Graham Kate, Kalbarczyk Anna, Ajijola Lekan, Das Emily, Sow Fatimata, Owino Kenneth, Malik Maheen
Department of Population, William H. Gates Sr. Institute for Population and Reproductive Health, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
PLOS Glob Public Health. 2025 Jan 3;5(1):e0004058. doi: 10.1371/journal.pgph.0004058. eCollection 2025.
Traditional engagement with local governments often relies on financial and human resources from international or local partners, leading to direct implementation by organizations, which can hinder sustainability. While some organizations include sustainability indicators, few focus on transferring technical and financial ownership to governments. The Challenge Initiative (TCI) uses a phased coaching model-lead, assist, observe, and monitor-to build local government capacity for scaling family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH) programs. TCI ensures local governments take the lead from day one, coaching them to manage and implement these programs sustainably, improving management, coordination, planning, budgeting, and data-driven decision-making. In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with stakeholders across 24 TCI sites in 8 countries-Benin, Kenya, India, Niger, Nigeria, Senegal, Tanzania, and Uganda-from October 2020 to March 2021. A total of 175 IDIs and 14 FGDs were conducted with 343 master coaches (52 TCI staff, 164 local government staff) and 127 coachees. Participants included TCI staff, local government officials, and health providers at both facility and community levels, all of whom received coaching. Examples were gathered to assess the impact of TCI's coaching model on government FP and AYSRH programs. TCI documented improvements in local government and health service provider leadership, management, and coordination of health programs through its coaching interventions. It linked health system outcomes to its coaching approach, building a cadre of master coaches and coachees at all levels. This strengthened local governments' capacity to lead and sustain the scale-up of FP and AYSRH programs beyond TCI's direct support. Improved monitoring and tracking of coaching quality is needed for further insights.
与地方政府的传统合作往往依赖国际或地方合作伙伴提供的资金和人力资源，导致由各组织直接实施项目，这可能会阻碍项目的可持续性。虽然一些组织纳入了可持续性指标，但很少有组织注重将技术和财务所有权移交给政府。“挑战倡议”（TCI）采用分阶段指导模式——引领、协助、观察和监测——来建设地方政府扩大计划生育（FP）以及青少年和青年性与生殖健康（AYSRH）项目的能力。TCI确保地方政府从一开始就发挥主导作用，指导它们可持续地管理和实施这些项目，改善管理、协调、规划、预算编制以及基于数据的决策。2020年10月至2021年3月，在贝宁、肯尼亚、印度、尼日尔、尼日利亚、塞内加尔、坦桑尼亚和乌干达8个国家的24个TCI项目点，与利益相关者进行了深入访谈（IDI）和焦点小组讨论（FGD）。共对343名主要培训师（52名TCI工作人员、164名地方政府工作人员）和127名学员进行了175次深入访谈和14次焦点小组讨论。参与者包括TCI工作人员、地方政府官员以及机构和社区层面的卫生服务提供者，他们都接受了培训。收集了相关实例，以评估TCI培训模式对政府计划生育和青少年及青年性与生殖健康项目的影响。TCI通过其培训干预记录了地方政府以及卫生服务提供者在卫生项目领导力、管理和协调方面的改善情况。它将卫生系统成果与其培训方法联系起来，在各级建立了一支主要培训师和学员队伍。这增强了地方政府在TCI直接支持之外领导和维持扩大计划生育及青少年和青年性与生殖健康项目的能力。需要改进对培训质量的监测和跟踪，以获得更深入的见解。
