TY - JOUR T1 - A Platform for Sustainable Scale: The Challenge Initiative’s Innovative Approach to Scaling Proven Interventions JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT DO - 10.9745/GHSP-D-22-00167 AU - Clea Finkle AU - Kim Martin AU - Ian Salas AU - Jessica Mirano AU - Lisa Mwaikambo AU - Kojo Lokko AU - Jose Rimon II Y1 - 2022/11/14 UR - http://www.ghspjournal.org/content/early/2023/03/14/GHSP-D-22-00167.abstract N2 - Key FindingsThere 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.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.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.Key ImplicationsLeadership, management, and coordination functions are critical areas for capacity building and successful programming, on par with support to strengthen technical capacity.Scale measures, including reach, uptake (adoption), and sustainability should be designed for local governments to monitor progress without external assistance.Strengthening sustainable systems for scaling effective interventions requires alignment of mission, management, and leadership with programmatic success.Introduction:The global health community continues to face barriers in scaling up evidence-based interventions for widespread adoption. Although many effective interventions have been developed over the years, expanding their reach to benefit broader populations has happened slowly or not at all.Overview:The Challenge Initiative (TCI) is a nontraditional development platform that supports local urban governments to rapidly scale up proven family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH) interventions for the urban poor. TCI prioritizes sustainability and local ownership and uses a health systems approach when planning for and managing scale. TCI strengthens urban health systems with seed funding, coaching, and technical assistance (TA), and TCI University houses “how-to” guidance and tools for implementing the interventions. In turn, local governments commit political will and financial and human resources while using TCI coaching to integrate interventions into routine practice and systems to achieve widespread and sustained impact at scale.Results:As of June 2021, TCI has supported 104 local governments across 11 countries in scaling up effective FP and AYSRH interventions, while also mobilizing about US$28 million from those local governments to facilitate their implementation. TCI has increased capacity and bolstered urban health systems, with 39 local governments “graduating” from TCI support and 2.02 million additional FP clients across 4 regional TA hubs.Conclusion:TCI aims to change how local governments coordinate, finance, and implement proven interventions to improve access to quality FP information and services. With built-in incentives for local governments, partners, and donors to participate, TCI is generating significant learning on how local governments can realize sustainable scale and demonstrating how organizations like TCI that facilitate governments to scale up effective interventions can accelerate the scale-up of these interventions across multiple geographies. ER -