%0 Journal Article %A Lekan Ajijola %A Victor Igharo %A Nneoma Anieto %A Lisa Mwaikambo %T Improving State Government’s Responsiveness to Family Planning Interventions in Nigeria Using an Innovative Reflection and Action Tool %D 2023 %R 10.9745/GHSP-D-22-00189 %J Global Health: Science and Practice %X Key FindingsThe Challenge Initiative (TCI) Nigeria applied the Reflection and Action to Improve Self-reliance and Effectiveness (RAISE) tool as a responsive feedback mechanism to enable all 13 state governments to assess their progress toward self-reliance in family planning/reproductive health programming; identify gaps; and incorporate learning and feedback to make improvements throughout the implementation life cycle.Adaptation of the RAISE tool to Nigerian and state contexts improved local and state government teams’ understanding of adaptive program management, leading to positive changes.Key ImplicationsPolicymakers should adopt and institutionalize the RAISE tool for responsive feedback to make improvements in primary health care programs in real time.Government program managers and implementers should scale up use of the RAISE tool to regularly obtain and analyze feedback data for continuous improvement.Decision-makers should use the findings from the RAISE assessments to make evidence-based decisions for adaptive management of their health programs.Background:The Challenge Initiative (TCI) works with state governments in Nigeria to scale high-impact family planning and reproductive health (FP/RH) interventions rapidly and sustainably. The Reflection and Action to Improve Self-reliance and Effectiveness (RAISE) tool is an innovative responsive feedback (RF) mechanism developed by TCI to periodically monitor governments’ readiness to sustain implementation of their FP/RH interventions.RAISE Description:The RAISE tool—a facilitated, self-administered tool used quarterly to track program improvements, identify gaps, and provide feedback—contains FP/RH progress indicators across 4 pillars: political and financial commitment, government capacity, institutionalization, and sustained demand. As a maturity matrix that helps state governments to understand the extent of their self-reliance in leadership and program management, the tool measures the stages of capacity: “beginning” (54% and below), “developing” (55–69%), “expanding” (70–84%), and “mature” (85% and above). Participants self-administer the tool with a trained government facilitator, develop a remediation plan with timelines and responsible persons assigned to address identified gaps, and communicate the plan to the broader FP/RH program team.Assessment Results:Thirteen supported states have completed 5 rounds of assessments between June 2020 and September 2022. Baseline results revealed that 4 states were at the developing stage, 8 were at the expanding stage, and 1 had a mature program. The most recent assessment revealed mature capacity for 9 states while the 4 others are in the expanding stage. Consequently, all the states demonstrated improved government self-reliance over the course of the year.Conclusion:To ensure objectivity, RAISE participants, who include government policymakers, program managers, and implementers, use available government data sources to complement assessment findings. As an RF mechanism, the RAISE tool contributed to governments’ enhanced leadership and management of their FP/RH programs, with current considerations for modifications to serve other primary health care programs. %U https://www.ghspjournal.org/content/ghsp/early/2023/03/03/GHSP-D-22-00189.full.pdf