cannot be using my mother’s own every time or it will finish,” Ene told TheCable. “Pads have become very expensive and I cannot reduce the number I use because my period is very heavy. The worst part is that the period comes when I don’t have money to afford a pad.” For young girls like Ene still in secondary school, some may argue that the burden of affording sanitary pads does not have to rest on their shoulders, especially as they are still under the responsibility of their parents or guardians. 
Despite VAT exemption from sanitary pads, economic woes push more women into period poverty

Some of the girls filling a questionnaire. Photo credit: Claire Mom/TheCable

But dozens of working-class women who TheCable spoke to confirm that only a few women can afford the luxury of consistently using a pad. For some, the subject was a touchy one even when provided with the option of anonymity.  HOW NIGERIA’S ECONOMIC SITUATION IS FUELLING PERIOD POVERTY What Peace and Tanko are experiencing is called period poverty — where girls or women cannot afford sufficient menstrual products. According to the United Nations Population Fund (UNFPA), the average woman sees her period for 2,535 days of her life. That is nearly seven years’ time of making sure you have a pad or tampon, finding a makeshift solution if you don’t, and managing pain and discomfort. For women in developing countries like Nigeria battling a near-daily surge in the cost of living, the situation is much worse. Despite accounting for the larger amount of the country’s economically active population, with 61.3 million (50.5 percent), according to Q4 2020 data from the National Bureau of Statistics (NBS), its most recent, women are underrepresented in the labour force with a gap of 13.42 percent when compared to men. The report adds that 18 million women are in the informal sector and less than one million women are employed in the formal sector, and that while only 20 million of the total employed population (46 million) are women, less than a million women are in formal employment. Women like Peace who work as domestic staff constitute 95 percent who are engaged within the informal sector. But in a nutshell, the NBS says the female unemployment rate in the country stands at 35.2 percent, a situation that forces a vast majority to weigh the things that matter most. For many, a sanitary pad does not make the list. To reduce the financial burden of having to deal with a natural process, the federal government, in 2020, announced the exemption of pads from value-added tax (VAT). Many female activists saw it as a step in reducing period poverty and hailed the government for taking applaudable steps in creating more access to sanitary pads for women.  Three years later, the prices have continued to surge, leaving many to question the impact and motive of a move that seemed economically smart at the time. Abiodun Folawewo, a professor of macroeconomics, labour, and development economics told TheCable that the exemption of VAT from sanitary pads has had very little effect because the product is a consumption tax and not a production tax. If it were the latter, factors that determine its production would be subsidised by the VAT removal which would lead to the highly sought-after change of a substantial reduction in price. “Pad is a consumption tax, it is not a production tax,” Folawewo said. “Now what determines whether the price of the sanitary pad will go down or not are things like import duties, export duties, and the tariff on other inputs that go into the production of sanitary.   “The VAT removal on sanitary pads was never meant to target the price of the product and that is why it doesn’t matter even if the government makes the removal permanent. That does not affect the price, what affects the price is the cost of inputs that go into the production of the product.” So, what then is the essence of the VAT exemption? In simple terms, VAT is a consumption tax paid when goods are purchased and services are rendered. If a woman goes to a store to buy a sanitary pad worth N300, for example, because the product has been exempted from VAT, there would be no extra charges (usually 7.5 percent) attached to the sanitary pad. As such, the woman is left at the mercy of the producers, many of whom have had to hike the price owing to other factors like inflation, foreign exchange, cost of electricity, among others.  According to the latest worldwide electricity pricing released by Cable UK, Nigeria ranks 108 on the global chart with the highest electricity cost. This might seem average on a chart consisting of 230 countries, but a closer look at Africa shows that Nigeria comes in at 24th in the continent with the most expensive electricity costs.  In a country where 133 million citizens are multi-dimensionally poor, people grapple with fending for necessities such as food, water, and shelter. For manufacturers, cost of electricity means that a difficult price has to be paid. But the consumers bear the brunt. A continuous surge in inflation makes the grim situation worse. In 2022, the consumer price index (CPI), which measures the rate of change in prices of goods and services, surged to 20.52 percent — the highest since October 2005.  The World Bank said the naira which had lost 10.2 percent of its value against the United States dollar at the time, was one of the main drivers of inflationary pressures in the country. Ibenta Nkem, professor of banking and finance/economics, told TheCable that as long as these factors continue to exist, the VAT exemption from sanitary pads will have no effect. “We don’t have an enabling productive environment. We don’t have the forward/backward and input/output linkages that are required to bring about efficiency in production. We don’t have the financial system that can promote local production to take advantage of the comparative advantage that we have in cheap labour so that we can produce at a cheaper rate and so that our products can be fare,” Nkem said. “In that way, we not only create employment, but we also generate income locally and improve the purchasing power of the people. “So, even if you exempt all the VAT and you still have very high costs in, take for instance, electricity and the cost of diesel, because most of these manufacturers are working with generators, how then can the cost of production reduce? Who can buy what you’re selling? How many students can buy at the push inflation that we’re going to experience in the short run?” ECONOMIC WOES COMPOUNDING HEALTH CHALLENGES While Peace showed off her colourful pieces of torn wrapper intended for her menstrual flow and demonstrated how she folds it tightly to avoid any leakages, she told TheCable that sometimes during her period, she has very painful urination. Her admission unlocked a memory for Tanko, her friend. “Since I have been seeing my period, I have never had an infection but now I just remembered that anytime I want to pee, the experience is never pleasant. My stomach will hurt so much at that time and sometimes, I even see blood in my pee,” Tanko chimed in. “I told my mother and she said it’s typhoid. This typhoid must be a very stubborn one.” Tanko’s recurring “typhoid” could be symptoms of urinary tract infections (UTIs), but she wasn’t sure. When both girls were asked if they have consulted a doctor, they replied with a shake of the head. “If we cannot buy a pad, is it a doctor we can afford?” Tanko answered wittily. Asides from using rags and pieces of cloth as substitute sanitary pads, some girls make use of newspapers, leaves, breadcrumbs, or other objects that can absorb or collect blood. The result is a biting diagnosis of reproductive tract infections such as bacterial vaginosis (BV) and UTIs.
Despite VAT exemption from sanitary pads, economic woes push more women into period poverty

Elizabeth, a mother of two, sometimes has painful urination and an irregular flow of her period. Photo credit: Claire Mom/TheCable

Studies have shown that women with BV may be at higher risk of adverse pregnancy outcomes like preterm birth, acquisition of sexually transmitted infections (STIs), and development of pelvic inflammatory disease. Although Brian Adinma, a professor of obstetrics and gynaecology, told TheCable that infections affecting the reproductive and urinary system in women cannot always be ascribed to period poverty, he affirmed that “complications specifically related to period poverty have not been adequately interrogated”. “Prolonged use of unhygienic menstrual products will certainly cause health hazards such as chaffing of the perineum, reproductive and urinary tract infections,” he said. “That is why good adherence to menstrual hygiene offers the woman the necessary emotional confidence related to menstruation and prevents complications that can arise from poor menstrual hygiene.” Adinma’s stance is not far-fetched. Research shows that period poverty can also negatively affect mental health, with women who suffer from period poverty being more likely to report moderate to severe depression.  OBTAINABLE PRACTICES IN OTHER AFRICAN COUNTRIES As part of efforts to cushion period poverty, many countries, including African states, have taken steps towards making sanitary pads free.  In an overwhelming approval in 2017, Botswana’s parliament adopted a motion to offer schoolgirls all over the country free sanitary pads. The motion was tabled to allow every girl in both private and public schools to have access to education even during their menstrual period. The action was taken after it was noticed that most girls missed school during their periods and suffered poor grades as a result. Thereafter, the Kenyan government followed suit. After becoming the first country worldwide to eliminate the “tampon tax”, the Kenyan government started distributing free sanitary pads to girls in public schools in April 2018. The decision to support the effort came after two years of parliamentary debate on the issue.  Zambia was also not left behind. Although the government announced in 2017 that it would distribute free sanitary pads to girls in rural and underserved communities, the plan was only implemented in 2019. Soon after, educators in rural Lusaka province reported that school attendance by females significantly improved since the measure went into effect.   Although countries like Scotland had long set the pace in championing access to menstrual hygiene products, all countries that joined in, no matter the time, had one common effect — an increase in the number of girls in school. FIXING THE PROBLEM According to a 2022 report, the United Nations Children’s Fund (UNICEF) said 60 percent of the 18.5 million out-of-school children in Nigeria are girls. Asides from insecurity being a prevailing factor, other health and socio-economic elements like period poverty contributed to the alarming statistics. Ashley Lori, founder and executive director of Pad-Up Africa, an NGO sensitising adolescent girls and women on good menstrual hygiene, told TheCable that the VAT exemption from sanitary pads has done little to eliminate period poverty in the country. To win the war against period poverty, Lori recommended that Nigeria joins in the action that Kenya, Botswana, and Zambia are taking to provide free sanitary materials to girls. “That is why we’re asking for a policy from the government that will provide free pads to girls in public schools, public toilets, markets, hotels, and any public place, and not just pads but good hygienic female toilets so they can be used by whoever that needs to because the truth is that we cannot shut down menstruation as humans, it’s a natural phenomenon,” she said. “If a girl is struggling at a very young age to afford to have her menstruation and the policymakers are not putting us into consideration while hiking every other thing like fuel price, which will definitely affect the cost price of things, then we’re backwards on achieving our goal of quality health. 
Despite VAT exemption from sanitary pads, Nigeria's economic woes push more women into period poverty

These girls are new to the concept of a period but they don’t want to be in a situation where they are forced to use rags instead of a pad. Photo credit: Claire Mom

“The budget should not be just focused on feeding children but also include the free supply of menstrual hygiene products; it will help the young girl stay in school.” One promise echoed throughout President Bola Tinubu’s campaigns, manifesto, and in his inaugural speech, was the prioritisation of women and issues that affect them. Activists like Lori and many young girls are hopeful that the president keeps to his word and improves on his predecessor’s achievements. “We can’t say for sure when the policy will be in place, but I’m certain that with relentless advocacy from civil society organisations and other concerned persons, the government will do the right thing and help us eliminate period poverty,” Lori said. “Already, President Tinubu said he will listen and act on women-related issues. We’ve seen him take a number of bold actions since he assumed office, we’re just hoping and praying for when he will take one that finally directly affects us.”

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