Expanding Effective Contraceptive Options (EECO)

The EECO project supports the introduction of new and underused contraceptive methods to address method-related reasons for non-use and better meet the reproductive health needs of girls and women.

Expanding Effective Contraceptive Options (EECO)

The EECO project supports the introduction of new and underused contraceptive methods to address method-related reasons for non-use and better meet the reproductive health needs of girls and women.

In developing countries, 218 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.

The EECO project introduces promising contraceptive methods in sub-Saharan Africa and Asia through pilot studies. Based on learning from these pilots, EECO produces roadmaps for introducing and creating demand for new and underused family planning products. 

Catalyst Global is proud to lead the EECO team. Our role is to identify and coordinate a skilled team of partners, link upstream product developers and suppliers with downstream marketing and distribution partners; lead regulatory and Quality Assurance efforts; troubleshoot and mitigate supply chain vulnerabilities; and work through both public and private sector channels to bring essential reproductive health commodities to the girls and women who need them.

The EECO portfolio

The Catalyst Global-led consortia has successfully introduced three innovative contraceptive methods in six LMICs, increasing women’s choices for voluntary family planning methods. Examples of products that Catalyst Global and partners have successfully introduced include the Caya® Diaphragm and Caya® Gel in Niger and Benin; the hormonal intrauterine device (IUD) in Zambia and Madagascar; and, the Woman’s Condom in Malawi and Zambia. In collaboration with the Population Council, EECO has also supported the introduction of the progesterone vaginal ring in Nigeria as well as an acceptability study of the Dual Prevention Pill, a multipurpose prevention technology that combines oral pre-exposure prophylaxis (PrEP) and an oral contraceptive, in South Africa.

Each product in the EECO portfolio has important benefits; for example, some are non-hormonal, long-acting, reversible, discreet, and/or can be used on demand. Several products are also self-care methods, which helps overcome barriers such as lack of access to health care providers or provider biases.

Products:

  • The Woman’s Condom
  • The Caya® Diaphragm and Caya® Gel
  • The progesterone vaginal ring 
  • The levonorgestrel-releasing hormonal intrauterine device (hormonal IUD), including AVIBELA from Medicines360 and an unbranded donated product from the ICA Foundation
  • Modern fertility awareness method (mFAM) smartphone apps
  • The Dual Prevention Pill (DPP) to prevent both HIV and pregnancy

Countries:

Benin, Madagascar, Malawi, Niger, Nigeria, Philippines, South Africa, Zambia

Project duration:

2013 – 2023

Product Registration Toolkit:

The Product Registration Toolkit is a digital collection of adaptable resources to guide the process of registering health products, like contraceptives, in low- and middle-income countries.

EECO Product Introduction Model

 

EECO-supported product introduction takes place in five stages, some of which occur concurrently:

STAGE 1

Regulatory Assessment & Product Registration

  • Perform regulatory landscape assessment
  • Engage stakeholders and meet with regulatory authorities
  • Support identification of a suitable market authorization holder
  • Prepare the registration package, submit and support its lifecycle upon approval

STAGE 2

Consumer & Market Research

  • Plan and conduct market research
  • Complete market segmentation analysis
  • Determine pricing and branding strategies

STAGE 3

Procurement & Quality Assurance

  • Perform manufacturer audits
  • Initiate pre-shipment inspection and testing of product
  • Develop and initiate pharmacovigilance systems

STAGE 4

Marketing, Distribution & Service Delivery

  • Launch product, with marketing and communications support
  • Supply stock to commercial outlets and providers
  • Deploy medical detailers to train and follow-up with providers

STAGE 5

Monitoring & Learning

  • Monitor and course-correct
  • Conduct baseline and endline evaluations
  • Disseminate lessons learned

“I hated taking pills! They just weren’t for me. I was always forgetting to take them when my husband was away, and on top of that, they made me nauseated. I eventually gave up on the pill, and during that time my husband and I used the withdrawal method.

We knew there were other options, but none of them seemed right. One day, a health worker came to our house. She told me about lots of different contraceptive methods, but the one that I thought was most interesting was the Caya® Diaphragm. It was the first time I had heard about this method. 

She showed me how it worked and how to use it. I started using it right away. My husband and I both really like this method. I’ve also told some of my friends about how you only have to use it when you have sex, and some of them are very interested. I’m really glad to have found a method that works for me.” 

Caya® Diaphragm user, Niger

Key results

More than 137,000 Woman’s Condoms were distributed through pilot introductions in Zambia and Malawi. Female condoms are the only available contraceptive method that is woman-initiated and that offers triple protection against HIV, STIs, and pregnancy.

Between 2017-2021, more than 4,800 women chose the hormonal IUD as their method of contraception in Zambia and Madagascar. In both countries, the probability of continuation of the method at 12 months remained high (over 80%).

In Niger and Benin, the launch of the Caya® Diaphragm and Caya® Gel provides women with the option of a self-care method that can be obtained either from a provider or a community health worker. Since the start of the pilots, more than 2,400 women have opted for the method.

Partners

Partners

Partners

Project Resources

Woman’s Condom

Case Studies/Reports
Blogs
Peer-Reviewed Literature

Hormonal IUD

Case Studies/Reports
  • Expanding Effective Contraceptive Options: Lessons Learned from the Introduction of the Levonorgestrel Intrauterine System (LNG-IUS) in Zambia and Madagascar (English, April 2019). EECO-LNG-IUS-Case-Study
  • Expanding Effective Contraceptive Options: Lessons Learned from the Introduction of the Levonorgestrel Intrauterine System (LNG-IUS) in Zambia and Madagascar (French, April 2019). EECO-LNG-IUS-Program-Brief_French
Blogs
Peer-Reviewed Literature

Caya® Diaphragm

Case Studies/Reports
Blogs
Peer-Reviewed Literature
Webinars

EECO Regulatory Work

Reports
  • Introducing New Contraceptive Options: Product Registration Basics for Global Health Program Managers (English, Mar 2019)

English: EECO-Regulatory-Guide

French: https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:44e2b310-1d09-499e-9576-f3eabf4354b9

Portuguese: https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:d1f28fe6-111b-421c-b09d-e3292b069c35

Spanish: https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:0a5e34ff-ae62-4105-95fa-17795d8acfcd

Blogs
Peer-Reviewed Literature

Other (non product-specific)

Blogs
Peer-Reviewed Literature
  • Barriers and Enablers Influencing Women’s Adoption and Continuation of Vaginally Inserted Contraceptive Methods: A Literature Review (Aug 2022). https://doi.org/10.1111/sifp.12209

Webinars

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