The Middflow Project is a public health infrastructure initiative focused on designing and embedding menstrual health access into everyday systems. We are not a distribution programme or an awareness campaign. We are a systems builder — working to ensure that access is continuous, reliable, and present wherever it is needed. Middflow operates at the intersection of public health, infrastructure, and equity — building solutions that move beyond once-off interventions and into everyday life.
“Equity does not emerge automatically. It must be intentionally designed.”
The Middflow Project began with a simple but unsettling realisation. During a period of economic strain, our founder encountered difficulty accessing menstrual products — despite being educated, previously employed, and socially perceived as middle class.
It was not the financial pressure alone that stood out. It was the response from systems that were expected to provide support. At clinics and institutions, the answer was often the same:
“We don’t have.”
“They stopped supplying them.”
“We used to give them out, but not anymore.”
The systems had changed — and no one had noticed. In some places, menstrual products had once been distributed to patients but had quietly disappeared from supply channels. Standing in those spaces revealed something deeper: access to menstrual care was not only shaped by affordability. It was shaped by systems that had slowly become inconsistent.
That experience raised an uncomfortable question: if access could fail someone who still had relative infrastructure — private sanitation, water, and social visibility — what did that mean for the millions of women navigating similar challenges under far more constrained conditions?
Women supporting households. Grandmothers raising grandchildren. Young people managing menstruation in schools without adequate facilities. For many of them, the question each month is not which product is best — it is what is available. And sometimes, what can be managed this month.
Many organisations have responded to menstrual health challenges through product donations. These efforts are important and often provide immediate relief. But they also reveal a limitation — when support depends on one-time donations or short-term campaigns, access becomes unpredictable.
Some communities receive repeated assistance. Others remain unseen. Products arrive for a moment, then disappear. But menstruation itself does not pause between programmes. It continues every month.
This realisation shaped the direction of The Middflow Project. Rather than focusing only on distribution, the organisation began asking a different question:
How can menstrual health access be designed as a reliable system — one that functions across schools, clinics, communities, and public spaces?
Across a lifetime, many women menstruate for 30 to 40 years. That means managing hundreds of cycles. Access systems should reflect this continuity. The Middflow Project therefore focuses on understanding the infrastructure that supports menstrual health — including distribution networks, sanitation systems, community awareness, institutional policies, and economic realities. When these systems work together, access becomes reliable. When they do not, people are forced to improvise solutions every month.
Before solutions can be designed, the system itself must be understood. Menstrual health access is shaped by many factors working together — product availability, affordability, sanitation infrastructure, school environments, healthcare access, and social norms. The Middflow Project observes how these factors interact in everyday environments to identify where access quietly breaks down.
Menstruation occurs every month. Support systems should reflect that same rhythm. The Middflow Project explores ways to strengthen the pathways through which menstrual health support reaches communities — including distribution models, institutional partnerships, and access across schools, workplaces, and community settings. The aim is not only to provide support in isolated moments, but to contribute to systems that allow access to remain reliable over time.
Menstrual health remains surrounded by silence in many communities. That silence can affect access, confidence, and decision-making. The Middflow Project works to support a more open and informed public conversation about menstrual health — not as a temporary awareness campaign, but as part of a broader effort to make menstrual health an ordinary topic within public health, education, and community life.
Public conversations about menstrual health have grown significantly in recent years. Awareness has increased. Research has expanded. Policy discussions have begun to take shape. These developments matter.
But awareness alone does not guarantee reliable access. That requires systems that function consistently over time. The Middflow Project continues to explore how menstrual health access can be strengthened through better system design, collaboration, and long-term thinking.
The goal is not only to increase awareness. It is to contribute to solutions where menstrual care becomes predictable, accessible, and integrated into everyday public health infrastructure. Not something people must negotiate quietly every month — but something society has designed to work.
The Middflow Project is not a product distributor. It is not a pad drive. There are excellent organisations doing important work in that space — and they complement the government’s own programmes well.
The Middflow Project sits at a different intersection. We work at the nexus of economic impact, public health, SRHR, WASH, and community systems — building the evidence base, the frameworks, and the relationships that make menstrual health access reliable, not just occasional.
We study how menstrual health access functions — and fails — across real environments. Community observation, qualitative research, and systems mapping to identify where the gaps are and why they persist.
Dialogue sessions, awareness conversations, and community events that bring menstrual health into the open — reducing stigma, building awareness, and strengthening the local systems that support access.
Publishing research insights, public health commentary, and systems analysis that advance the conversation about menstrual health as a public health priority — not a charity matter. Monthly insights, weekly articles, and active public engagement.
Building the institutional relationships, corporate partnerships, and policy connections needed to embed menstrual health access into the systems people rely on — workplaces, public health facilities, educational institutions, and community organisations.
Where We Work
The Middflow Project operates at the intersection of economic impact, productivity, public health, SRHR, WASH, and community systems. Menstrual health is not a narrow issue — and the work to address it must not be either.
Who We Serve
The Middflow Project focuses on the women who fall through the gaps of existing support — the forgotten middle. Not those served by school programmes. Not those with full economic agency. The women in between:
✓ Women in formal and informal employment
✓ Women who are unemployed or between work
✓ Post-matric and tertiary students
✓ Caregivers and women in intergenerational households
✓ Women in community and public spaces
✓ Users of public health facilities
“Once out of the school environment, women are simply expected to fend for their menstrual hygiene out of pocket — whether or not they can afford to carry that burden. This expectation is rarely examined. It is the gap the Middflow Project exists to address.”
Currently Active
Gauteng and KwaZulu-Natal — pilot phase. The Middflow Project is building the evidence base and community relationships that will inform national-scale systems work.
