Expanding effective contraceptive options: Introducing the Caya Diaphragm in Niger

Download File


In developing countries, 214 million women want to avoid pregnancy but are using no modern method of family planning (FP). Sub-Saharan Africa has the highest proportion of women with an unmet need for modern contraception in the world. (i) Side effects, infrequent sex, breastfeeding, and opposition to use are among the top reasons women cite for non-use of contraception globally. (ii) The introduction of new contraceptive options can address several of these reasons for non-use, giving women more choices as they seek to plan their families in a way that aligns with their needs and preferences.

The Expanding Effective Contraceptive Options (EECO) project, funded by the United States Agency for International Development (USAID), was designed to address women’s method-related reasons for non-use of FP. To this end, EECO introduces new and improved contraceptive methods with varying key benefits: some are non-hormonal, others are long-acting and reversible, and still others are discreet or used only on-demand. Many EECO products are also woman-initiated, helping to overcome provider-related barriers to access like shortages of skilled healthcare professionals and provider bias. These methods expand the range of choices available to women who wish to delay, space, or limit births, giving women more power to fulfill their reproductive intentions in ways that suit their needs and desires at different points in their lives.

WCG Cares (WCG) leads the team, bridging the private sector and non-profit worlds, linking upstream product developers/suppliers and downstream marketing and distribution partners. WCG also leads EECO’s regulatory and quality assurance efforts. Population Services International (PSI), the social marketing and service delivery partner, works through existing healthcare and product distribution networks to market the products in EECO’s portfolio.

EECO collaborates with a variety of market players along the supply chain, from manufacturers to providers and clients, to introduce new and innovative contraceptive methods. In addition, EECO works with a diverse group of stakeholders, such as regulatory bodies, Ministries of Health (MOH), donors, and other implementing agencies, to influence the policy environment around the introduction and potential scale-up of these methods. EECO-supported product introduction takes places in five stages, some of which occur concurrently, as described in Figure 1.