Karl Jays, in partnership with ITAD, conducted a process evaluation of The Challenge Initiative (TCI) in Uganda, focusing on the East Africa Hub districts of Iganga and Tororo. Commissioned by Johns Hopkins University and the Gates Foundation, the evaluation explored the implementation and effectiveness of high-impact interventions (HIIs) designed to increase contraceptive uptake and improve adolescent and youth sexual and reproductive health (AYSRH) outcomes.
The assignment assessed how local governments were empowered to scale evidence-based practices in family planning and AYSRH. Key areas of focus included:
Karl Jays applied a rigorous mixed-methods approach, combining quantitative time series analysis with qualitative assessments of implementation fidelity. Stakeholder engagement was central to the process, with learning sessions designed to validate findings and co-create recommendations. The evaluation provided critical insights into what works, what needs adaptation, and how local systems can be strengthened to sustain impact.
TCI's model of empowering local governments to lead family planning scale-up is a cornerstone of sustainable health system transformation. By evaluating its implementation in Uganda, Karl Jays contributed to a growing evidence base that supports smarter investments, stronger partnerships, and more responsive reproductive health services for youth and communities.