In a cramped corner shop tucked in middle of the Ethiopian capital, Mahder Alebacchew scans the shelves with a familiar sense of dread. The 21-year-old university student has watched the price of sanitary pads climb each month—like clockwork, but without mercy.
“Last year, I could buy a decent pack for 50 birr,” Mahder said. “Now, even the cheap, uncomfortable ones—the kind that feel like cardboard—cost between 70 and 90. The good ones? 120 birr, sometimes even more. Every month, I’m forced to choose between making photocopies of my course materials and preserving my dignity.”
Across Ethiopia, from urban neighbourhoods in Addis Ababa to displacement camps in conflict-ravaged Tigray and Amhara, menstruation is becoming a crisis in its own right. Soaring inflation, supply chain disruptions, and the burden of conflict have turned what should be a basic right into a recurring hardship for millions of women and girls.
What many find most confounding: the state still treats sanitary pads as non-essential goods—taxed like luxuries rather than the necessities they are.
A Silent Emergency
For decades, middle-income women in cities like Addis Ababa had relatively reliable access to menstrual hygiene products. But over the past two years, a steady economic decline has changed that. Today, shelves are thinning, prices are climbing, and choices are narrowing.
“We used to stock imported pads with a small margin,” says Bethlehem Melkamu, a pharmacist in the city’s bustling kirkos sub city. “Now, even local products are becoming too expensive—they rely on imported raw materials. When costs go up, the pads sit on the shelves for months.
According to Bethlehem, customers are even opting out of buying the lower-priced ones as most women are increasingly going to their neighbourhood shop because the retail prices are lower.
The problem, she said, isn’t just shrinking sales—it’s shrinking autonomy. “The worst part is watching women lose their choices, bit by bit.”
The causes of the crisis are many: persistent foreign exchange shortages, ballooning import costs, disrupted domestic manufacturing, and shipping delays linked to Red Sea tensions. Together, they’ve made sanitary pads both scarcer and more expensive.
Disproportionate Pain
While women in cities are forced to make uncomfortable trade-offs, those in rural areas and displacement camps face starker consequences. In shelters for internally displaced people, where even food and clean water are scarce, menstrual products are a luxury few can afford.
A public health expert who spoke on condition of anonymity says that for displaced women, it’s not a matter of inconvenience—it’s about survival. Many resort to using rags or other unsafe materials.
The impact goes far beyond hygiene. “There’s a direct link between access to menstrual products and school attendance,” the expert added. “Girls miss class, fall behind, or drop out entirely. This isn’t just about health—it’s about dignity.”
‘A Cycle of Risk’
In Tigray, the situation is even more dire. Thousands of internally displaced women live in makeshift shelters, cut off from clean water, sanitation, or basic menstrual hygiene products. Among them are survivors of sexual violence—women with untreated injuries, some experiencing chronic leaks of bodily fluids, a result of brutal assaults endured during the conflict.
Humanitarian access to the region remains severely limited. What little aid arrives is stretched thin, often prioritizing food and medicine over less visible needs.
“In Shire Endaselassie and Mekelle, we’ve met women using scraps of old cloth,” said a local NGO worker who requested anonymity due to the political sensitivity surrounding aid operations. “These are not just displaced people. Many are survivors of war—and of sexual violence. Yet, they’re forced to manage menstruation in humiliating, undignified ways.”
The distribution of menstrual kits has largely fallen to a few overstretched NGOs, operating under logistical strain and financial constraint. “Donors understandably prioritize nutrition and medication,” the NGO worker added, “but this neglect has quietly triggered a health emergency no one’s talking about.”
Berhan, a 35-year-old mother of two who fled Western Tigray, now lives in a crowded shelter in Shire Endaselassie. She hasn’t used a sanitary pad in over a year. “We share water with dozens of people. Privacy is nonexistent, and planning a valued possession,” she said. “When my period comes, I just pray it ends quickly.”
In Ethiopia’s Amhara region, where clashes between federal forces and local militias have displaced hundreds of thousands since mid-2023, menstrual hygiene is rapidly becoming an afterthought.
Local health posts in many towns have closed or are operating with minimal supplies. With market routes disrupted, even where sanitary pads are available, prices have tripled compared to pre-conflict levels.
The crisis has a gendered shadow. A December 2024 humanitarian report by ReliefWeb paints a stark picture: between July 2023 and October 2024, the Amhara Public Health Institute documented 1,681 survivors of sexual violence—1,645 women and 36 men—across just 32 health facilities.
Nearly half—47 percent—of those survivors were under the age of 18.
But the report warns the true scale is likely far worse. These figures, it notes, only reflect a fraction of facilities. Underreporting due to stigma, fear of retaliation, and access challenges remains widespread. The absence of a formal Gender-Based Violence Information Management System (GBVIMS) further obscures the scope of the crisis.
Despite the escalating need, humanitarian response has been insufficient. As of late 2024, only 30 percent of the USD 35 million requested for gender-based violence response had been funded. ReliefWeb warned that an additional USD five million is urgently needed to keep service centers operational in the region’s hardest-hit zones, especially in western Amhara.
And yet, for women and girls, there’s another silent hurdle: sanitary pads.
“Rural women don’t just face high prices—they face silence,” said Selamawit Abebaw, a nurse in the Amhara region. “No one talks about periods. But every woman and girl must live with them.”
Selamawit has seen girls routinely miss five to six days of school each month, simply because they lack menstrual products. In communities where reproductive health is still shrouded in taboo—and where female genital mutilation remains practiced—periods can become an added source of shame and isolation.
“We teach girls how to make reusable pads from cloth,” she said. “But then the next question is—where do they find clean water to wash them safely? It’s a cycle of risk.”
Taxed Like Perfume
Amid rising inflation, conflict, and displacement, Ethiopian women and girls are facing yet another obstacle: taxation. Despite the scale of the issue, Ethiopia continues to classify sanitary pads as luxury items in its import tariff schedule. Advocates say it’s a glaring policy failure—and a reflection of how women’s needs are often sidelined in economic planning.
While countries like Kenya and Rwanda have removed taxes on menstrual hygiene products to address period poverty, Ethiopia continues to impose value-added tax (VAT), customs duties, and other levies on imported sanitary pads. Pads and tampons are still subject to a 15 percent VAT—even after the government scrapped a 10 percent surtax and lowered import duties to 15 percent in 2022. A Ministry of Finance directive issued in June 2023, which provided VAT holidays on essential goods, did not include menstrual products.
“This is a glaring contradiction,” said a women’s rights lawyer based in Addis Ababa. “On one hand, the government claims to champion gender equality. On the other, it taxes pads like they’re indulgences, not necessities.”
Efforts to push for tax reform have grown louder. In 2023, a coalition of women’s rights groups submitted a petition to the Ministry of Finance, urging the removal of VAT on menstrual products. The government’s response? Silence.
In the absence of political will, advocacy organizations like AIDS Healthcare Foundation (AHF)-Ethiopia have taken up the charge. At a Menstrual Hygiene Day event in Addis Ababa last week, AHF renewed its demand for tax-free sanitary products, stressing that menstruation is not a luxury—and managing it shouldn’t be either.
“Access to safe, affordable menstrual hygiene products must be recognized as a right,” said an AHF campaigner at the event. “Not a privilege reserved for the middle class.”
The call is part of a broader campaign to eliminate period poverty—which includes not just lack of products, but also lack of sanitation infrastructure and education.
Local Solutions, Structural Challenges
Some local manufacturers have attempted to fill the gap, branding themselves as affordable, Ethiopian-made alternatives. But these producers still rely on imported materials—pulp, adhesives, and packaging—which makes it hard to keep prices down.
Social enterprises experimenting with reusable or biodegradable pads also face roadblocks. In rural areas, water scarcity and stigma continue to hinder adoption. “You can’t ask a girl to wash and reuse a cloth pad if she doesn’t even have access to clean water,” said Selamawit. “It becomes a cycle of exclusion.”
The deeper issue, experts say, is political apathy.
“Menstrual health isn’t seen as a policy priority—it’s viewed as a private problem,” said the Addis-based lawyer. “But it’s not. It’s a public health issue, an economic issue, a rights issue.”
For too long, menstruation has been dismissed as a niche concern, observers say.
“Menstrual health is not just about pads,” said Selamawit. “It’s about equity, access, and recognition. It’s about saying that women’s health matters—not just on some ceremonial Women’s Day, but every day.”
In a country already stretched thin by war and economic hardship, the cost of a menstrual product may seem minor. But for Mahder and Berhan, for girls missing school, it is the difference between dignity and degradation.
Until Ethiopia’s policies reflect the lived realities of half its population, menstruation will continue to be taxed—not just economically, but socially and emotionally.
