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El diafragma de Caya

How a New Self-Care Product in Niger Is Meeting Women’s Unique Needs During COVID-19

Este pieza fue publicado originalmente por PSI.

As COVID-19 disrupts access to essential healthcare across the globe, it is more important than ever to offer a wide range of voluntary family planning (FP) options including methods that a user can start, stop and fully control herself. Women who normally rely on a method that requires regular interaction with a provider may be most at risk of losing access to FP care during COVID-19. Experts predict a rise in demand for self-care during the pandemic due to stay-at-home orders, strain on health systems and fear of acquiring COVID-19 in healthcare settings.

Enter the Caya™ Diaphragm, a new self-care product available to Nigerien women as of June 2019 that offers contraception without having to see a provider in a healthcare facility. “I like the diaphragm because I can insert it and remove it myself,” explained one of the first women in Niger to use the new product.

Caya Diaphragm and the Appeal of Self-Care

Él appeal of self-care is among several benefits of the Caya diaphragm that I’ve drawn more than 800 women in Niamey, the capital of Niger, to adopt the method over the past year. Through the USAID-funded Expanding Effective Contraceptive Options (EECO) proyecto, WCG cares and PSI have led a pilot introduction of the Caya Diaphragm and accompanying Caya gel in Niger since June 2019. EECO offers the method as part of voluntary FP services and public facilities, private clinics and free community health workers (CHW). Users say they appreciate that Kia is a user-controlled, reusable and non-hormonal method that causes no side effects and can be used on demand.

“I had tried other methods before Caya…which I didn’t like…I heard about the diaphragm and decided to try it. I like that there aren’t any side effects at all! And it’s easy to use and easy to remove.”

Caya user in Niamey, Níger

A new program brief from the EECO project documents initial lessons learned from Caya’s first introduction in Africa. The brief, Expansión de opciones anticonceptivas eficaces: Introducing the Caya Diaphragm in Niger, is available in English and Francés. Intended for use by those interested in adding Caya into a country’s contraceptive method mix, it is also useful for those exploring the introduction of any FP method into a new market. ele brief includes a journey map to reflect the dynamic and diverse ways that clients in Niger move from awareness to Abogacía de Caya.

Él Caya Diaphragm’s Role in Niger’s FP Method Mix

As the COVID-19 pandemic unfolds, la Caya Diaphragm may come to play a unique role in the FP method mix. Here’s why:

  1. Caya can be obtained outside of crowded health centers. Due to lockdowns y la increased burden that COVID-19 places on healthcare systems, many women are unable or reluctant to visit healthcare centers. Fortunately, obtaining the Caya Diaphragm doesn’t require a visit. Unlike earlier diaphragm models, Caya is one-size-fits-most por lo tanto eliminating the need for a provider fitting. Mediante EECO's pilot, women can access Caya through CHWs who visit their homes and/or communities.
  2. As a self-care method, women can continue, pause and stop use of Caya at any time, without the aid of a provider. Some FP methods require frequent visits to a provider for eficaz continued use. Por ejemplo, inyectables require reinjections from a provider every one to three mess; long-acting reversible contraceptives, como implants, necessitate a clinic visit when women want to stop using them. Caya, on the other hand, is reusable for two years (though la gel1 may need to be replaced) and a woman may pause or stop using it for any reason, whenever she wants and for as long as she wants, con no follow-up visit necessary.
  3. Caya can serve as an excellent back-up method. UNn unfortunate implication of COVID-19 is that many women’s usual contraceptive methods may become unobtainable during periods of lockdown or supply chain disruption. In these cases, Caya can act as a temporary back-up solution for some women in addition to its role as the primary method choice for other women. Because a woman can obtain y initiate use of Caya without a clinic visitar, she can safely use it durante times when a visit to the clinic is impossible or undesirable.

What’s Next Para la Caya Diaphragm Rollout

Over the next year, EECO will continue its Caya pilot introduction in urban Niger, expand into peri-urban areas, complete a mixed-methods user study and launch a pilot introduction in neighboring Benin. The project will monitor changes in Caya consumo durante la pandemia de COVID-19, documenting if and how it fills gaps in the broader FP market. Even during this global period of great disruption, providing a woman with access to an FP method that delights and satisfies her remains at the core of EECO’s goals.

For any questions or inquiries regarding the EECO project’s introduction of Caya, please be in touch with Alexandra Angel (

EECO Caya User Journey
El diafragma de Caya
alejandra angel

Consejero tecnico, PSI

Alexandra Angel is a Technical Advisor at Population Services International (PSI) in Washington, corriente continua. She advises PSI's global programs on developing, implementar, and sustaining quality sexual and reproductive health programs and services for women and girls. Her areas of focus are quality of care, client-centered FP counseling, and introducing the Caya diaphragm as a method choice. Alexandra speaks French, and much of her work is focused on Francophone West Africa. She has a BA in French and Francophone Studies and in Religious Studies from Santa Clara University and an MPH in from the George Washington University.

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