With our longtime Nigerien partner, GRADE Africa, OASIS is working to reduce maternal mortality and increase uptake of postpartum family planning across the Sahel by evaluating an innovative group pre- and post-natal care approach implemented by GRADE with the Midwives Association of Niger (Association des Sages-Femmes du Niger) in government health centers in Maradi region.

The ‘Kula da Juna’(KDJ) program seeks to improve and measure women’s:

• Prenatal care visit participation

• Knowledge of danger signs in pregnancy

• Skilled birth attendance

• Immediate postpartum family planning use

• Postpartum care visit participation

• Infant immunization

Through testing this group approach to pre and post-natal care, OASIS and GRADE Africa’s aim is to demonstrate a cost-effective practice that the government can adopt to reduce maternal and infant mortality in Niger and expand and integrate routine opportunities for women to access contraception.

KDJ’s “Wave 1” results with 1016 women are substantially better than national averages [1]:

• 80% of KDJ participants had the full WHO-recommended complement of 4 prenatal care visits (vs. 33% nationally) 

• 78% of KDJ participants delivered in the health center with a skilled birth attendant (vs. 33% nationally) 

• 34% of KDJ participants chose to adopt a birth spacing method (PPFP) within one month after giving birth (vs. less than 11% nationally), and 

• 43% of KDJ participants who delivered in the health center adopted PPFP (vs. 29% nationally)

Based on these promising results, with the support of OASIS, in July 2023 GRADE began a cluster randomized evaluation of the KDJ group pre and postnatal care intervention versus results achieved through the standard practice of individual visits.