A panel discussion held at the India launch.

The Challenge Initiative for Healthy Cities (TCIHC) launched today in New Delhi, India. TCIHC is a four-year global intervention designed to address family planning and maternal and child health needs among the urban poor. Currently implemented in four areas – East Africa, Nigeria, Francophone West Africa and now India – TCIHC in India is supported by the Bill and Melinda Gates Foundation (BMGF), the U.S. Agency for International Development (USAID) and Maternal and Child Survival Program (MCSP), along with Population Services International/India.

Welcoming the delegates Mr. Pritpal Marjara shared his personal pleasure of being a part of this “business unusual” approach to scaling and sustaining reproductive health solutions with proven results and trusted partners.

Speaking in support of this Initiative, Mr. Xerses Sidhwa, USAID’s Health Office Director, said: “USAID’s vision is very simple. We want to ensure that the most vulnerable people living in urban slums in India have access to high-quality health services. Through this program, we aim to strengthen city-level health systems to end preventable maternal and child deaths.”

We are delighted to be here today to witness the launch of the Initiative in India,” said Kojo Lokko, Deputy Director of the Initiative. “We are overwhelmed by the positive response here and welcome the participation of Uttar Pradesh, Odisha and Madhya Pradesh.”

With urban health strengthening, TCIHC can play a critical role in improving urban reproductive, maternal, newborn, child and adolescent health (RMNCH+A) interventions and coverage. The urban poor need to be addressed and TCIHC is an opportunity to strengthen the existing systems in India.

“I am pleased to see two major development partners of the government of India – USAID and the Gates Foundation – joining hands to create this platform, which creates more opportunities for many more to join hands together to serve the urban poor,”  said Shri C.K Mishra, Secretary, Ministry of Health and Family Welfare (MoHFW)

The Genesis of TCIHC: From 2009 to 2015, the Gates Foundation supported the Urban Health Initiative (UHI) to test a comprehensive approach to improve contraceptive access among underserved populations in 11 cities of Uttar Pradesh, as well as urban areas of Kenya, Nigeria and Senegal. At the same time, USAID supported the Health of Urban Poor (HUP) program, which provided technical support in designing and drafting the National Urban Health mission. HUP also had a demonstration component on urban health planning, community processes, vulnerability mapping and implementation in select cities from eight states in India. Rigorous third-party evaluation of UHI and HUP showed the effectiveness of these strategies, with a significant and dramatic increase in number of women able to access modern contraception. It also showed even greater improvements among poor women. This success suggested a pathway of technical assistance to urban health, urban family planning and urban maternal and child health interventions.

The Initiative Approach: The TCIHC Initiative will work with 31 cities across Uttar Pradesh, Madhya Pradesh and Odisha to improve health services for the poor. The Initiative staff and city officials jointly identify health service gaps and provide technical guidance to address gaps and improve the overall health system. The Initiative recommends proven models and approaches to improve family planning and maternal and child health services. It links the private sector to government and utilizes available services to help meet the demand and need for urban health care. Through community outreach and behavior change campaigns, the Initiative’s regional hub partners help to raise awareness and increase demand for health services. Finally, through advocacy at the state and national level, this Initiative helps ensure continuity and sustainability in the funding and functioning of city health systems.

TCIHC  takes an innovative, demand-driven approach where participating cities self-select to participate (starting in Year 2), bring their own resources to the table and develop simple proposals for implementing cost-effective interventions customized to their urban needs. The cities have access to light touch technical guidance, TCI University and a Challenge Fund, initially seeded by the Gates Foundation, but open to other investors.

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