Public health programs can only deliver benefits if they are able to sustain activities over time. Most donors require implementing partners to factor in strategies aimed at sustainability into proposals; however, few projects are designed to be sustainable from the beginning. Family planning in Rivers State provides a good example of this lack of planning for sustainability from the beginning. In Rivers State, family planning service statistics dropped between 2015 and 2017 when implementing partners exited the State due to the closeout of a donor-funded program.

TCI entered the picture in 2018 with its business unusual approach, which requires State ownership; promotes resource mobilization; provides technical support; and facilitates sharing and learning for rapid scale-up of evidence-based family planning interventions. This case study highlights the early results that TCI Nigeria’s novel performance-based tracker is having in ensuring State financial commitment and release.