Women awaiting family planning services in Mukono, Uganda.

Contributors: Victor Igharo (Nigeria), Lekan Ajijola (Nigeria), Prabhat Jah (India) and Allan Katamba (East Africa)

Learning is the foundation of The Challenge Initiative’s model. As its regional hubs support local governments in implementing evidence-based approaches, they learn what works. The Initiative collects and evaluates those learnings on a regular basis. If something isn’t working, the program can “fail fast” and quickly regroup for success. Below are some initial learnings from Nigeria, India and East Africa.

Ensuring Local Ownership in Nigeria

In Nigeria, the Initiative has completed five 72-hour makeovers to date – three in Delta and two in Ogun. As a result of the 72-hour makeover, the communities now see that their health is in their hands and they don’t need to wait for the government to take action and make improvements. The Initiative learned that engaging stakeholders early on, being transparent and setting expectations upfront is critical for success.

“Early engagement through whole-site orientation helped to set the stage for involvement and roles, making the makeover relatively easy in the end because it was led by the QA teams,” said a government representative from Ogun state who coordinated one of the makeovers.

Based on this experience, the Initiative engaged the newly formed, Quality Improvement Team (QIT) in Kano State – which includes community members there – to complete the facility assessments prior to the selection of makeover sites. Given the QIT’s local knowledge of the vendors and artisans in the community, they engaged them directly as part of the assessments and were able to obtain renovation quotations from them within the week instead of the 3-week time period that it took in Delta and Ogun. The QIT is able to serve as an accountability structure for the community and state, which facilitates responsiveness.

Expanding Women’s Contraceptive Choice in India

Prior to TCI Healthy Cities (TCIHC), injectables had only been available at the district level in Madhya Pradesh (MP). Due to TCIHC’s continuous advocacy efforts, engaging state level officials and sharing with them data on young couple’s unmet need, the MP government issued a new order to introduce injectables at the urban primary health center (UPHC) level.

Data made all the difference. And, now women even beyond TCIHC-sponsored cities in MP have better access to contraceptives of their choosing.

Reducing Missed Opportunities in Uganda

Mukono Health Center IV in Uganda has recognized a number of missed opportunities prior to the Initiative.

“They get over 100 mothers coming for immunizations, 25 deliveries in a day, and 80-120 attending antenatal care,” said Dr. Kkonde Anthony, the Principal Medical Officer in Mukono Municipality who coordinates Initiative activities there.

Through whole site orientation (one of the Initiative’s proven approaches), more health workers know about family planning and are trained to counsel and offer family planning services. To date, 1,442 facility staff have participated in whole site orientations ( 438 in Kenya, 695 in Tanzania and 309 in Uganda). Dr. Anthony is seeing mindset changes among their staff, as well as new engagement with partners such as Population Services International to obtain long-acting methods, and the government agreeing to procure necessary equipment – all as a result of the Initiative’s engagement in East Africa.

TCI University Offers More Learning Opportunities

TCI University now has nearly 1,500 registered users. And, more than 18% shared their experience using TCI-U via a recent online survey (English and French). The survey stops accepting responses on Friday, August 3, so share your thoughts if you are a registered member. If you aren’t a member, sign up now to learn about the evidence-based approaches the Initiative uses for family planning and adolescent and youth sexual and reproductive health.