Figures & Tables
Tables
- TABLE 1.
Challenges and Corrective Actions to Ensure Use and Effectiveness of P&R Sessions in Nigeria
Challenges in Implementing P&R Sessions Corrective Actions Implemented TCI staff have competing priorities leading to their inability to dedicate time and participate in the P&R session Made P&R sessions part of end-of-quarter reporting processes and made attendance mandatory.
The P&R sessions are now on everyone's calendar well in advance of the session itself and as a reoccurring meeting, so that team members can plan accordingly.Staff travel and geographic dispersion affected staff availability for the P&R sessions Transitioned to virtual P&R sessions to allow relevant participants to participate effectively, irrespective of their current locations. This became essential during the COVID-19 pandemic. Occasional difficulty in selecting reflection areas due to dissenting opinions Shared with staff the criteria for selection of topics (i.e., cross-project relevance and timeliness), examples of currently emerging themes, new strategies, and challenges reported or observed.
Developed a schedule of reflection topics to guide implementation.Initial reluctance among staff to discuss challenges or failures due to perceived fears of management sanctions TCI management oriented the team on the importance of discussing failures to ultimately achieve success.
Used an experienced facilitator, usually the TCI KMO, to address perceived participant concerns, ensure active participation, and elicit open dialogue.Abbreviations: KMO, knowledge management officer; P&R, pause and reflect; TCI, The Challenge Initiative.
- TABLE 2.
P&R Session to Identify Effective Strategies for Scale-Up and Systems Strengthening
Key Insights Actions Taken The TCI lead, assist, and observe coaching approach that allows government teams to learn during TCI lead phase, partially lead during TCI assist phase, and fully lead during TCI observe phase is effective in building local government's capacity for self-reliance in FP programming.16 Continued scale-up of the TCI lead, assist, and observe coaching model within current states, expanding into more local government areas. FP in-reaches were identified as an effective strategy for increasing access to FP services among women, including adolescents and youth, as evidenced by increasing service usage data on the health management information system. Implemented learning exchange visits where states performing optimally as a result of in-reaches provided step-by-step guidance on the implementation of in-reaches to other states to enable them to implement the intervention. RAISE assessments effectively assess the state government's capacity to implement FP/RH programs, but there is a need to review the tool to make it more user-friendly and less cumbersome. Scheduled the next P&R session on the RAISE tool and assessments to enable the team to have a deeper discussion on the tool and identify areas for improvement. Use of advocacy core groups catalyze state governments to release domestic funds for FP program implementation; however, TCI-supported states have achieved different levels of financial release based on the capacity of their respective advocacy core group.17 Strengthened the capacity and functionality of the advocacy core groups with closer tracking of financial releases at the state level to monitor impact. Abbreviations: FP, family planning; P&R, pause and reflect; RAISE; Reflection and Action to Improve Self-reliance and Effectiveness; RH, reproductive health; TCI, The Challenge Initiative.
Key Insights Actions Taken States need greater support to disseminate RAISE findings to ensure relevant stakeholders are updated on progress and supportive of the action plans derived from the assessment findings. Besides email, RAISE findings could also be disseminated through technical working group meetings, contraceptive technology update meetings, and other relevant stakeholder meetings. Supported states to conduct formal dissemination of findings from RAISE assessments through joint development of slides and printing of dissemination materials.
Identified government leads to implement recommendations from RAISE assessments at the state level within stipulated timelines.The action plan component of the RAISE tool should be modified to allow state teams to clearly articulate their technical assistance needs and to identify a state government lead who would be responsible for tracking implementation of action plan activities by responsible persons. Updated the RAISE tool action plan component and simplified it for ease of reflection on technical assistance required alongside responsible persons and implementation timelines. Innovative ways to triangulate RAISE assessment results with client volume trends for the period under review should be explored. Triangulated data from RAISE assessments with other data sources like a health management information system and project data to further inform program improvements.
Kept the RAISE dashboard at the state level to enable TCI and government teams jointly evaluate the use of the tool and monitor scores closely.Guidance should be provided to states to select the right mix of stakeholders to participate in the RAISE assessment, conduct orientation on the application of the tool and clarify expectations addressing key issues raised above. As much as possible, the same set of participants should be maintained, and the small consensus groups should be evenly distributed based on the domain areas to support an objective assessment. RAISE facilitators engaged relevant state coordinators to follow the guidance on the RAISE tool for participant selection to ensure the right mix and representation of teams for objectivity in review and scoring. RAISE assessment should be conducted quarterly for the first 2 quarters and biannually subsequently to give adequate time for identified issues to be resolved before a new assessment. Implemented RAISE assessments quarterly for states receiving active support from TCI and biannually for states that have graduated from the TCI program. Abbreviations: P&R, pause and reflect; RAISE; Reflection and Action to Improve Self-reliance and Effectiveness.
- TABLE 4.
Recommendation Generated at the P&R Session on Graduation Activities in TCI States
Planning and logistics Start planning for graduation events and production of graduation documentation earlier to allow for quality control and more time to review; documents will take at least 1–2 months to finalize.
Clearly itemize what needs to be done and come up with a timeline for each task; consider creating a production schedule for each deliverable.
Identify needs for additional support (i.e., knowledge management/finance and operations) during the graduation/dissemination event.
Work with state government officials as soon as possible to identify individuals who should be recognized/honored during the graduation dissemination events; this is important to ensure no one is overlooked or omitted in the process.
Budgeting Begin planning process early and allow enough time to engage with vendors, including obtaining estimates early enough for appropriate approvals.
Work realistically and within the current budget but ensure state budgets include contingency funds for unexpected situations.
Key Insights Actions Taken The development of a coaching schedule based on the outcome of the routine FP quarterly supportive supervision and RAISE assessments conducted by the state government team with support from TCI is critical. States that develop the schedule seem to implement coaching seamlessly compared to states that do not. All supported states are recommended to develop quarterly coaching plans and schedules to aid the implementation of coaching. Supported states that were implementing coaching without a particular structure to develop quarterly coaching plans and schedules to guide their coaching interventions. Disaggregate coaching into scheduled, on-demand, and ad hoc and ensure reporting to aid TCI management's understanding of state peculiarities and how to help the states to improve knowledge transfer between coaches and coachees. Disaggregated coaching interventions clearly in reports to identify whether they were scheduled, on-demand, or ad hoc. TCI Nigeria is using this information to further program with the states.18 Develop a coaching logbook and ensure that relevant reporting parameters are captured in the logbook. Developed a coaching logbook that captures relevant indicators, including coach/coachee information, type of coaching, coaching topic, and duration of coaching. This information is relevant for programming.19 Institute a more routine means of assessing coachees' satisfaction with the coaching they have received. Currently, TCI implements annual online TCI-U surveys, which measure satisfaction and quality of coaching.20 Developed a quarterly coachees' satisfaction checklist that is currently undergoing TCI management's review before roll-out.21 Develop more animated videos22 on TCI University (TCI-U)23 that coaches can use as part of their coaching sessions with stakeholders. The animated videos provide easy steps for the coachees to understand how to replicate a particular approach in their context. Began efforts to identify and prioritize high-impact FP/RH interventions to convert into animated how-to videos for stakeholders. TCI Nigeria started with the development of an in-reach video.22 Abbreviations: FP, family planning; P&R, pause and reflect; RH, reproductive health; TCI, The Challenge Initiative; TCI-U, TCI University.
