This study presents findings from a systematic review of evaluations of family planning interventions published between 1995 and 2008. Studies that used an experimental or quasi-experimental design or had another way to attribute program exposure to observed changes in fertility or family planning outcomes at the individual or population levels were included and ranked by strength of evidence. A total of 63 studies were found that met the inclusion criteria. The findings from this review are summarized in tabular format by the type of intervention (classified as supply-side or demand-side). About two-thirds of the studies found were on demand generation type-programs. Findings from all programs revealed significant improvements in knowledge, attitudes, discussion, and intentions. Program impacts on contraceptive use and use of family planning services were less consistently found and less than half of the studies that measured fertility or pregnancy-related outcomes found an impact. Based on the review findings, we identify promising programmatic approaches and propose directions for future evaluation research of family planning interventions.

Despite the proliferation of Mobile Instant Messaging (MIM) platforms, such as WhatsApp, studies that examine their role for learning and knowledge sharing are still rare. Using the context of global health, this study seeks to examine the ways in which MIM platforms are being used for learning and knowledge sharing and identify associated potentials and constraints. A survey with open- and closed-ended questions was administered and the experience of 40 respondents from 44 different project settings was gathered and analyzed. The findings indicate that MIM, and particularly WhatsApp, are used in a boundary-crossing manner, i.e., involving various groups of health professionals, students, and patients from across a range of low-income countries, particularly from Sub-Saharan Africa. MIM platforms are used in informal learning settings for knowledge creation and sharing, supervision, enacting social presence and collaborative problem solving, and for the support of formal education. In addition to enhancing communication efficiency and responsiveness, MIM was also used to bridge geographical (e.g., central-local and urban-rural) and social divides (e.g., professional rankings). Despite technical and socio-behavioral constraints, the use of MIM was reported to significantly benefit distributed global health work and to enhance learning and knowledge sharing in “distributed” networks of practice.

Background There 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 (TCI), aiming to rapidly and sustainably scale up evidence-based reproductive health and family planning solutions. Methods The main objective of this study was to explore critical elements needed for implementing and scaling evidence-based family planning interventions. The research team conducted thematic analysis of 96 stories collected using the Most Significant Change (MSC) technique between July 2018 and September 2019. After generating 55 unique codes, the codes were grouped into related themes, using TCI’s model as a general analytical framework. Results Five key themes emerged: (1) strengthening local capacity and improving broader health systems, (2) shifting mindsets of government and community toward local ownership, (3) institutionalising 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.

reported that using the Most Significant Change (MSC) technique had resulted in learning within and across countries to diffuse evidence-based interventions, as well as take concrete adaptive management actions.n Collecting significant change stories allows various voices and perspectives across the health system, from the community level to policy makers, to be captured about the impacts of programs, thus enabling prompt corrective actions.n Selection meeting discussions and responsive feedback about the significant change stories among various project stakeholders are critical for learning and collaboration.