IPPF Theory of Change example
RATIONALE
Our Theory of Change stipulates why and how seven inter-related strategies – dovetailing with the Nigerian Government’s Family Planning Blueprint1 – lead to seven medium term outcomes, which are prerequisites for long- term outcomes. The buy-in demonstrated by the Oyo State Ministry of Health, LGAs and communities can be replicated and will be key to reaching vulnerable populations in the Kaduna State.
The ClusterPLUS model combines inter-related training, task shifting and community mobilisation strategies. Increasing knowledge leads to informed, mobilised communities, which will demand more SRH services and who are then better able to advocate and hold decision-makers to account. Advocacy will promote affordability through both the voucher scheme and community-based health insurance scheme (CBHIS): advocates will push for greater coverage of the CBHIS and adoption of the voucher scheme to implement it. Training is integral to quality assurance and the youth-centred approach: building capacity to deliver youth-friendly services and combatting stigma against young people and underserved populations, such as people living with HIV, people with disabilities and Lesbian Gay Bisexual Transgender/Transsexual Intersex (LGBTI) communities. Working closely for buy-in and on government advocacy is a key post-project sustainability measure.
Our strategies will increase access, availability, affordability, acceptability of family planning, enhance youth agency and demand, and will promote government ownership and commitment. This will expand the offer of quality; rights-based family planning services and increase the use of family planning services by 136,237 new users. LARCs play a key role in satisfying the unmet need for family planning, and therefore we ultimately expect that contraceptive prevalence will increase, and contribute to Nigeria’s ambitious target of 36% CPR by 2018. Furthermore, family planning improves maternal and newborn health, enables women and girls to reach their potential, enhances women’s economic empowerment and improves economies, reducing poverty. Family planning is a development “best buy”, playing a pivotal role in the achievement of the Sustainable Development Goals.2
The strategy is informed by PPFN’s experience of the successful cluster model and learning and evidence from the ClusterPLUS pilot. Evidence from the pilot underpins many of the assumptions. The pilot identified demand creation (acceptability) and reaching youth as key strategies to be strengthened. These areas are also not being targeted at all or as strongly by other main development partners in the country. The Oyo pilot shows that when offered informed choice, an increased number of vulnerable women use family planning, particularly LARCs, and uptake of essential SRH services rises; CHEWs – when supported and motivated -generate demand and increase service uptake; and the voucher scheme extended access for vulnerable populations.
1 Federal Ministry of Health. Nigeria Family Planning Blueprint (Scale-up Plan). 2014. http://www.health.gov.ng/doc/Nigeria%20FP%20B_print.pdf
2 Starbird E, Norton M, Marcus R. Investing in family planning: key to achieving the sustainable development goals. Glob Health Sci Pract. 2016;4(2):191-210.