Naomi has designed a system where women in local communities can improve their livelihoods by developing sustainable solutions to their problems. She has built an industry out of simple, low cost health care solutions to solve some of the most pressing health challenges that women face. Through the design of locally made, reusable and affordable health products for women and girls, she is positioning women to solve their health problems in a more sustainable way
The New Idea
Naomi is increasing reproductive health awareness and retention rates of girls in schools by building community ownership for reproductive health awareness in communities with little to no access to the relevant information, products and services. Contrary to some unsustainable foreign aid approaches, Naomi supports communities to solve this problem on their own, which also has the effect of helping break cultural taboos around discussing these issues.
To keep girls in school during their menstrual period, Naomi has developed an effective, reusable sanitary pad that can be made from locally available materials and is fostering local business around its production and sale. She trains girls to make the pads for themselves with whatever materials are available. And she trains women’s cooperatives to produce a quality version, which is Ministry of Health certified, under a common brand that they then sell locally to generate income for themselves. Women and girls in the community thus have access to affordable sanitary pads as well as a new source of income.
The women who produce the pads are also trained to educate customers on reproductive health information and breaking the culture of silence around this issue. As part of Naomi’s outreach strategy, she also creates peer-groups consisting of young women and girls who are in regions that characteristically lack education on reproductive health or with those who are at-risk and supports them to become leaders, developing work plans and goals for bringing reproductive health awareness to their community.
As a result, she is reversing the school drop-out rate for girls related to reproductive health issues, equipping women with the tools and information to create simple healthcare solutions to their reproductive health challenges, and reducing social stigma and cultural beliefs that prevent women from exercising reproductive rights and managing their reproductive health.
Liberia is a low-income country that relies heavily on foreign assistance and remittances from the diaspora. In the 1990s and early 2000s, civil war and government mismanagement destroyed much of Liberia's economy and the infrastructure to support it. During the 2014-2015 Ebola crisis, the economy declined, and many foreign-owned businesses departed with their capital and expertise. The epidemic forced the government to divert scarce resources to combat the spread of the virus, reducing funds available for needed public investment. The cost of addressing the Ebola epidemic coincided with decreased economic activity, reducing government revenue.
Most hospitals and health care services in Liberia are confined to the capital of Monrovia, with virtually no medical services outside of the city. Of the medical care that is available, it is very basic with a shortage of equipment and adequately trained doctors and healthcare staff. Liberians suffer from high mortality and morbidity, resulting from a combination of poor living conditions and the lack of quality health care and knowledge.
According to UNFPA women of reproductive age constitute approximately 23 percent of Liberia’s 3.5 million population. Many variables put these women at risk. Families consider it a taboo to discuss reproductive health issues, so while the government passes laws that support and affirm the sexual and reproductive health rights of girls and women, these laws often directly contradict accepted cultural practices, and the laws are not enforced. Women and girls are not encouraged to discuss reproductive health issues, there is a culture of silence surrounding reproductive health issues.
Net enrolment rate in primary school is 46% with boys enrolling at 61.41% and girls at 34.12%. However, Liberia’s school dropout rate for students before grade 5 is high, soaring at 65% for boys and 73% for girls. Studies have shown that a prominent factor for female school dropout in Liberia is due to a lack of access to sanitary pads. Oftentimes these girls feel reluctant to continue going to school during their menstrual period. A girl being absent from school due to menstruation can add up to 24 missed weeks of learning.
Liberia is a low-income country that relies heavily on foreign assistance and remittances from the diaspora. In the 1990s and early 2000s, civil war and government mismanagement destroyed much of Liberia's economy, especially infrastructure. During the 2014-2015 Ebola crisis, the economy declined, and many foreign-owned businesses departed with their capital and expertise. The epidemic forced the government to divert scarce resources to combat the spread of the virus, reducing funds available for needed public investment. The cost of addressing the Ebola epidemic coincided with decreased economic activity, reducing government revenue.
Menstruation is one of the most ordinary individual female experiences but, in Africa, the experience often negatively impacts society as a result poor sanitation standard, and the lack of products to cope with menstruation in a healthy manner. Menstruation usually comes as a problem to women and girls thereby contributing to disempowerment and health risks. Overall, affordable and hygienic sanitary protection is not readily available to many women and girls, and those from poor families usually cannot afford to buy sanitary pads. These women resort to using unhygienic rags and cloths, which puts them at the risk of infections. This is a critical factor as it has been proven that higher levels of women's autonomy, education, wages, and labour market participation are associated with improved reproductive health outcome
Naomi is making it possible for women and girls to take control of their reproductive health without waiting for the government or relying on outsider investment and support. To do so she has established a business run by women in the community to manage the production of sanitary pads. Through her model she is enabling women to be active participants in income generating activities, while also producing pads and being multipliers of reproductive health knowledge in the community. Furthermore, she is positioning women and girls as promoters of reproductive health awareness.
To address female school dropout rates due to a lack of access to menstrual hygiene products, Naomi designed a quality, low-cost, locally made and reusable pad. The pads can be washed and reused for a period of one year and are very easy to produce. The pad is made up of affordable and locally sourced synthetic fabric, towel and a snap button. The pads are sold in packs of 6 to last through one menstrual period before washing. They come with a manual that describes how to use them, as well as information on maintenance of the pad. The pads have been certified by the Ministry of Health.
To produce the pads, Naomi works through networks of women’s cooperatives in the region as many of these groups were formed by other NGOs but without a sustained engagement or the tools to develop themselves. With Naomi’s vision and production plan, she can capitalize on already formed groups by giving them a more tangible output and mission. To gain buy-in and support from these groups, Naomi taps into a common feeling and relatable problem that all women share about their menstruation and reproductive help. Through trainings she then enables the women to learn how to make the pads and to become the agents of change in promoting reproductive health information and actively supporting their fellow women in getting the necessary sanitary products needed to engage in everyday activities without the stress of menstruation. Those women who have been trained, train other women in their specific cooperatives, and then they all serve as checks to ensure that the standard of the pads are maintained.
The women are also trained in business management. When ready, the women sign a contract and receive a starter pack of 20 pads to sell to generate revenue to buy the raw materials. The cooperatives are self-sustaining through dues and run by members who have been selected by their peers. The group identifies a leader, a secretary and a treasurer, who also serve as the monitoring team of the cooperative production process. Important in this business model is that revenue is converted into a savings account at which at the end of every year, is split amongst all its members. Along with learning how to produce the pads and understanding the business management side of the process, each women’s group also becomes reproductive health trainers in the community. Every woman in the program becomes an advocate for reproductive health and menstrual hygiene and has the responsibility of sharing reproductive health information to the women who purchase the pads.
Apart from her work with the cooperatives, Naomi also works with groups of girls to lead on reproductive health awareness strategies in their communities. In 2016 she started Live, Lead, learn groups in which she engages teenage mothers who likely have been sexually abused and dropped out of high school, she encourages them to go back to school. Naomi also works with other at-risk girls to form peer support groups, in which each person is engaged and mentored once every week for a period of six months. Within this six-month program, the girls develop and act on a work plan for how they will build reproductive health awareness in the community. The girls run campaigns, engage with community members using their local languages to gain acceptance and trust, create space for girls in the community to talk, and more. When they complete their work plans, the girls join the women’s groups and collaborate with them to continue changing the culture in their communities. The girls also learn to sew their own pads using whatever materials they have available, such as old clothes. This ensures that girls have a completely free option to address their menstrual hygiene needs, if necessary.
Although there are national Non-Governmental Organizations working on reproductive health issues, they are mainly based in Monrovia the capital and are not reaching underserved communities. Naomi partners with the United Nations in Liberia and is airlifted once a month to visit and champion these girls’ groups in hard to reach communities in Liberia.
Presently, she is in 21 communities and has trained 15 girls groups and 300 women in pad production. According to the teachers in the schools where the girls in her program attend, girls’ retention in schools has increased, the women’s income and economic power in the communities where she works has also increased. The taboo of speaking about these issues is also weakening. Other NGOs have already begun to adopt her model working with vulnerable girls in underserved communities.
In the next few years, Naomi intends to spread to communities in all 15 counties of the country and then start training women’s groups in other countries to replicate the model. She is presently working with the Liberian Ministry of Education to put reproductive health education into the school curriculum nationally. She already initiated an agreement with them to create a pilot in 10 schools. Although she is now having to renegotiate that agreement with a new Minister, if the government doesn’t move forward, she intends to work with school nurses and spread a model of reproductive health clubs in schools.
Naomi Tulay Solanke was raised in Liberia. At age 14 she became pregnant She was blamed and shamed and it was expected that she would drop out of school and not be able to achieve her full potential. Naomi decided to prove everyone wrong. She worked very hard to change her trajectory, went through school against all odds and earned a master’s degree.
As a trained nurse Naomi treated people in her community after work. While doing this she realized the gaps in the health sector and to help solve the problem she resigned from her paid job, and assembled a team of medical practitioners to start a mobile community clinic aimed at reaching underserved and hard to reach vulnerable population. The team went to communities to diagnose and treat patients. Naomi’s efforts became forestalled by the Ebola crisis and this made her change her approach to creating awareness about Ebola prevention.
Naomi redesigned the handwashing buckets to enable more people access it during the Ebola crisis. Naomi created prevention kits for underserved communities, when she ran out funds, she decided to organize a fundraiser where she was identified by an organization that partnered with her to start up the Safe school’s program.
The safe schools program was designed to equip adolescents with information on reproductive health, Naomi realized that the girls would drop out and then decided to research the cause of this. She discovered that during menstruation the girls didn’t have sanitary pads, could not afford them and had no information about personal hygiene hence she developed a system where the community takes charge of their health, wellbeing and the education of women and girls by playing active roles in creating locally made, reusable and easy to make health products that provides economic incentives to women, helps girls to remain in schools as well as increase the communities awareness about healthcare management.