Congratulations and welcome to TCI.  Now that your expression of interest (EOI) has been accepted, the next step is to design your family planning program in the city/geography you selected.

The program design guidelines and worksheets contained in this document will help you and your design team identify, select and prioritize proven family planning approaches to meet the needs of underserved families in your selected urban geographic areas.

The design process is divided in three sections.

Review of general information about your organization and program design team.  (Much of this information may have already been presented in the EOI). The purpose here is to provide primary contact information and basic details about the submitting government/organizations.

Landscaping (Section 2a) and Gap Analysis (Section 2b). In this section, you will capture the most up-to-date and relevant demographic information and information about key FP organizations, FP service providers/health facilities, FP funders, and potential partner organizations in your program geography. You will then use the Gap Analysis tools and worksheets to determine FP program gaps (across supply, demand and advocacy/enabling environment), set priorities, determine root causes and identify appropriate proven solutions and tools to use in designing and implementing your program.

Completing the Program Design template. This is where you transfer the information from the worksheets and complete an outline of the activities of your family planning program! This section will help you adapt proven family planning solutions and tools for each of the selected priorities identified in the gap analysis, along with proposed suggestions on leveraging resources, institutionalizing the approach, monitoring and measuring impacts, and your timeline and budget.

Section 1: General Information
Go to the TCI Program Design template and fill in the requested contact information.
Section 2A: Landscape Analysis
Use local data and readily available resources to complete the landscape exercise and this landscape section. (You will likely need to spend some time in the specific city/geography to talk with people and do some simple field work. In addition, you will likely need to do a simple literature review to identify and gather the most up-to-date and most relevant demographic data. This data collection/literature review can be done in conjunction with identifying and developing the list of current organizations supporting family planning, since these same groups often conduct studies and have access to relevant data and information specific to meeting family planning needs.) 

You will be looking at two main areas for the landscape analysis:

  • Demographic profile and relevant health indicators of the geographies where you intend to implement the program. You will collect only the information that will be helpful for designing your program.
  • Family planning organizations and other “assets” that support family planning in the areas where you will implement the program. These “assets” include identifying: Family planning organizations; Family planning service providers; Family planning donors/financial support; and related tangential services, any/all of whom might provide potential opportunities for partnership or leveraging.

Once completed, the landscape analysis should provide the design team with a deeper understanding of the family planning context, coverage and “players” in the TCI-targeted geography and surrounding areas. Your Hub can provide any needed guidance in completing these sections of the design process.

The following templates and forms need to be completed and uploaded to your TCI Program Design Template:

Demographic Landscape: Use the demographic analysis in the expression of interest and/or any other additional local data and resources to identify and highlight the key demographic indicators specific to the TCI urban geography in which the program design will be focused.  (Be sure to note data sources and dates when collecting this information for your own files.)

Family Planning Organizations in the TCI Selected Geography:Identify any/all of the relevant organizations engaged in family planning and related health programs in the immediate TCI geography and surrounding areas.  For each organization, indicate the type, size, location(s), role, and any other important facts/factors.  When possible, include a key contact name and number.

Use the templates/forms below to help capture this information.

NOTE: It isn’t essential that you capture each and every organization; rather you want to focus on the most relevant/important as they relate to your FP program design.  Your TCI Hub can provide additional guidance on how best to collect and gather this information.

  1. FP organizations
  2. FP service providers / facilities
  3. FP donors
  4. Related / tangential services, providers and facilities
Section 2B: Gap Analysis
The purpose of the gap analysis is to provide TCI program design teams with a format in which to:

  • Compare the best evidence-based practices with the actual practices currently in place in your TCI city/geography
  • Determine the “gaps” and the barriers and/or root causes behind the gaps between your TCI city’s practices and the identified evidence-based practices
  • Establish priorities on which specific gaps to address under the TCI umbrella and in your program design
  • Select the best TCI approaches/proven solutions and tools you plan to implement in your TCI city/urban geography program

The template and related tools are intended to help focus and guide the gap analysis specific to the TCI city/geography.  The template will help identify program area priorities and which specific approaches/proven solutions and tools will be adapted and used.

In general, the gap analysis will focus on identifying gaps in the key program areas (supply, service delivery, demand, enabling environment) in the specific urban geography AND help identify which TCI approaches/proven solution and tools will be selected for closing/filling these gaps to improve FP outcomes. In addition, the gap analysis will help the design team identify and set priorities, allowing the finite resources within their leveraged TCI budget to be invested in those proven solutions most likely to provide the maximum impact and return on investment.

In addition to all the proven solutions and approaches found in TCI University, the following three worksheets will be used to complete your Summary of Priority Areas template, which will be uploaded to the Program Design Template for review

  • Worksheet #1Gap Analysis Table is the overarching table for the Gap Analysis.
  • Worksheets #2 and #3 help complete individual columns in Worksheet #1.

You can access the full list of TCI Approaches and Proven Solutions to help complete the last column of Worksheet #1.

Upon completion of the gap analysis, your program design team will have:

  • An understanding of the differences between current practices and best
  • An assessment of the barriers and root causes that need to be
  • A prioritized list to help determine what the geography can and should include in their TCI program.
  • A guide to the selection of TCI approaches and tools that can be used for successful implementation and improved impact.

The best approach to developing and completing the gap analysis is to start within the specific selected city/geography to get a true sense of the current FP status.  This will likely involve one or more field visits, discussions with local stakeholders, and some simple exploratory research and observations among women, families, clients and service providers.  While considerable information may be available through documents, reports, studies and other “desk top” references, they don’t fully convey the richness that comes with spending time in the program city/geography.

Your TCI Hub can offer considerable coaching and guidance as you prepared to conduct the gap analysis and complete the gap analysis and priority setting templates.


Graphical Overview of the Process for Gap Analysis

The figure below provides an overview of the TCI Gap Analysis process. The figure references columns in Template #1.

Worksheet #1: Gap Analysis Table – INSTRUCTIONS

NOTE: Again, this worksheet serves as the overarching table for the Gap Analysis. Worksheets #2 and #3 and TCI University’s list of approaches will help complete the last 3 columns of Worksheet #1.

Start by reading and reviewing Columns 1 & 2.

These outline the key program components (Column 1) and key sub-components (Column 2) of an evidence-based, best practice-oriented family planning program.  These two columns present the ideal model for a robust and successful FP program.  Review and, if needed, adapt this list of the key evidence-based program areas in Column 1, and associated best practice sub-components in Column 2 for your specific TCI geography. Your TCI Hub can provide guidance, if needed.

Enter information regarding your identified TCI geography into Column 3.

In this column, describe the status of the program components and subcomponents as they exist now in your identified TCI geography. (This will likely require both a desk review of relevant documents and one or more field visits to the proposed city/geography).

Be sure to identify and describe what is real and currently happening in the TCI city/geography. Use the ideal conditions presented in each row of Column 2 to guide your thinking. Describe how the reality differs from the ideal evidence-based practices in Column 3.

  • For each row of Column 2, first describe the current status.
  • Once you have written the status of each row, write a simple “problem statement” for each row where current program is not performing (or significantly under-performing) as compared to the ideal.

Remember to focus on the targeted TCI urban geography to reflect the reality in that location. Be specific and include as much as possible:

  • Quantitative descriptors (e.g., numbers of facilities not offering contraception or with no providers trained in FP counseling and/or method provision; low m-CPR; stock-out data, etc.)
  • Qualitative descriptors (e.g., inadequate space, privacy, materials for FP counseling; inadequate contraceptive method mix available at the time of your visit; condition of facility, provider bias; capacity to report to HMIS and quality of HMIS data; observations on FP promotional campaigns or outreach, FP norms and social support, etc.)
  • Any relevant information on policies, protocols, guidelines, staffing, capacity issues, etc.

You can also use the data collected as part of the landscape analysis in Section 2a to provide insights that may guide some of the field visit activities.  Your TCI Hub can provide additional guidance.

Fill out five rows of Column 4 AFTER using Worksheet #2

Worksheet #2: Prioritization Matrix

This matrix will help you to prioritize the gaps that you have identified above.

INSTRUCTIONS FOR WORKSHEET #2: PRIORITIZATION MATRIX

You may want to recreate the matrix on a larger piece of paper or on a flip chart to make it easier to fill out the boxes.     

  1. Transfer each of the problem statements from Column 3 into the first column of the Prioritization Matrix.
  2. For each problem statement, provide a score for the criteria in column A-G.
  3. Total the score for each row.
  4. Complete each row (problem statement) before moving to the next row.
  5. Rank the totals so that the highest score is ranked 1st, the next highest is ranked 2nd and so on.
  6. Transfer ONLY the five highest scores, or the top five priorities, to their appropriate cells in Column 4 of Worksheet #1.

NOTE: You can also review the priority rankings to create a ‘short list’ of problems/areas of under-performance to be addressed (8-10 problem areas). While these will not be included the final TCI program design template, this reference list can be shared with stakeholders in the geography to ensure that priority family planning gaps are being addressed.

Fill out the same five rows in Column 5 as in Column 4 AFTER using Worksheet #3

Worksheet #3: Root Cause & Barriers Analysis

This tool will help you identify the root causes of gaps and performance problems only for the five priority areas that TCI will address directly (those that you rated as the top five priorities in Column 4).

Use any (or all) of the following three techniques and tools to conduct a root-cause analysis of the 5 priority gaps identified in Column 4. The techniques and tools are:

  1. Brainstorming
  2. The 5-Whys
  3. Fishbone Diagram

Detailed instructions for each of these techniques are included in Worksheet #3.

The goal is to identify why things are the way they are and which barriers need to be overcome or root causes addressed in order to improve performance across the program sub-components.

You may consider factors such as: funding/resources; clear performance expectations/feedback; systems, procedures, policies, and people; workspace, equipment, supplies, and tools; motivation/engagement and incentives to perform; timely feedback on performance; other organizational support; and the knowledge and skills necessary to perform to standard.

Once you have completed the Root Cause Analysis, record your findings in Column 5.

Fill out Column 6 using the TCI University Toolkit and/or the TCI University Site Navigator – a comprehensive index of TCI’s Proven Approaches.

TCI University Site Navigator: Index of TCI Approaches/Proven Solutions

Identify the most appropriate TCI approaches, proven solutions and tools you plan to use to overcome barriers, close the gaps, improve performance and drive impact and outcomes for each of the five identified priority gaps.

Refer to this index for the full list of TCI approaches/proven solutions to help identify and select the best program interventions.

You may need to spend some time in the TCI University Toolkit familiarizing yourself with these approaches and tools to select the most appropriate combination. You may also want to discuss these options with your TCI Hub coach, who can provide advice and share experiences specific to the adaptation of the TCI approaches and tools.

Once you have completed all the steps above, use your worksheets to complete the Summary of Priority Areastemplate, then upload it to the Program Design Template.

You are finished with Section 2! Continue to Section 3 to finish designing your family planning program and activities.

Section 3: TCI Program Plan
This section has six components:

  1. Outline of the key program intervention areas (with a focus on adapting proven approaches and tools to close priority gaps and improving family planning outcomes in the specified program geography.)
  2. Leveraging and alignment with other family planning programs
  3. Institutionalizing the approach
  4. Program monitoring
  5. Program timeline
  6. Budget timeline

A: TCI Program Outline and Activities

Use the Outline Template for Program Approaches and Activities to outline and organize your program.

NOTE: The outline template can be modified to suit your program design. If you find that you need to add more yellow boxes, please do so. If you would like to combine priorities into one table, please do so.

First, transfer the five priorities into the first line of each page.

  • Identify which program area the priority fits into (Supply/Commodity Improvements, Supply/Service Delivery, Demand, or Advocacy/Enabling Environment)
  • Write a (SMART) objective to address the priority gap.
  • Transfer the TCI approaches and tools from Column 6 of the Gap Analysis Worksheet #1.
  • Continue to brainstorm activities with your program design team to help implement the approach. Use the Hub and TCI University toolkits to identify tools that will facilitate implementation. Describe what you hope to see as the expected outcomes/impact.

Your TCI Hub can provide guidance on how best to complete this section, if needed.

NOTE: While it is not mandatory for your designed program to implement approaches/activities all three program areas (Services & Supply, Demand Generation and Advocacy), your program should ensure that there are strong linkages between them, even if you are going to leverage other programs in the area. Describe how you will work other family planning programs to ensure strong linkages between the program areas in B. Leveraging and alignment with other family planning programs   

B. Leveraging and Alignment with other Family Planning Programs

Explain how the TCI program will initiate, complement, and/or leverage coordination with other family planning and/or health related programs and projects in the TCI city.  (Refer back to the landscaping templates to identify potential appropriate opportunities. Your TCI Hub can provide guidance, if needed.)

You may write your response in the Program Design Template, since you will need to submit this information.

C. Institutionalizing the Approach

Explain if and how your program design will facilitate a broader participation of key stakeholders and build partnerships with key urban actors; and what strategies might be used to ensure TCI interventions are sustainable beyond the initial investments. Refer back to the family planning organizations you outlined in the landscaping templates. Your TCI Hub can provide guidance, if needed, in exploring how your program might incorporate sustainability strategies.

You may write your response in the Program Design Template, since you will need to submit this information.

D. Program Monitoring and Evaluation & Data for Decision-Making

Use Worksheet #4 to build the basis for a Data-to-Action plan by first entering information in the blue cells (the first three columns). Refer back to the gaps, priorities and approaches identified in the previous sections to then identify programmatic or policy questions. When considering data sources, do not limit yourself to only survey data. Consider all data sources, HMIS, project records, client exit interviews (CEI), household surveys (HH), service delivery point surveys (SDP), etc.
Once completed, the Data-to-Action form can be used and the remaining columns completed during regular stakeholder review meetings to review data findings to either ensure the project is on track to rapidly scale up high-impact family planning approaches or to decide on actions to adjust program design, implementation and management. The purpose of Worksheet #4 is to identify actions/decisions related to programmatic management AND coaching needs as the program is implemented and to encourage regular monitoring and necessary adjustments.

You may write your response in the Program Design Template, since you will need to submit this information.

E. Program Timeline

Develop a simple timeline outlining the key steps you and your team will take in the refinement and adaptation of the selected TCI approaches and tools and program implementation over the next two years.

You may write your response in the Program Design Template, since you will need to submit this information.

F. Budget Allocation

Develop a rough budget based on the needed resources, and how resources will be allocated across the key priority program areas (supply, service delivery, demand, and advocacy/enabling environment) based on the selected TCI approaches and tools.  These budgets will be refined as deeper planning and tool adaptation takes place during the early phases of implementation.  For now, estimated needs and allocations across program areas along with both direct and leveraged TCI funding should provide sufficient context for design discussions and approvals. Be sure to identify and include the leveraged resources from the government and/or other resources, along with the TCI requested resources, and show how these various resources will be allocated/assigned to the TCI program design priority areas and tools.

You may write your response in the Program Design Template, since you will need to submit this information.

Use the guidelines and worksheets in each section to capture the findings, analysis and key components and to organize these components in a way that will ultimately become your program.

It is important that you keep in regular contact with your regional TCI Hub as you get oriented to TCI’s business unusual model and as you work through the Program Design Guidelines and Worksheets to design your urban FP program. The goal will be to simplify the design process as much as possible while helping to ensure you design a technically sound and cost-efficient family planning program that gets results. Your TCI Hub will provide a full orientation, and work with you and your team in providing detailed instructions on how best to approach and complete the design process and fill out the Program Design Template.  Your Hub will also provide ongoing coaching and technical guidance in using the tools and worksheets, engaging stakeholders and developing your final design for approval.

As you will see, our focus is on “filling in the blanks/boxes” with key information that guides the design of a targeted, low cost, high return, effective FP program while minimizing the need to do lots of formal writing.

This is business unusual.