The Challenge Initiative (TCI) is a “business unusual” platform launched in 2016 to help local governments sustainably scale up high‑impact family planning practices. Led by the William H. Gates Sr. Institute for Population and Reproductive Health at Johns Hopkins University and funded by the Bill & Melinda Gates Foundation (with additional support from Bayer for its second phase) TCI has grown rapidly. By 2024, it was working with 214 cities across 13 countries, reaching 285 million people.
TCI’s model is built on government ownership: local governments commit their own resources while drawing on TCI’s Challenge Fund, technical assistance, coaching, and digital learning through TCI University. This approach aims to strengthen self‑reliance and ensure family planning programmes endure beyond TCI’s direct support.
This Executive Summary presents high-level findings from Itad’s independent monitoring, learning, and evaluation partnership with TCI. The evaluation tested TCI’s Theory of Change through an impact evaluation, process evaluation, and cost‑efficiency analysis, examining three core outcomes: increased voluntary uptake of modern contraceptive methods, greater local government self‑reliance in implementing high‑impact practices, and improved efficiency of the TCI platform in supporting sustainable, scalable impact.
