TCI delivers lasting impact through its business unusual model, which includes the following key features:
- Demand-driven: Cities self-select to join TCI, bringing their own financial and human resources.
- Local ownership and system readiness: Cities must be ready, willing and able to address their challenges.
- Right-fitting proven interventions: TCI starts with evidence-based family planning and AYSRH interventions related to service delivery, demand generation and advocacy and helps cities to right-fit them for their particular context.
- Coaching and TCI University: TCI uses a “Lead, Assist, Observe” coaching model to transfer capacity using TCI University, an online learning platform, to support coaching and capacity transfer.
- Leveraging existing systems: Rather than working outside of existing systems, which can lead to duplication, waste and missed opportunities, TCI works within existing government- and community-led systems in order to harmonize strategies, plans, funding and technical assistance.
- Near-time, real-time data for decision-making: TCI strengthens capacity to use data for problem solving and better decision-making.
Currently, the model is being applied to urban family planning and AYSRH, but TCI is in the process of proving that its business unusual model can be applied to any urban health area with success in terms of scale, impact, cost efficiency and sustainability.
Four-Stage Approach
TCI’s business unusual model incentivizes cities to have a high level of commitment and responsibility for serving the reproductive health needs of their citizens. The model’s four-stage process is intended to prime local ownership at the outset and nurture a leading role for cities in program design and implementation. These stages also provide visibility on the appetite for change that exists in many vibrant urban communities.
Background
Like no other project before, the Urban Reproductive Health Initiative (URHI) was designed specifically to address the urban poor and their reproductive health needs. URHI was a Bill & Melinda Gates Foundation-funded multi-country program in India, Kenya, Nigeria and Senegal that aimed to improve the reproductive health of the urban poor by increasing the accessibility, quality and use of family planning services. From 2010-2016, the projects used different interventions, both demand and supply side, to increase use of and access to contraceptives.
From baseline to endline, it achieved increased modern contraceptive prevalence (mCPR) especially among the poorest quintiles, improved knowledge around modern methods and saw large increases in use of long-acting and permanent methods including implants, IUDs and, mostly in India, female sterilization. These increases were observed among all women and across the wealth groups. Although URHI was not an adolescent-focused program, there were significant impacts among young people and important lessons learned – particularly from the Nigerian and Kenyan contexts.
URHI was a “proof of concept” to figure out what works where and why. Watch The Key to Sustainable Development: Investing in Urban Reproductive Health to understand how we moved from URHI to the Initiative and why investing in urban reproductive health is so important.
STAGE 1
Submit an Expression of Interest
If you are interested in improving access to family planning services and information in you city (or county, state), contact TCI to signify your interest in joining. One of our regional hub partners will work with you to document and validate your interest. You will be asked to provide the following in TCI’s expression of interest form:
- Evidence of political commitment
- A description of health system capacity
- An account of demographic need
- A commitment of local resources to contribute to implementation
STAGE 2
Design a Program
If your expression of interest is approved, you will receive technical support from the regional hub partner to identify gaps and design a program that addresses the most critical gaps. In the course of designing your program, you will explore TCI University and its outstanding package of high-impact interventions with practical guidance and tools for successful program implementation. You will outline your funding needs to get support from TCI’s Challenge Fund while confirming the local resources you will contribute towards the proposed program.
STAGE 3
Implement a Program
Selected cities from Stage 2 will receive financial assistance from TCI’s Challenge Fund to supplement their own local contribution. TCI’s regional hub partner will be on hand to provide technical coaching that begins at a high intensity but declines as local capacity and health systems are strengthened. The city will also join TCI’s global community of practice, where participants learn from each other and share proven best practices in delivering quality family planning and health services to their citizens. Together with the city, TCI will track progress in real-time to provide immediate feedback on what is working well and what needs adjustment.
STAGE 4
Self-Reliance
After meeting a set of criteria for “graduation,” selected cities from Stage 3 will transition to coaching on-demand. Support from TCI’s Challenge Fund will decline, but monitoring will continue. The city also becomes eligible for TCI’s alumni network and can serve as a resource for new cities engaging with TCI.
