Family planning and female sanitary products
Family planning and female sanitary products
Business Model Description
Produce and provide affordable familiy planning products, such as condoms, and affordable female disposable and reusable sanitary products.
Expected Impact
Support family and female productivity and wellbeing.
How is this information gathered?
Investment opportunities with potential to contribute to sustainable development are based on country-level SDG Investor Maps.
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Country & Regions
- Uganda: Central
- Uganda: Western
- Uganda: Acholi
Sector Classification
Health Care
Development need
Uganda has a major challenge with SDG 3 - Good Health and Wellbeing, particularly indicators such as high maternal and neonatal mortality rate.(I) The index for inequality-adjusted life expectancy within the Human Development Index (HDI) framework is only 0.481, positioning Uganda as 160th in the HDI country ranking.(II)
Policy priority
Through the National Development Plan, government has increased spending on social sectors namely healthcare and education. However more investment will be required to provide basic but high-quality social services, especially in healthcare. Uganda plans to devote USD 7 million for human capital development which includes healthcare.(IV)
Key bottlenecks introduction
Uganda has achieved 75% geographical coverage of the population living within a 5 km access of any facility providing health services for communicable diseases. However, the functional coverage is much lower in reality. This is caused by insufficient coverage of comprehensive services, especially specialty and diagnostic services.(IV)
Biotechnology and Pharmaceuticals
Pipeline Opportunity
Family planning and female sanitary products
Produce and provide affordable familiy planning products, such as condoms, and affordable female disposable and reusable sanitary products.
Business Case
Market Size and Environment
< USD 50 million
In 2018, Uganda imported almost USD 972,000 worth of rubber sheath contraceptives and almost USD 465,000 worth of chemical hormone-based contraceptives.(4) This large demand could be satisfied through domestic production.
In 2018, the market for providing contraceptive services to the 253,000 women aged 15–19 in Uganda who currently use modern contraceptives was approximately USD 2 million.(3)
Additionally, almost 11 million females in Uganda between 15-59 years old need sanitary products to improve their hygiene and wellbeing.(34) In 2018, Uganda imported almost USD 29 million worth of sanitary towels (pads) and tampons, napkins and napkin liners for babies and similar articles, of any material.(4)
Indicative Return
15% - 20%
The estimated return rate for investors is 19% to 23%. This rate is a benchmark calculated based on a cost of equity with a country risk premium, reflecting an average return required by investors active in the healthcare products subsector.(23)
A case study from other emerging markets for mini-scale sanitary pads production facilities estimates a rate of return between 23% and 29%.(24),(25)
Investment Timeframe
Medium Term (5–10 years)
The investment timeframe should be considered medium term, reflecting the required capital expenditure, construction period and time needed for obtaining permits to manufacture pharmaceuticals and female disposables in Uganda.
According to a company active in the sector, the breakeven point for manufacturing sanitary towels takes 7-10 years.(38)
Market Risks & Scale Obstacles
Business - Business Model Unproven
Business - Supply Chain Constraints
Market - High Level of Competition
Impact Case
Sustainable Development Need
In 2018, there were 116.07 births per 1,000 adolescent females aged 15-19 in Uganda, which is higher than the already above-average ratio for Sub-Saharan Africa of 101.22 (26). This negatively affects the education of young women in the country, because the earlier a female has a child, the fewer years of education she completes.(27)
Moreover, there were 1.4 new HIV infections per 1,000 uninfected population in 2018.(1)
Another challenge for the country is insufficient access to and high cost of female sanitary products. An estimated one in every four adolescent girls doesn't attend school because of issues associated with access to sanitary products and menstruation problems.(29)
Gender & Marginalisation
In 2018, only 53.5% of females aged 15-49 who are married or in unions have their demand for family planning satisfied by modern methods.(1)
Approximately 50% of pregnancies among young females in Uganda are unplanned, which results in 30% of them ending with an abortion.(3) These abortions are usually conducted in an unsafe environment, which in turn leads to more than 10% of all maternal deaths in the country.(28)
Expected Development Outcome
Increased access to family planning products. Lowered price of family planning products. Reduced amount of unplanned pregnancies. Stabilized rate of population growth.
Reduced spread of Human Immune Virus (HIV) and venereal diseases. Increased average income per person and reduced poverty. Improved participation rate of women in the job market and in school.
Gender & Marginalisation
Higher levels of female family planning opportunities allow women to realise individual and household ambitions.
Increased female productivity and wellbeing and lower incidence of female drop-out rates due to increased access to and affordability of sanitary products.
Primary SDGs addressed
3.1.1 Maternal mortality ratio
3.3.1 Number of new HIV infections per 1,000 uninfected population, by sex, age and key populations
3.7.1 Proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods
4.6.1 Proportion of population in a given age group achieving at least a fixed level of proficiency in functional (a) literacy and (b) numeracy skills, by sex
5.6.1 Proportion of women aged 15–49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care
Secondary SDGs addressed
Directly impacted stakeholders
People
Gender inequality and/or marginalization
Planet
Indirectly impacted stakeholders
People
Public sector
Outcome Risks
Increased pollution caused by latex condoms and disposable sanitary products, which may pose a threat to aquatic systems if not disposed of properly (17)
Impact Risks
Required doctor consultations may limit uptake of contraceptives (16)
Impact Classification
What
Positive impact on national health, alleviation of poverty levels and productivity. Moreover, it is likely that more women will join the job market and remain in school.
Who
Society in general with a focus on females who face challenges with family planning and menstrual poverty that disrupt their lives
Risk
Although the business model is market proved, production- and distribution-related challenges as well as socio-cultural barriers exist.
Impact Thesis
Support family and female productivity and wellbeing.
Enabling Environment
Policy Environment
Uganda One Health Strategic Plan 2018 - 2022: This plan identifies reproductive health and reducing the spread of sexually transmitted diseases as one of the key priorities for Uganda's health sector.(5)
Adolescent Health Policy Guidelines and Service Standards: These standards aim to provide and increase availability and accessibility of appropriate, acceptable, and affordable quality information and health services to adolescents.(9)
Third National Development Plan (NDPIII): This plan recognises the need for family planning and improved access to reproductive health as one of the key challenges hampering Uganda's development and a significant obstacle to poverty reduction.(7)
National Drug Authority Strategic Plan July 2016 - June 2021: This plan emphasises improving the quality of medicines and healthcare products in Uganda.(8)
In response to the challenge, the Ugandan Government established the Menstrual Hygiene Management Charter in 2015, which supports non-government and other organisations to provide menstrual training for adolescents and teachers, and monitor the menstrual hygiene facilities in schools. (33)
Financial Environment
Fiscal incentives: Raw materials for manufacturing medicaments are exempt from all taxes under the 5th schedule of the East African Community Customs Management Act 2004.(6) Medicated cotton wool is exempt from value added tax (VAT) import duties.(6)
Regulatory Environment
National Drug Policy and Authority Act Cap. 206: This Act establishes a national drug policy and a national drug authority to ensure the availability of drugs and safeguard the appropriate use of drugs.(10)
Guidelines on Good Distribution Practice for Pharmaceutical Products: These guidelines require that drugs are handled properly and that a reasonable degree of control over the acquisition, storage, sale, supply or disposal of drugs is maintained.(11)
Guidelines on Submission of Documentation for Marketing Authorisation of a Pharmaceutical Product That Is Prequalified by World Health Organisation or Approved by a Stringent Regulatory Authority: These guidelines outline the procedure and list of documentation required for submission.(13)
Reusable sanitary towels - Specification: This document determines the requirements and test methods for reusable sanitary towels (including reusable panty liners) for external use, including absorbency levels, packaging, materials and marking.(36)
Marketplace Participants
Private Sector
Reckitt-Benckiser, DKT International, Marie Stopes Kenya, Pfizer Inc., Innolatex (Thailand) Ltd, Hartwood Enterprises, Merck Co. Inc, AFRIpads
Government
Ministry of Health, Menstrual Hygiene Management Charter, Ministry of Education, Science, Technology and Sports, WoMena
Multilaterals
World Bank, World Health Organization (WHO)
Non-Profit
United States Agency for International Development (USAID), Bill and Melinda Gates Institute for Population and Reproductive Health, Women Across Frontiers, Reproductive Health Uganda, International Planned Parenthood Federation (IPPF)
Target Locations
Uganda: Central
Uganda: Western
Uganda: Acholi
References
- (I) Sachs, J., Schmidt-Traub, G., Kroll, C., Lafortune, G., Fuller, G., Woelm, F. (2020). The Sustainable Development Goals and COVID-19. Sustainable Development Report 2020. Cambridge: Cambridge University Press. (II) United Nations Development Programme. Briefing note for countries on the 2019 Statistical Update: Uganda. (III) Government of Uganda (2016). Review Report Of Uganda’s Readiness For Implementation Of The 2030 Agenda. (IV) National Planning Authority. National Development Plan III (NDPIII) 2020/21 – 2024/25.
- (1) Sachs, J., Schmidt-Traub, G., Kroll, C., Lafortune, G., Fuller, G., Woelm, F. (2020). The Sustainable Development Goals and COVID-19. Sustainable Development Report 2020. Cambridge: Cambridge University Press.
- (2) Family Planning 2020. Uganda Commitment Maker Since 2012. http://www.familyplanning2020.org/uganda
- (3) Guttmacher Institute (2018). Adding it up: Investing in Contraception and Maternal and Newborn Health for Adolescents in Uganda. https://www.guttmacher.org/sites/default/files/factsheet/adding-it-up-contraception-mnh-adolescents-uganda.pdf
- (4) UN Comtrade database. https://comtrade.un.org/
- (5) Government of Uganda (2018). Uganda One Health Strategic Plan 2018 - 2022. https://www.health.go.ug/download-attachment/CCY3qunW3-LB6euIjn5lm8UPmuQuRTqIDgBTV6Xxb_o
- (6) Uganda Revenue Authority (2019). A Tax Incentives Guide for Investors in Uganda. https://www.ebiz.go.ug/wp-content/uploads/2020/03/TAX_INCENTIVES_GUIDE_FOR_INVESTORS_IN_UGANDA_October_2019.pdf
- (7) National Planning Authority. National Development Plan III (NDPIII) 2020/21 – 2024/25.
- (8) National Drug Authority. National Drug Authority Strategic Plan July 2016 - June 2021. https://www.nda.or.ug/publications/
- (9) Ministry of Health (2011). Adolescent Health Policy Guidelines and Service Standards. http://library.health.go.ug/sites/default/files/resources/Adolescent%20Health%20Policy%20and%20Service%20Standards%20-%20May%20%202012.pdf
- (10) Government of Uganda (1993). National Drug Policy and Authority Act 1993 (Ch 206). http://faolex.fao.org/docs/texts/uga104984.doc
- (11) Government of Uganda (2018). Guidelines on Good Distribution Practice for Pharmaceutical Products. https://www.nda.or.ug/human-medicine-guidelines/
- (12) National Drug Authority (2020). Guidelines on Good Manufacturing Practice for Medicinal Products Part 1. https://www.nda.or.ug/human-medicine-guidelines/
- (13) National Drug Authority. Guidelines on Submission of Documentation for Marketing Authorisation of a Pharmaceutical Product That Is Prequalified by World Health Organisation or Approved by a Stringent Regulatory Authority. https://www.nda.or.ug/human-medicine-guidelines/
- (14) Ministry of Health. About Ministry of Health. https://www.health.go.ug/about-moh/
- (15) National Drug Authority. NDA Profile. https://www.nda.or.ug/nda-profile-page/
- (16) Office on Women’s Health in the U.S. Department of Health and Human Services (2017). Birth control methods. https://www.womenshealth.gov/a-z-topics/birth-control-methods#9
- (17) Lambert, S., Johnson, C., Keller, V.D.J., Sinclair, C.J., Williams, R.J. and Boxall, A.B.A. (2013). Do natural rubber latex condoms pose a risk to aquatic systems? https://pubmed.ncbi.nlm.nih.gov/24162606/
- (18) Guttmacher Institute (2017). Contraception and Unintended Pregnancy in Uganda. https://www.guttmacher.org/fact-sheet/contraception-and-unintended-pregnancy-uganda
- (19) United Nations Industrial Development Organization (2020). Pharmaceutical Sector Profile: Uganda. https://open.unido.org/api/documents/4699932/download/Pharmaceutical%20Sector%20Profile%20-%20Uganda
- (20) International Growth Centre (2017). Special Economic Zones. https://www.theigc.org/wp-content/uploads/2020/02/Special-Economic-Zones-in-Uganda-28.01.20_format.pdf
- (21) Uganda Bureau of Statistics (2018). National Labour Force Survey 2016/17. https://www.ubos.org/wp-content/uploads/publications/10_2018Report_national_labour_force_survey_2016_17.pdf
- (22) Namasivayam, A., Lovell, S., Namutamba, S. and Schluter, P.J. (2019). Improved contraceptive use among women and men in Uganda between 1995-2016: A repeated cross-sectional population study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6638941/
- (23) PwC analysis based on Prof. A. Damodaran data, 2020.
- (24) NIIR Project Consultancy Services. Low cost project to setup mini sanitary napkin manufacturing. India. https://www.entrepreneurindia.co/Document/Download/Low-Cost%20Project%20to%20Setup%20Mini%20Sanitary%20Napkin%20Manufacturing.%20Production%20of%20Disposable%20Sanitary%20Pad%20for%20Girls%20and%20Women.%20-163779-.pdf
- (25) NIIR Project Consultancy Services. Sanitary Napkin (Low Investment Project). India. https://www.entrepreneurindia.co/project-and-profile-details/SANITARY%20NAPKIN%20(LOW%20INVESTMENT%20PROJECT)
- (26) World Bank database, 2020.
- (27) Zheng, L. (2019). 'Human Capital Development: A Look at the Impacts of Adolescent Fertility and Urbanization on Education Attainment', The Park Place Economist, vol. 27. https://digitalcommons.iwu.edu/parkplace/vol27/iss1/21
- (28) Guttmacher Institute (2018). First Study on the Incidence of Abortion Among Ugandan Adolescents. https://www.guttmacher.org/news-release/2018/first-study-incidence-abortion-among-ugandan-adolescents-released#
- (29) Reach A Hand Uganda (2017). Action Time: Menstrual Hygiene Management in Uganda. https://www.girlsglobe.org/2018/06/12/action-time-menstrual-hygiene-management-in-uganda/?doing_wp_cron=1608640421.7394230365753173828125
- (30) Momodu, S. (2018). Uganda stands out in refugees hospitality. United Nations. https://www.un.org/africarenewal/magazine/december-2018-march-2019/uganda-stands-out-refugees-hospitality#:~:text=Though%20poor%2C%20Uganda%20is%20the,hosting%20countries%20on%20the%20continent.
- (31) Järvinen, P. (2018). Sustainable menstrual health solutions for women in Uganda. United Nations Development Programme. https://impakter.com/sustainable-menstrual-health-solutions-women-uganda/
- (32) United Nations High Commissioner for Refugees (2020). Uganda - Refugee Statistics November 2020. https://data2.unhcr.org/en/documents/details/83563
- (33) Birkwood, S. (2018). Tackling Uganda’s period poverty one sanitary pad at a time. Women Across Frontiers. https://wafmag.org/2018/10/tackling-ugandas-period-poverty-one-sanitary-pad-at-a-time/
- (34) Ministry of Education, Science, Technology and Sports (2015). Menstrual Hygiene Management Charter – Uganda 2015. https://www.ircwash.org/sites/default/files/menstrual_hygiene_management_charter_finalised_april_2015_1_.pdf
- (35) The Independent (2020). Committee approves tax exemption on sanitary pad raw materials. April. https://www.independent.co.ug/committee-approves-tax-exemption-on-sanitary-pad-raw-materials/
- (36) Uganda National Bureau of Standards (2017). Reusable sanitary towels — Specification. https://members.wto.org/crnattachments/2017/TBT/UGA/17_3724_00_e.pdf
- (37) Uganda National Bureau of Standards (2017). Disposable adult absorbent (incontinence) products — Specifications. https://ec.europa.eu/growth/tools-databases/tbt/en/search/?tbtaction=search.detail&Country_ID=UGA&num=723&dspLang=en&basdatedeb=03/08/2017&basdatefin=24/08/2017&baspays=&basnotifnum=&basnotifnum2=&bastypepays=ANY&baskeywords=
- (38) UNDP/PwC private sector interviews, 2021.