New Journal Article Reveals Factors for Successfully Scaling High-Impact Interventions in Nigeria

Health worker in Bauchi State reviews family planning methods with potential client.

The Challenge Initiative (TCI) has just published an article in Global Health: Science and Practice examining the factors necessary for state governments in urban areas of Nigeria to successfully scale up family planning interventions, while also strengthening health systems. TCI coaches Nigeria state officials in rapidly and sustainably scaling up high-impact family planning and adolescent and youth sexual and reproductive health (AYSRH) interventions through public health systems to respond to unmet need among the urban poor.

The article is a mixed-methods comparative case study that triangulates 32 stakeholder interviews – state government leaders and managers, non-governmental organization leaders and TCI’s Nigeria staff – with intervention records and government health management information system (HMIS) data. Using the Consolidated Framework for Implementation Research (CFIR), the authors compared two higher-performing states with a lower-performing state to identify what led to successful adoption and implementation of the interventions.

According to the article, interviewees reported that several TCI strategies were critical to states successfully adopting and sustaining the interventions. In higher-performing states, external champions’ contributions and strengthened state planning and coordination were particularly important success factors. Higher-performing states also implemented a combination of service delivery, demand generation, and advocacy interventions.

External champions, state planning and state coordination were found to be requirements for successfully introducing and maintaining family planning and AYSRH interventions at the top of local government agendas. The authors found that strengthening state governance structures and managerial skills can best support local government scaling efforts.

“While it is not possible to generalize directly from the findings here, we believe that the patterns seen here merit consideration by others trying to scale up interventions at subnational levels,” the authors concluded.

“What Underlies State Government Performance in Scaling Family Planning Programming? A Study of The Challenge Initiative State Partnerships in Nigeria” was written by Oluwayemisi Denike Ishola, Sarah Jane Holcombe, Andrea Ferrand, Lekan Ajijola, Nneoma Nonyelum Anieto and Victor Igharo.