When Women Lead: Building Inclusive Markets for Sanitation and Menstrual Health

Across the world, millions of women and girls still face daily challenges in accessing safe sanitation and managing their menstrual health with dignity. These challenges extend beyond health, determining who is able to stay in school, maintain employment, and participate or lead in their communities.

At the Sanitation and Hygiene Fund (SHF), we believe this can change. We are working to build systems and markets that don’t just reach people, but remove barriers so women, girls, and other marginalized groups can live healthier, safer, and more dignified lives.

Achieving safely managed sanitation and menstrual health does not just mean households building toilets or distributing products. It means transforming the systems that determine who has access, who makes decisions, and who benefits. Across low- and middle-income countries, 3.4 billion people still lack safely managed sanitation, and more than 613 million women and girls rely on improvised materials like rags or paper to manage their periods. SHF’s Gender Equality and Social Inclusion (GESI) vision goes beyond programmatic approaches, it aims to reshape how sanitation and menstrual health markets work so that they are inclusive, fair, and driven by local innovation. Market-based approaches can unlock lasting change by cultivating entrepreneurship, fostering innovation, and creating local jobs. This can only happen when markets are deliberately designed to include women who are too often left behind.

Both of SHF’s core areas—Next Generation Sanitation (NGS) and Capital M for menstrual health—embed GESI as a driver of innovation and impact.

• NGS supports countries to develop sanitation as a market that generates value, jobs, and equity. By strengthening local enterprises and non-sewered systems, NGS helps extend access to underserved areas while creating economic opportunity—particularly for women.
• Capital M reframes menstrual health not as a product gap but as a systemic market failure. The menstrual health market is worth USD 28 billion annually, yet hundreds of millions remain excluded. Building inclusive markets—through policies, standards, and investment that prioritise women-led enterprises—can unlock both dignity and economic growth.

This approach recognizes that inclusive markets don’t just deliver better outcomes—they build resilience. When women shape the design, financing, and delivery of sanitation and menstrual health services, those systems become more innovative, responsive, and accountable.

When women are supported to lead, entire systems start to shift. But transformation also depends on the policies and norms that shape how societies function. 

That’s why SHF works with partners to support gender-responsive policies, promote equity targets in public–private partnerships, and strengthen the leadership of women’s organizations across the sanitation and menstrual health sectors. It also means addressing the structural barriers that limit women’s participation—from access to finance and data to workplace safety and representation.

Making sanitation and menstrual health markets  inclusive is not the job of one actor. It’s a collective responsibility.

• Governments must integrate gender and inclusion in national WASH and climate strategies, budgets, investment cases and monitoring frameworks.
• Investors and development partners should ensure financing criteria and reporting reflect GESI outcomes, not just infrastructure delivery.
• Enterprises can lead by embedding fair employment, equitable pay, and safety for women across value chains.
• Civil society and social movements play a critical role in keeping accountability and lived experience at the forefront of system reform.

Inclusion cannot be an afterthought—it must be a design principle for every decision and every dollar invested.

At SHF, we know that inclusive markets don’t just deliver better products and services—they deliver opportunity, dignity, and power. When women lead, markets grow stronger. When marginalised voices are heard, solutions last. Through our new strategy, we’re helping to build a future where everyone can access safe sanitation and menstrual health with dignity—and where equality isn’t a distant goal, but a lived reality for all.

Dietske Simons and Leisa Christine Gibson

Dietske Simons is the Head of Impact at SHF. A leader in sustainable finance and impact management, she leverages her extensive background in development finance and international banking to drive strategy for climate-resilient and gender-inclusive growth.

Leisa Christine Gibson is a gender and inclusion specialist focused on embedding Gender Equality and Social Inclusion (GESI) into strategies, policies, and operations. She supported SHF in developing its GESI framework.