Key Factors to Facilitate Locally Driven Family Planning Programming: A Qualitative Analysis of Urban Stakeholder Perspectives in Africa and Asia

Abstract BackgroundThere has been greater recognition of the importance of country ownership in global health and development. However, operationalising country ownership to ensure the scale up and sustainability of proven interventions remains elusive at best. To address this challenge, we undertook a thematic analysis of interviews collected from representatives of local governments, public health systems, and communities in poor urban areas of East Africa, Francophone West Africa, India, and Nigeria, supported by The Challenge Initiative, aiming to rapidly and sustainably scale up evidence-based reproductive health and family planning solutions. MethodsThe main objective of this study was to explore critical elements needed for implementing and scaling evidence-based family planning interventions. The research team conducted interviews and collected 96 stories using the Most Significant Change (MSC) technique between July 2018 and September 2019, and coded and analyzed the stories. Most frequently used codes were identified and grouped into emerging themes.ResultsFive key themes emerged: (1) strengthening local capacity and improving broader health systems, (2) shifting mindsets of government and community toward local ownership, (3) institutionalizing the interventions within existing government structures, (4) improving data demand and use for better planning of health services, and (5) enhancing coordination of partners. Conclusion While some themes feature more prominently in a particular region than others, taken together they represent what stakeholders perceive to be essential elements for scaling up locally-driven health programmes in urban areas in Africa and Asia.