How The Challenge Initiative Adapted and Used Pause and Reflect Responsive Feedback Sessions for Adaptive Management in Nigeria.

backgroundThe Challenge Initiative (TCI) supports state governments to effectively and sustainably scale up family planning and reproductive health (FP/RH) programming in Nigeria. Given the limited evidence on successful scale-up of health interventions, TCI has established responsive feedback (RF) approaches to regularly review and reflect upon its strategies to quickly adapt and document lessons for scaling FP/RH interventions. One of the RF components adopted was pause and reflect (P&R) exercises to facilitate adaptive management.

methodsTCI conducted quarterly P&R exercises to identify what works, adapt strategies where needed, and document lessons learned. These exercises were typically conducted as focus group discussions where staff members deliberated on a topic, strategy, or action and discussed how best to refine, diffuse, or discard it. About 10-15 staff participated in each session, including country office technical advisors, state program managers, and technical leads.

resultsTCI has conducted 4 P&R exercises to date. The first P&R focused on identifying effective strategies for scaling up FP/RH interventions and led to the recognition of TCI's coaching strategy and FP in-reaches as evidence-based approaches. The second P&R focused on how to improve TCI's Reflection and Action to Improve Self-reliance and Effectiveness tool to effectively measure governments' capacity to implement FP/RH interventions. The third P&R on graduation activities of TCI's first phase states revealed best practices for planning graduation activities for its second phase states. The fourth P&R on TCI's coaching strategy showed that geographies require a more structured coaching plan to effectively manage their coaching interventions. Implementation of identified actions from the P&R exercises contributed to noticeable improvements in programming.

conclusionThe P&R exercise has contributed to improvements in adaptive management in TCI programming in Nigeria and is recommended for use by implementing partners, government officials, and other community stakeholders as a useful RF tool.