Menstrual health access does not exist in isolation. It is shaped by the communities, environments, and relationships within which people live their everyday lives. Understanding how communities experience access — and where systems fall short — is essential to improving them.
The Middflow Project engages with communities not as beneficiaries of programmes, but as participants in understanding. Community knowledge, lived experience, and everyday observation are central to how Middflow approaches the challenge of menstrual health access.
Currently active in Gauteng and KwaZulu-Natal — with a focus on understanding access across diverse community environments.
National policies and large-scale programmes are important. But the daily experience of menstrual health access is fundamentally local. It is shaped by the clinic at the end of the street, the school in the neighbourhood, the workplace across town, and the community organisations that exist in between.
When communities are equipped with information, when conversation about menstrual health becomes ordinary, and when local institutions are supported to maintain consistent access — systems improve. The Middflow Project works to contribute to this at the community level.
Supporting open conversation about menstrual health as an ordinary public health topic.
Understanding how access works — and fails — in real community environments across South Africa.
Working alongside community members, organisations, and institutions to strengthen local systems.
Menstrual health does not occur only in clinics or classrooms. It is experienced across the full range of environments where people live, work, study, travel, and gather. The Middflow Project examines access across all of these spaces — because designing for continuity means designing for everyday life.
Where access often begins — but too frequently ends at graduation.
Public health infrastructure that should be a consistent access point.
Where continuity of access often breaks — and where policy can make a difference.
Markets, community halls, transport nodes — everyday spaces that shape everyday access.
Where access is most private — and where economic pressure is most directly felt.
Transit environments where access needs are real but rarely accounted for.
Facilitated dialogue sessions that create space for communities to discuss menstrual health openly — building awareness, reducing stigma, and surfacing the everyday realities that shape access.
Working with schools to understand how menstrual health access functions within educational environments — and exploring how schools can serve as consistent, reliable access points beyond awareness campaigns alone.
On-the-ground observation of how menstrual health access functions across different community environments — gathering qualitative insights that inform the Middflow Model and contribute to the broader evidence base.
Events that bring communities together to support the Middflow Project’s work — raising funds while creating opportunities for engagement, conversation, and shared ownership of the menstrual health agenda.
“These are not rare experiences.
They are everyday realities that often remain invisible in public conversations.”
Whether you are an individual, a community organisation, a school, or a business — there are meaningful ways to support and participate in the Middflow Project’s community engagement work.
Beyond the conversation · Lived experiences
Menstrual health is not experienced in the same way by everyone. For some, the challenge is the cost of menstrual products. For others, it is pain, heavy bleeding, limited access or the circumstances that make managing a period difficult.
These stories reflect experiences shared with The Middflow Project. They bring attention to realities that are often left out of conversations about menstrual health, access and dignity.
When buying menstrual products means having less money for food at home.
When menstrual pain and heavy bleeding make ordinary daily activities difficult.
When getting menstrual products depends on asking someone for permission.
Heavy menstrual bleeding, severe iron depletion and a late fibroid diagnosis.
When the need for menstrual products becomes entangled with financial control and violence.
Names are pseudonyms. These accounts are presented with respect for the individuals concerned and should only be published with appropriate consent and safeguarding review.
These experiences are part of a bigger conversation.
Understanding menstrual health means looking beyond products alone — at access, information, health, affordability and the environments in which people live.
Support the menstrual health appealThe Middflow Project · Community
Different names. Different lives. Different realities. One shared question: what would meaningful menstrual-health access look like in your world?
We are building towards practical solutions. But before we talk about what we are building, we want to keep sight of the people it is intended to serve.
Meet the possibilities
Tap a name. Meet a perspective. These characters are starting points for exploring the different realities that good design needs to consider.
The next chapter is calling.
Open her perspective +The friend who knows.
Open her perspective +Every rand has a job.
Open her perspective +“I know someone.”
Open her perspective +“But what about…?”
Open her perspective +One solution won’t fit everyone.
Open her perspective +Life does not pause.
Open her perspective +What could work better?
Open her perspective +Your perspective belongs here.
Explore the project +These are illustrative characters and perspectives, not testimonials from real individuals. They are intended to prompt reflection, not to speak for everyone.
A question for all of us
Sometimes the answer is a product. Sometimes it is information, suitable facilities, affordability, choice or a system that remembers to restock. Often, it is more than one thing.
From purpose to practice
The Purple Flow Box is a concept under development by The Middflow Project. We are working towards a prototype and bringing together the ideas, skills, resources and partnerships needed to move the work forward.
The human possibility is why. Thoughtful design is how we intend to begin responding.
Explore the Purple Flow Box → Explore The Middflow ProjectFor Karabo. For Thando. For all of us.
The Middflow Project · Equity by Design.
