New Journal Article Spotlights How Local Governments Use TCI’s RAISE Tool in Progressing towards Self-Reliance

by | Jul 25, 2022

The Challenge Initiative (TCI) has just published an article in the peer-reviewed journal Public Health Management and Practice about its Reflection and Action to Improve Self-reliance and Effectiveness (RAISE) self-assessment tool that local governments use throughout their engagement with TCI.

TCI plans for sustainability from the very beginning of this engagement as it transfers capacity to local government implementers and strengthens health systems. This effort is designed to ensure that TCI’s family planning and adolescent and youth sexual and reproductive health (AYSRH) proven interventions will sustain beyond the period of engagement  – typically about 3.5 years.

Launched in 2019, RAISE is used by local governments, with TCI technical coaching support, to self-assess progress in implementing FP/AYSRH programs. In quarterly workshops, a city’s key health personnel use RAISE to evaluate the quality and effectiveness of their activities and implementation strength to make necessary course corrections.

As of June 30, 2021, 39 of the 92 local governments conducting RAISE assessments at that point had reached the highest stage of maturity and graduated from TCI’s direct support. TCI currently operates from six regional hubs covering 12 countries (Benin, Burkina Faso, Cote d’Ivoire, India, Kenya, Niger, Nigeria, Pakistan, the Philippines, Senegal, Tanzania and Uganda). As noted in the article, RAISE applies a standard set of indicators across TCI’s four sustainability domains:

  1. Political and financial commitment
  2. Capacity (knowledge) transfer of family planning skills
  3. Institutionalization of TCI’s interventions at all levels of the health system
  4. Sustained demand through improved attitudes and behaviors towards family planning.

According to the article, TCI’s East Africa hub was the first to begin using RAISE and has completed seven out of seven possible rounds of assessments with 47 local governments across Tanzania, Uganda, and Kenya. On average, 86.2% of local governments eligible to conduct RAISE assessments in East Africa completed them on a quarterly basis. Francophone West Africa began assessing progress in the last quarter of 2019 and completed five of six possible rounds (83.3%) with 12 local governments across Benin, Burkina Faso, Cote d’Ivoire, Niger, and Senegal. More than 78% of those local governments, on average, completed quarterly assessments. Nigeria and India began using RAISE in June and July 2020 and have both completed four rounds. In Nigeria, of the 13 eligible states, 95.6% consistently completed quarterly assessments. In India, 98.7% of local governments (n = 20) in Uttar Pradesh state completed quarterly assessments.

Of the 39 local governments that have progressed to self-reliance, 20 were in East Africa, 16 in India and three in Nigeria. Although the monitoring of adoption and implementation of RAISE is still in the early days, the data suggests those consistently completing rounds of the assessment were more likely to become self-reliant, meaning those local governments are consistently monitoring their FP/AYSRH programs, identifying gaps and solutions, and making course corrections.

In conclusion, the article noted that experts have stated that it can take up to 15 years for a sustainability assessment tool such as RAISE to be adopted into government policies.