Over the years, the health district in Koudougou, Burkina Faso, has received financial and technical support from a variety of partners to implement public health programs, including family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH). However, the district often faced difficulties in continuing to implement these programs when funding for a particular program ended. The Reproductive Health (RH) Manager, Eunice Wanda, noted:
“When partner support and funding ends, strategies or initiatives developed in Koudougou, showing good results, have not been pursued, notably due to the lack of a clear short- or long-term roadmap to ensure the ownership and the exercise of responsibilities at different levels of health systems.”
Working with the local government, The Challenge Initiative (TCI) helped design a program specifically aimed at strengthening Koudougou’s local health system and the capacity of its health workforce so results will be more sustainable after the program ends. Through transformational leadership activities, local leaders were introduced to TCI’s approach to sustainability and coaching model that encourages local ownership of its high-impact practices and other interventions. In addition, TCI’s self-assessment process using the Reflection and Action to Improve Self-reliance and Effectiveness (RAISE) tool helped encourage Koudougou’s local government to lead and own their FP and AYSRH programs, continue contributing resources to support those programs, and be held accountable for its results. Koudougou graduated from TCI’s direct support in December 2022 and is now implementing activities autonomously with minimal coaching on demand.
Interventions such as FP Special Days, Universal Referral and coaching have been institutionalized in the health system and are now included in district action plans and integrated into supervision and monitoring tools. In addition, TCI coaching has led to more timely and complete data on contraceptive use at the district level so program performance can be used for decision-making and shared with other stakeholders in the district. Mr. Ayel Bassolet, the head of statistics for the Koudougou health district, pointed out:
Improved data management, particularly ongoing analysis, has enabled us to identify certain shortcomings and find solutions.”
As the municipality completed its 2022 work plan budget, the President of the Special Delegation of the Commune of Koudougou organized an extraordinary session in the first quarter of 2023 and explained the need for a budget line for FP/AYSRH programs. All the members of the Special Delegation approved the request and a sum of 3,000,000 CFA (about USD $5,000) was committed for the FP/AYSRH program, pending the budget allocation. TCI has also strengthened collaboration between the municipality and the health system, enabling them to share a common vision in implementing the FP/AYSRH program and sustain major elements of the program post-graduation.
Mr. Sylvain Soubeiga, the district’s Chief Medical Officer, shared:
We are satisfied with the TCI model because, despite TCI’s financial withdrawal, interventions continue, and this is possible because the mayor’s office has taken the lead and understood the need to support the health system. This is a clear sign of ownership by the players involved, reflecting the institutionalization and sustainability of the TCI model.”
Mr. Richard Zida, a TCI coach, added:
Thanks to the TCI coaching approach, we’re seeing a change in mentality among healthcare providers.”
New providers assigned to the health district are now systematically coached by their peers on TCI’s high-impact practices and other interventions, further contributing to the sustained improvements in access to quality FP services in Koudougou.