Mpigi, Uganda — Maria Nantubwe cuts through layers of banana leaves. She splits the fleshy material, and beats two-foot long pieces with an improvised bat. Pulp flies everywhere, exposing long fibers inside the stem.

Once dried, these fibers will become the absorbent center of sanitary-pads used by 40,000 Ugandan women each month.

These pads could be a solution for more of Africa’s female population, helping keep women at work and girls at school during their periods while protecting them from sexual violence and prostitution. Because they are manufactured from local materials by women and sold by women, the pads are helping remedy a public health issue that affects millions in Africa and giving women high earning jobs.

In fact, market research estimates that sanitary pads in Africa could grow to nearly a $780 million market by 2022.

The need is vast. About 1.7 billion women and girls worldwide need feminine hygiene products and 350 million likely face challenges obtaining them. Many of these girls miss school regularly because they don’t have sanitary napkins. Similarly, working women don’t go to work and lose wages during their periods.

One study on menstruation found that 50% of school-age girls in seven Ugandan districts were missing school during their periods. In Kenya, 65% of women and girls cannot afford to buy pads, which forces them to skip school. The situation fosters low self esteem and other problems, experts say.

“If you are sitting on a pile of leaves [for lack of a pad] how can you believe you have as much to contribute to your community and that your voice counts?” asks Celeste Mergens, the founder of Days for Girls, a non-profit started in 2008 that supplies pads to women and girls throughout Africa.

Mergens is part of a growing global community of nonprofits and social enterprises, including Afri-pads, Bana and Sustainable Health Enterprises, working to get feminine hygiene products to women in Africa.

Sustainable Health Enterprises — known as SHE — produces pads from banana tree fibers. Founded in 2008 by American MIT student Elizabeth Scharpf, the startup sold 227,000 pads to 11,150 girls in 2016. In addition, SHE provided menstrual hygiene education to 1,500 school girls. In an effort to create jobs in local communities, the company uses small production facilities near where the pads are needed and sold.

I visited Uganda’s Bana, another sanitary pad startup that uses banana tree fibers, and met with Mergens to understand how the company is providing a much-needed product to women and redefining distribution models by helping African women become micro-entrepreneurs.

These ladies are more than just saleswomen, though; they’re also activists, forcing local populations to tackle a hush-hush topic in society — female menstruation.

“This is a need that is keeping girls from school and women from work, creating isolation, indignity, exploitation and lost opportunity, not only for women and girls but for entire communities all over the world. Simple things matter,” says Mergens.

While the emphasis has been on getting pads to girls to keep them in school, and women at work, Mergens has learned that menstrual hygiene is not just a sanitation problem but also a safety issue. Some girls who were having difficulty accessing feminine hygiene products were also being sexually exploited, she says. A 2015 study of 3000 Kenyan women, revealed that one in ten 15-year-old girls were prostituting themselves for money to buy pads.

For instance, Beatrice Andayi who lives in Nairobi, Kenya, said she had regularly prostituted herself to buy feminine hygiene products so she could finish school. Her plans were foiled by a teen pregnancy. Now 24, she is working to finish high school with the help of a sister who cares for her child, and becoming involved in Days For Girls programs as well as using their products.

Providing affordable access to pads is playing a role in protecting young women from gender-based violence. The female-to-female menstrual education taking place in villages is helping demystify menstruation and restoring dignity, Mergens says. “It helps women feel more proud and dignified about their bodies.”

At a 10,000 square foot manufacturing facility in Mpigi, Uganda, banana fibers are processed, whitened, formed, wrapped and packaged into consumer-ready pads, which are completely biodegradable.

A small army of women work the supply chain from start to finish: 300 women work in cooperatives to supply the banana fibers. A dozen women work in the production facility, packaging pads. An additional 184 women sell the products on consignment, earning the equivalent of about $30 a month.

School girls (and girls who have dropped out) are also incorporated into the model, says Bbaale. About 200 school girls are assembled into clubs where they receive a startup kit that includes Bana products accompanied by six months of vocational training. The program is designed to complement their education.

Bana Pads look just like the feminine pads sold in stores around the world. The pads are more affordable due to the low cost of materials and distribution. Photo Credit: Devin Thorpe

Bana currently produces and sells 40,000 ten-packs of pads per month to women in Uganda. Not only are Ugandan women employed through the production and sourcing of raw materials, they also sell the products through an Avon-like distribution model. The sales process provides customers with meaningful education on menstruation.

A box of ten pads sells for about $1.80 and Naluyage keeps 30 percent as a commission. One of the first distributors who signed on with Bana six years ago, she has built a network of sub-agents with whom she splits commissions.

Fausta Cibe, another distributor in Mpigi, is a mother of six who works like Naluyage, selling pads directly to customers and to women who resell them, working as agents who help her increase her volume.

Asked how the business changed her life, she says with a cheeky grin, “I feed [my family] well and I look beautiful, as you can see.”

Fausta Cibe, Bana distributor. Photo Credit: Devin Thorpe

In contrast to the disposable approach used for pads by Bana and SHE, Days for Girls, based in Washington state and operating in over 100 countries in the developing world, provides reusable pads to schoolgirls.

Founder Celeste Mergens says the original handsewn pads made of cotton were white and girls hated them. Now, 28 versions later, the pads are of brightly colored cotton. The fabric slips into a plastic shield that cleans up easily and dries quickly. The changes came from listening carefully to women, she emphasizes.

Days for Girls operates two models. Some pads are sewn by volunteers in the U.S. and shipped to low-resource communities and refugee camps in countries including Kenya, Uganda and Rwanda. The second model is similar to Bana’s, in which women and girls who are post high-school age are trained to produce the pads and act as entrepreneurs, selling them to their neighbors. Prices vary from $1.50 to $9.00 per kit, which can include two plastic shields, eight cotton pads, a washcloth, two pair of underwear, a small bar of soap and a plastic bag the girls can use to carry a used pad home for cleaning.

In a school in Uganda, almost 50% of the female student population reported missing school due to menstruation, Mergens says. Two years after the Days for Girls started work in the area, that number ​was down to just 4%, she says.

Patricea Ayumah was a college student in Nairobi when she was introduced to Days for Girls. She regularly missed school due to a lack of sanitary pads. After receiving the pads from Days for Girls, she started attending more regularly. Now, she works as a volunteer mentor for Days for Girls, helping girls 12 to 19 learn about menstruation and providing them the kits they need to stay in school and avoid sexual exploitation.

“I love Days for Girls because now I’m able to do my things even when I’m on my mensuration,” she says.