A Platform for Sustainable Scale: The Challenge Initiative’s Innovative Approach to Scaling Proven Interventions

Abstract

There is a great need to scale up proven health interventions for the urban poor, including improving access to contraception, in a sustainable and cost-efficient way.n To enable the scale-up of intervention packages across multiple geographies, The Challenge Initiative (TCI) platform includes regional technical assistance hubs that meaningfully engage local stakeholders and systems and a global partner that raises funds; supports shared learning; and upholds consistent practices, processes, and standards across all hubs.n Government self-selection and commitment of funds to participate in TCI are critical to the ownership and sustainability of the change process; they also complement and reinforce local leadership in program design, implementation, and management.

Implementing Quality Improvement Initiatives to Improve the Use of Adolescent- and Youth-Friendly Health Services in Zou, Benin

“…In 2016, The Challenge Initiative (TCI), with funding from the Bill & Melinda Gates Foundation and supported by IntraHealth International, worked with local governments in Francophone West Africa to strengthen, scale up, and sustain high-impact FP practices that improve access to and uptake of contraceptive services. 16 In June 2018, TCI secured funding to improve the quality of AYFHS and contraceptive accessibility for married and unmarried adolescents and youth ages 15–24 years, a subset of the broader demographic of women of reproductive age (WRA) 15–49 years. 17 In the Zou department, one of 12 departments in Benin, the 9 communes collectively submitted the first expression of interest to TCI in 2018 for improving AYFHS in the SDPs ( Figure 1 ) and thus were selected.…”

Innovations in Public Financing for Family Planning at Subnational Levels: Sustainable Cofinancing Strategies for Family Planning With Nigerian States

“…TCI is a partnership and platform that invited states in Nigeria to apply, pledge annual funding, and commit to assuming a leadership role to receive technical and seed funding support to scale up evidence-based, high-impact FP and adolescent and youth sexual and reproductive health (AYSRH) interventions in a sustainable manner. 15 A state’s engagement with TCI typically spans 3 to 4 years and goes through 4 broad stages: commit/start-up, surge, pre-graduation, and graduation. Across these stages ( Figure 1 ), TCI’s coaching support, which is initially intense, gradually reduces as systems strengthen and local stakeholders become increasingly capable of independently implementing the FP interventions.…”

Boosting Contraceptive Uptake in Urban Uganda: Older Women Benefit When Layering Adolescent and Youth Interventions Onto Existing Family Planning Programming

“…Improving contraceptive uptake and use for WRA is in itself a challenge that TCI continues to address. 22 Adding a focus on increasing contraceptive rates for adolescents and youth is an even more sensitive issue 18 – 20 that can create community backlash. 25 Therefore, TCI partnered at governance, facility, and community levels with adolescents and youth 23 to ensure acceptance and support for AYSRH-focused interventions with gatekeepers and adolescents and youth themselves.…”