What does it take to build a family planning program strong enough to stand on its own? Across Francophone West Africa, two lessons from the past year are pointing the way.
The first was hard-won. In Senegal, health worker strikes, reporting gaps, and inconsistent data reviews revealed how quickly weak information systems can undermine a program’s ability to function – even when the underlying work is sound.
The second was quietly encouraging: 16 cities across Côte d’Ivoire, Senegal, and Togo that had completed intensive support from The Challenge Initiative (TCI) continued to deliver family planning services after that support ended – and in many cases, outperformed cities still receiving active assistance.
Together, these experiences are shaping how TCI approaches urban family planning as it scales across six countries (Benin, Burkina Faso, Côte d’Ivoire, Niger, Senegal, and Togo) in 2026.
When Data Breaks, Decisions Falter
Data gaps don’t just create paperwork problems – they create strategic blind spots. Without reliable information flowing from health facilities, it becomes difficult to detect declining trends early, monitor contraceptive availability, and hold local systems accountable for results. TCI has invested in making data a management tool, not just a reporting obligation. Weekly performance reviews were strengthened in Francophone West Africa. Rapid diagnostic tools were introduced to assess facility-level performance, including a pilot in Pikine, Senegal. Root cause analyses became part of routine city-level planning, and monthly monitoring of contraceptive stock-outs was established across cities and countries.
The results were visible in how cities operated. Those that regularly reviewed and acted on their own data resolved problems faster and demonstrated stronger local ownership over their programs. Real-time commodity tracking – including coordination via messaging platforms across cities – helped prevent and respond to contraceptive stock-outs before they became crises.
The shift was straightforward but significant: when health systems treat data as a decision-making backbone rather than an afterthought, programs improve.
Graduation Is Not the End – It’s the Proof
Perhaps the most encouraging finding from the past year came not from cities receiving active support, but from those that had completed it. Conventional thinking might expect performance to decline once external attention moves on. In Francophone West Africa, the opposite happened. Cities that had completed TCI’s direct support phase demonstrated greater resilience during periods of supply disruption and staffing constraints than many cities still receiving assistance. Local budget execution rates averaged 86%, up from 65% the prior year. Municipal governments continued to finance family planning activities, coordinate interventions, and use local data to guide decisions – with minimal outside input.
This didn’t happen by accident. It reflects years of deliberate investment in local leadership, governance, and embedding family planning into municipal budget processes – the patient, unglamorous work of building systems rather than projects. Sustaining these gains requires continued attention. Periodic data reviews and targeted technical support help ensure that local ownership, once established, doesn’t erode. The goal is not dependence on outside assistance, but accountability to results.
The Through Line
Both lessons point to the same conclusion: sustainable health programs require infrastructure – not just financial, but informational and institutional. Cities that use their data build better programs. Programs built on systems, not on donor cycles, endure. As TCI continues its work across Francophone West Africa, these aren’t lessons from the past but a blueprint for what comes next.
