Breaking Barriers
A national SBC initiative to dismantle the silence, shame, and misinformation surrounding menstrual health and hygiene in rural Pakistan, designed across three provinces, three target audiences, and the full socio-ecological model, with a 90% communication effectiveness rate and readiness for national rollout.
SBC Strategy, Co-Creation & National Toolkit Design
White Rice served as UNICEF's SBC strategy and creative partner across the full programme cycle, from a national study and community co-creation workshop in Sindh, through the design of Pakistan's first MHH SBC Toolkit, to the Phase II scale-up across five villages each in Rajanpur (Punjab) and Battagram (KPK). Every element of the programme, conversation guides, storybooks, training materials, monitoring systems, was designed by White Rice with and for the communities it served.
Key Outcomes
of girls.
No knowledge.
The Challenge
Menstrual health and hygiene in rural Pakistan is not simply a product access problem. It is a deeply entrenched social norm problem, one shaped by shame, silence, misinformation, and the complete absence of open dialogue between the people who need to have it most: fathers and daughters, mothers and sons, women and their own bodies.
White Rice and UNICEF's 2021–2022 national study identified four intersecting root causes: socio-cultural norms and behaviours; product affordability; accessibility barriers; and inadequate WASH infrastructure. Any programme that addressed only one of these would fail. And any programme built around information alone, without addressing the relational and normative context in which that information needed to travel, would reach no one.
Phase II added a further layer of complexity: scaling an approach that had worked in Sindh's Khairpur into two entirely new provincial contexts, conservative, patriarchal Rajanpur in Punjab, and the hilly, remote villages of Battagram in KPK. Both had been identified as likely to resist. Both would prove more open than anyone expected.
If I speak to my mother about this, she will kill me.
The Strategy
The strategy was built on three foundational commitments: co-creation with the community before designing anything; a Knowledge-Attitude-Behaviour (KAB) framework that moved participants through a structured arc rather than attempting single-session awareness; and a radical inclusion of fathers as primary programme participants rather than afterthoughts.
Three stages. Three shifts.
One complete behaviour change journey.
- Engage local influencers to on-board and gain community support
- Separate group sessions for mothers, fathers, and girls, using specialised conversation guides for each
- Open the discussion; create the first safe space for the subject to exist publicly
- Meetings held in all five villages per province
- Address individual barriers and challenges in adopting the target behaviour
- Girls' Guide (Sara & Saba story) initiates open conversation through narrative
- Build confidence to speak about MHH and demand products
- Multiple sessions per village; mostly home visits and smaller gatherings
- Validation and conversion: intention to action
- Storytelling to probe deeper on behavioural intentions
- Get pledges and document commitments from participants
- Capture stories from early adopters for peer-led social proof
The conversations that were never supposed to happen.
What we expected to find.
What the community showed us instead.
The Impact
The programme's most significant finding was not a statistic. It was the overturning of every assumption that had made people hesitant to tackle MHH in rural Pakistan in the first place. Fathers spoke. Mothers demanded. Girls asked questions. Religious leaders gave endorsements. The silence broke, and it broke in the most conservative corners of the country.
The path to national impact is now clear. If affordability is addressed, through product subsidies, supply chain improvement, or economic empowerment for women, Pakistan's communities are ready. The programme did not just break a barrier. It proved that the barrier was never as solid as it appeared.
The silence was not consent.
It was design.
And design can be changed.
Breaking Barriers demonstrated that with the right co-creation process, the right messengers, and the right framework, the most entrenched taboos in the most conservative communities are not as immovable as they appear. Pakistan is ready. The toolkit is ready. What comes next is scale.
