The SOS (Sanitary/period product box On Site) box toolkit

A guide for how to a feasible, sustainable and effective period product provision

scheme for unexpected or financial needs can be designed and introduced 

For period parity champions: healthcare workers, leaders and employers

From small to large scale

General considerations

There are a number of considerations when establishing a local or wider SOS box-like initiative.

The information shared below is designed to make the already infinitely possible box adoption process even more streamlined, whilst allowing you to tailor this to the needs of your community. As no community is quite the same.

You are warmly welcomed to please feedback your experiences and any outstanding questions you have after reading the information below.

  1. Materials: the box

  2. Logistics: siting (installing) the box

  3. The impact: monitoring, evaluating and refining

  4. Sustaining: funding, employer adoption

Materials: the box

The ingredients

Depending on your local needs, a box can consist of:

  • 4.5 - 8 litre water/airtight, wipe clean box

  • 1-2 boxes each of: regular, super +/- super plus applicator tampons (can be a mix of applicator and non-applicator, ideally plastic free)

  • 1 packet each of: medium (non-winged) and heavy flow winged sanitary towels (ideally plastic free)

  • 1 packet of panty liners (ideally plastic free)

  • Consider including (even as a trial) 2-4 reusable products: period/menstrual cups, washable pads

  • Consider including two or more foecal incontinence pads with a pack of urinary incontinence pads

  • Biodegradable disposal bags if no period product disposal bins at site

  • Laminated explainer sheet of initiative and ‘how to use’ instructions fixed to inside of box (see below)

  • SOS box name, contact details or process for restocking outlined on laminated sheet attached to top of box

  • Optional laminated sheet attached to box with evidence-based ‘womens’ health initiatives: reminder of cervical, ovarian or breast cancer awareness, support services for domestic abuse or workplace sexual harassment

Raising awareness

You can raise awareness via a variety of ways:

  • Advertise using simple posters placed in staff rest areas, toilets, via email (create a bespoke email account)

  • Don’t forget your Emergency Department colleagues!  They may be unable to leave the department whilst on shift. Create a box for their toilets/changing rooms/rest room

  • Don’t forget others who may not identify as women with periods/who menstruate

  • Highlight scheme during staff inductions, team-working days and on any organisational intranet

  • Create a concise ‘explainer’ email and ask your organisational leads for permission to circulate around staff at regular intervals

  • Create advertising material for use on any workplace messaging groups such as Teams or WhatsApp groups

  • Encourage your department leads or overall employers to adopt, or sponsor via any organisational wellbeing or staff development fund. Or temporarily trial a ‘use one, donate one if possible’ approach (for a limited time before gaining employer adoption and sponsorship)

Examples of past box posters/liners and wall posters advertising the SOS box presence, and how to use

Style, phrasing and exact instructions can be adapted for your locality

As you can see, the materials do not require a high level of technical or artistic skill, although these can definitely be harnessed for the project

Posters and liners were laminated to align with infection, prevention and control purposes

Siting SOS boxes (location and introduction)

If initially setting up yourself as an individual healthcare worker, or team of healthcare workers: firstly, thank you for your generosity. As occurred with the original SOS box project, this can lead to employer-wide (Trust, Health Board or organisation) adoption with time (sometimes a relatively short period).

Below are some points to consider when planning a SOS box project

It is usually best to involve those who manage the healthcare workplace area where you are aiming to introduce the SOS-type boxes. Depending on your locality:

  • Permission is either essential or helpful to ensure the boxes remain in place (and aren’t removed, for example, due to uncertainty about governance). Try clinical directors, site managers or GP partners

  • Where relevant also gain permission to install in ‘male’ toilets, especially if unisex/gender neutral toilets aren’t available

  • Liaise with Infection Prevention and Control (or equivalent) regarding specific requirements for the boxes and where they can be placed

  • Discuss with facilities, site managers or equivalent regarding specific requirements for box installation and if their teams can be involved (if applicable). For example, in some locations, boxes needed to be fixed on walls. They therefore may need to be within modified containers that do not prominently jut out from a wall at eye level especially where the room has a small turning space (to avoid injuries).

  • Consider where healthcare workers would prefer having the SOS-type boxes/resource: close to clinical workplaces, in toilets or a staff room has usually been requested in the past. Why not canvas the preferences of colleagues directly?

  • What scale do you plan on introducing at? What is realistic and feasible with the resources you have?

  • How many boxes do you need? What quantity of period products will you need at the initial outlay based on the ‘ingredients’ list above? How will you monitor the boxes and know when to replenish or if a box would benefit from being moved location-wise? Can those involved access all these areas (security passes, drivable to etc)? In past pilots, the initial maintenance and restocking has been conducted by the founder, or if at a distant site where security access was unobtainable, other peer period parity champions working at these locations aided using stock provided by the founder. For organisation-based adoption, the facilities departments have been invaluable in securing their domestic/cleaning staff are able to restock.

  • How do you plan on financing and resourcing replenishment? Does your department or organisation have a staff wellbeing fund or grants you can apply for? Is there a wider benevolent fund regionally or nationally? Can you apply to regional or national offices? Can you acquire charitable resources (Hey Girls currently offers support)? If not, can you/your colleagues self-fund a pilot (please do not feel obliged or coerced to do so, everyone’s financial situation is different and it is a challenging time for healthcare workers in this context. Interestingly, past experiences show that NHS procurement services can be far more expensive than ‘off the shelf’ bought supplies (see images below).

  • How will you get more of your community involved? Start discussing, inviting input via the SOS-box posters, raise awareness and invite via email, staff intranet, group messaging services and more.

  • Additionally, by involving other, senior staff members, awareness of the initiative will grow.

The impact: monitoring, evaluating and refining

Following the impact of your SOS box (or SOS-like) project, potentially really important aspects of this then is the monitoring, evaluating and refining of your period product provision initiative. No-one will introduce a service that will perfectly match the needs of your colleagues and that is in line with employer-based governance processes such that they can support continuance initially. However, it doesn’t need to be fully optimised for your colleagues to benefit and learning how to best adapt to the environment can be a really interesting process.

Involving your colleagues in feeding back can also get them more involved in the concept and advocacy in terms of spread and long-term employer-based adoption.

Impact can be measured in multiple different ways:

The human impact

You could gather:

  • Impact on the users of the initiative (or potential users) - running a pre-introduction census can be useful, then comparing with post introduction experiences.

  • Perspectives of those who will not use the box (people without periods/menstruating), some (often higher level) managers: to assess any cultural or other concerns, challenges, support and allyship that need to be addressed

  • Perspectives of those involved in installation and maintenance (including facilities staff)

  • Patients or wider community and their perspective on healthcare being supported in this way

  • Canvassing-based information be in the form of one or serial questionnaires (noting any ethics, governance and data protection requirements in your area), focus groups, individual interviews or case studies. One informal but powerful approach used in the past was to leave a notepad with a pen within boxes to allow users of the box to write contemporaneous feedback. This could be converted to an online (anonymous, if desired) notepad.

  • A combination of quantitative and qualitative data has proven to be most successful in demonstrating effect, with qualitative data being notably powerful - don’t underestimate the potency of the human experience and story telling in this context!

The financial impact

This can be very useful - if not essential - for demonstrating the feasibility of your period product provision initiative, especially to those who would be responsible for deciding whether organisation-wide adoption and funding would be possible.

The financial impact cost could include:

  • The expense of start up per box: boxes, initial period product supplies, printing and laminating costs, any installation equipment

  • Costs associated with maintenance of the boxes. This will usually relate to replenishment of period products and occasionally alterations to the storage container or box (e.g. damage). Costs could be calculated through weekly recording, monthly or another time period that provides sufficient detail of impact but fits in with the project leaders’ commitments. Depending on your preference, recording time points or how the box is used, you could count the number of period products used (usually by type and absorbency is useful for later scaling of the initiative) e.g. by week, or record every time a pack is completely used.

  • The last point dovetails in with recording of usage, this helps demonstrate that the resource is useful, accessible, is being used and is not being used in an unmanageable way (as some canvassed in the past have raised concerns). It also allows for forward planning - through being able to project need for supplies, this can help with short-term maintenance but also with employer-based consideration regarding possible wider adoption and sustainability.

Sustaining your SOS box-like/period product provision initiative

Even if you don’t before, once you set up your project you should see the truly compelling impact and feasibility of your SOS box/period product provision initiative - possibly with surprising or new-to-you ways facets to the need and impact. You will also very likely see how much the initiative is needed long-term in the location or locations you’ve been running this in, and more widely.

Sustainability of the project can be challenging for a variety of reasons: funding, founders/leaders moving placement, location, going on leave, having time between workdays for the project or having a variable shift pattern. In practice, the SOS box founder found that many of these logistical issues which might seem otherwise sizeable were, in actuality, relatively small for them or had a feasible solution.

Below are some reflections and learning points from introduction of SOS boxes from the founder to aid your own plans:

  • Involving others in the maintenance of the project, for example, near peers or senior leaders within departments or the organisation. Furthermore, securing facilities/domestic services support can be a far more guaranteed and wider scale option.

  •  Creating a local community of period parity champions supporting the project and wider change can be helpful for sustainability of the project but also any culture change needed (there are other aspects to achieving period parity at work as explored such as easy access to unscheduled toilet breaks, comfortable, dark coloured work uniforms and period/menstrual leave.

  •  Gaining financial and/or logistical support for the project regarding period product supply costs and acquisition.

  •  If you do reach out for donations from individuals or the wider community, be they monetary or actual period product supplies, please ensure you keep a clear, detailed record of their use, following local or national laws and any professional regulations regarding donations. Try to avoid any behaviour that might appear to be coercive and feedback to any donators with thanks regarding their impact and the success of the project if you can.

  • Having the impact data is extremely useful, especially when presenting this to key decision makers .

  • Use of evidence-based lobbying letters (as used in the original SOS box projects) to organisational chief executives and local MPs can be helpful to secure powerful supporters. Don’t forget the wider benefits your project will be having on productivity, presenteeism, innovative practice and healthcare worker health promotion - including if you are sharing information about womens’ health issues.

  • Contacting local healthcare and wider press about your initiative and the impact can also be helpful.

  • Reviewing the patterns of period product usage from boxes per se, and by location can be helpful to adapt what is contained to meet the needs of colleagues within the locality to help with cost and product usage effectiveness.

Receive support and/or share your learning

Have you or are you about to launch an SOS box-like initiative?

Please make contact for further support to help enable, accelerate and smooth your launch.

Share your own learning points from the process thus far with the SOS box initiative - it would be fantastic to further build this supportive resource with your wisdom and experiences.