The Challenge Initiative

The Challenge Initiative (TCI)

Overview

The Challenge Initiative (TCI) is a global platform designed to support governments in rapidly scaling up proven family planning and reproductive health solutions. In Pakistan, TCI is implemented by Greenstar Social Marketing Pakistan, working in close partnership with provincial and district governments. TCI operates under a “Business Unusual” model emphasizing:
  • Local government ownership
  • Cost-sharing and sustainability
  • Data-driven decision making
  • Rapid scale-up of high-impact interventions
The initiative focuses on strengthening public health systems to deliver quality family planning services, particularly for underserved urban populations.

Geographic Coverage

TCI Pakistan works across multiple districts and cities in:
  • Punjab
  • Sindh
  • Islamabad Capital Territory (ICT)
The program prioritizes urban and peri-urban areas where unmet need for family planning remains high. Target Population The initiative focuses on:
  • Women of reproductive age
  • Youth and adolescents
  • Urban underserved communities
  • Low-income populations
  • Married couples with unmet need
Special attention is given to improving equitable access to quality reproductive health services.

Program Focus

TCI strengthens government systems rather than creating parallel structures. The focus is on:
  • Improving service quality in public facilities
  • Expanding access through outreach
  • Building capacity of health providers
  • Strengthening data use for decision-making
  • Ensuring sustainability through government ownership
High-Impact Interventions Below are the core intervention areas implemented under TCI in Pakistan:
  1. Community Health Worker (CHW) Engagement
TCI strengthens the role of community health workers by:
  • Improving their technical knowledge
  • Enhancing referral linkages with facilities
  • Supporting counseling skills
  • Promoting family planning awareness at household level
This approach increases community demand and improves continuity of care.
  1. Integrated Outreach Camps
Mobile outreach services are organized to:
  • Deliver family planning services in underserved areas
  • Provide counseling and method choice
  • Increase access to long-acting reversible contraceptives
These camps bridge service gaps in hard-to-reach communities.
  1. Facility Makeovers & Quality Improvement
Selected public health facilities are upgraded to:
  • Improve client privacy and comfort
  • Ensure infection prevention standards
  • Strengthen counseling spaces
  • Improve service readiness
The objective is to enhance client experience and increase service uptake.
  1. On-the-Job Training (OJT)
Instead of traditional classroom training, TCI promotes:
  • On-site mentoring
  • Practical skill development
  • Real-time clinical coaching
This ensures immediate application of learning and improved service quality.
  1. Data for Decision Making (D4D)
TCI strengthens routine data systems by:
  • Training staff on data recording and reporting
  • Supporting data review meetings
  • Promoting evidence-based planning
Regular data use helps districts identify gaps and improve performance.
  1. Advocacy & Government Engagement
Sustainability is ensured through:
  • Engagement with district leadership
  • Budget advocacy for family planning
  • Policy alignment with provincial strategies
Government ownership is central to TCI’s model.
  1. Coaching Model
A structured coaching approach supports:
  • District health managers
  • Facility staff
  • Program implementers
Coaching builds leadership capacity, accountability, and problem-solving skills within government systems.

Sustainability Approach

TCI emphasizes:
  • Institutionalizing high-impact interventions
  • Integrating activities into district work plans
  • Building long-term capacity
The goal is not temporary support but durable system strengthening.  

IMPACT & RESULTS


Through collaboration with government partners, TCI Pakistan has achieved:
  • Thousands of service delivery camps conducted
  • Additional family planning users reached
  • Health providers trained and mentored
  • Facilities upgraded for improved quality
  • Strengthened district data systems
These achievements demonstrate scalable, sustainable improvements in urban family planning services.
Impact Metrics Dashboard TCI Impact Dashboard
Outcomes narrative: Through the implementation of High Impact Interventions (HIIs), TCI achieved significant improvements in family planning service delivery and health system strengthening. A total of 30,786 service delivery camps were supported including 16,686 Family Health Day camps that served over 816,000 FP clients. Outreach camps further expanded access reaching more than 561,000 clients. Capacity building remained central with 323 on-the-job training sessions, 27,731 coaching sessions, and the development of 654 Master Coaches, 281 of whom remain active. Facility readiness was enhanced through the renovation and upgrading of 83 health facilities. Data-driven decision-making was strengthened through 570 review meetings. These combined efforts resulted in an estimated 386,532 additional family planning users, demonstrating sustained impact and institutionalization of HIIs.

Stories & Testimonials


Government officials and health managers have recognized TCI’s contribution in:
  • Improving service coverage
  • Enhancing provider skills
  • Strengthening data systems
  • Expanding access to underserved populations
Their testimonials reflect strong collaboration and measurable results at district level.
Kojo Lokko

Kojo Lokko

Executive Director, TCI Global

"Over the past four and half years, together we have been pursuing a simple but a powerful goal: enabling women and families to decide when to have children and how space their births. This is not just about numbers, it is about healthier mothers, stronger children and more prosperous communities. Family Planning saves lives and builds futures. Pakistan stands at pivotal moment with 64 percent population under the age of 35. This is the country of young energy, ambitions, and possibility. There is no doubt that the country has extraordinary potential. Yet the population growth remains high which is a challenge. That is why, working on strengthening Family Planning and reproductive health is central to unlocking Pakistan's promise and ensuring that women and families thrive. None of the progress would have been possible without the strong leadership. I want to appreciate the amazing leadership at provincial and district levels in Punjab and Sindh and above all the hard-working health and population workers. They are the heart of this transformation. The aim of TCI has always been to build local capacities to transfer knowledge, skills, and systems so that districts can sustain what works. TCI will continue to stand as a critical friend of health & Population departments of Punjab and Sindh. I am grateful to our partner Greenstar Social Marketing-Pakistan under the leadership of Dr. Azizur Rab CEO-GSM and his dedicated team for housing and guiding TCI in Pakistan with such excellence. The stories of Family Planning in Sindh and Punjab are those of courage, commitment, and collaboration. May this momentum continue to grow ensuring healthier mothers, healthier children, and healthier Sindh and Punjab."
Khawaja Imran Nazir

Khawaja Imran Nazir

Minister for Health & Population, Government of Punjab

"Since assuming the responsibility of Minister for Health and Population, Punjab, the organization I have seen working with the greatest dedication and passion is Greenstar Social Marketing–Pakistan. Through its projects and close collaboration with the Health and Population Departments, Greenstar has been steadfast in advancing the well-being of women across Pakistan. I commend their commitment and wish them continued courage and determination as they scale up family planning services to ensure better health for every woman in the country."
Dr. Azra Fazal Pechuho

Dr. Azra Fazal Pechuho

Minister for Health & Population, Government of Sindh

"One of the most commendable contributions of TCI-GSM has been the renovation and upgradation of vulnerable health facilities which has significantly improved service delivery and increased family planning clientele. I look forward to a long-term collaboration with TCI-GSM to further strengthen maternal and child health outcomes across Sindh."
Rehan Baloch

Rehan Baloch

Secretary Health, Government of Sindh

"While the Population Welfare Department has a dedicated mandate for family planning, the Health Department also provides family planning services alongside maternal, neonatal, child healthcare, and gynaecological services. In collaboration with TCI-GSM, we have been working to deliver quality family planning services in underserved urban areas. Through initiatives such as Family Health Days and Satellite Camps, we have been able to reach communities where health facilities are distant or access to services is limited."
Dr. Shah Faisal Zahir

Dr. Shah Faisal Zahir

Director, CTL&S, PWD, Sindh

"The population challenges in the urban slums of Karachi and Hyderabad have been effectively addressed through the support of The Challenge Initiative (TCI) under Greenstar Social Marketing-Pakistan. TCI-GSM’s collaboration with government departments particularly the Population Welfare Department, Sindh has been highly commendable. The implementation of best practices and evidence-based high-impact interventions with TCI-GSM’s technical support has delivered tangible results enabling us to achieve more than 100,000 additional users. This timely support to the government has been crucial and I am confident that continued implementation of interventions such as Family Health Days, Satellite Camps, and capacity-building initiatives will further help reduce the population burden in the urban slums of Karachi and Hyderabad."
Dr. Asif Arbab Khan Niazi

Dr. Asif Arbab Khan Niazi

CEO Health, Lahore

"Although TCI-GSM has been active in six major and most populous districts of Punjab, I had the privilege of working closely with their team in Rawalpindi and Lahore. In Rawalpindi, we achieved significant impact through evidence-based interventions such as Family Health Days and Satellite Camps. A key highlight was our focus on male engagement where we designed and implemented activities to enhance male involvement in family planning. Special counselling counters for men were established at health facilities and our mobilization staff received targeted capacity-building to strengthen male participation. After my appointment as CEO in Lahore, we continued with the same energy and commitment. TCI-GSM provided technical support for the capacity building of health managers and staff of the newly outsourced Maryam Nawaz Health Clinics focusing on high-impact family planning interventions and improved maternal and neonatal child healthcare."
Dr. Umar Munir

Dr. Umar Munir

District Coordinator, DHA, Gujranwala

"Since 2023, the Health & Population Department, Gujranwala, in collaboration with TCI-GSM, has been working to scale up family planning services in the district. TCI-GSM provided technical support for capacity building of healthcare staff, with a special focus on family planning, covering all levels of staff both clinical and non-clinical. We organized Family Health Days, Satellite Camps, and Whole Site Orientation sessions and emphasized the use of Long-Acting Reversible Contraceptive (LARC) methods by issuing clear official guidance and institutionalizing evidence-based high-impact interventions. As a result, the contraceptive prevalence rate in Gujranwala increased from 17% to 49%."
No name

No name

District Population Welfare Office, Gujranwala

"The District Population Welfare Office, Gujranwala, in collaboration with TCI-GSM, has been working vigorously to scale up family planning services in the district. TCI-GSM trained master coaches whose knowledge was cascaded to staff leading to significant improvements in family planning uptake and overall healthcare services. Previously, Gujranwala ranked 36th in Punjab in contraceptive prevalence rate (CPR). Following the implementation of high-impact interventions, focused capacity-building trainings, and enhanced awareness activities, Gujranwala now ranks 2nd in Punjab, with a CPR of over 49%."
Dr. Muhammad Usman Zia

Dr. Muhammad Usman Zia

District Coordinator, DHA, Khanewal

"We have been collaborating with TCI-GSM in Khanewal for over two years. During this period, we implemented high-impact interventions such as Family Health Days and Satellite Camps, while focusing on the capacity building of healthcare staff, particularly on postpartum family planning. These efforts have contributed to a significant improvement in family planning services in Khanewal."
Khizer Hayat

Khizer Hayat

District Population Welfare Officer, Multan

"The collaboration between the District Population Welfare Office, Multan and TCI-GSM has brought new energy to family planning efforts in the district. We began by analyzing existing structures, policies, and community needs through program design workshops and then developed contextualized and focused interventions. These efforts have significantly improved family planning services and awareness in Multan."
Dr. Umar Nawaz

Dr. Umar Nawaz

District Coordinator, DHA, Faisalabad

"Most notably, TCI-GSM has transformed the behavior and approach of our healthcare staff through its coaching model. Their well-designed and practical coaching approach continuously motivates staff, keeping them on track and inspiring them to better serve the community."
Dr. Ehsan Ghani

Dr. Ehsan Ghani

CEO Health, Rawalpindi

"The Health & Population Department, Rawalpindi, has benefited from TCI-GSM’s technical support for over two years. Our primary focus has been on institutionalizing high-impact interventions, which have significantly increased family planning uptake. Through this collaboration, we improved service quality, ensured easier access, enhanced staff capacity, and fostered positive behavioural change among health leadership."
Dr. Naveed Akhtar Malik

Dr. Naveed Akhtar Malik

Project Director, Punjab AIDS Control Program

"As District Coordinator in Rawalpindi, I and my team worked closely with TCI-GSM to implement high-impact interventions. These efforts not only improved family planning indicators but also enhanced maternal and neonatal healthcare in the district. We revitalized health facilities in vulnerable areas improving both their infrastructure and family planning service delivery which resulted in increased client uptake across these facilities."
Dr. Waqar Mehmood Memon

Dr. Waqar Mehmood Memon

Director General, Health Services, Sindh

"Prioritizing family planning has been a top agenda item for the Health Department and Minister for Health & Population, Dr. Azra Fazal Pechuho. Sindh has the advantage of integrated leadership for health and population matters. TCI-GSM’s technical support significantly contributed to increased family planning uptake through focused camps and staff capacity-building initiatives. Together, we renovated 29 health facilities under the Facility Makeover HII and the before-and-after comparisons show a multifold increase in clientele across all facilities."
Dr. Lajpat Kessani

Dr. Lajpat Kessani

District Health Officer, Karachi West

"The Department of Health, in collaboration with TCI-GSM, placed a strong focus on male mobilization which stands out as a key highlight of this partnership. Through TCI-GSM–facilitated capacity-building trainings, Saleem, a male nurse, was trained in Jadelle insertion and now he provides this service with full confidence. The trainings on advanced family planning methods, postpartum family planning, and effective communication skills have collectively contributed to significant improvement in the quality of FP services."
Mukhtar Ahmad Memon

Mukhtar Ahmad Memon

District Population Welfare Officer, Karachi Central

"Since entering into partnership with TCI-GSM, we have been working closely to strengthen the health system in Karachi Central. The implementation of high-impact family planning interventions has enabled Karachi Central to achieve the top ranking across Sindh. TCI-GSM’s technical support in engaging Community Health Volunteers helped bridge mobilization gaps for family planning, resulting in increased family planning clientele."
Bakhat Ali Sial

Bakhat Ali Sial

District Population Welfare Officer, Hyderabad

"The Population Welfare Department has been serving communities since 1965; however, there has always been a need to expand and strengthen our efforts. With the support of TCI-GSM, we organized family planning camps for underserved communities providing free access to quality services. TCI-GSM’s technical assistance in upgrading Family Welfare Centres in Hyderabad led to increased family planning clientele while Community Health Volunteers supported by TCI-GSM played a vital role in generating demand for family planning services."
Dr. Wali Muhammad Rahmoon

Dr. Wali Muhammad Rahmoon

District Health Officer, Keamari

"Since 2023, the Department of Health, Keamari, has been collaborating with TCI-GSM to strengthen family planning services. Prior to this partnership, efforts were fragmented and comprehensive family planning interventions were limited. With TCI-GSM’s technical assistance, we adopted evidence-based high-impact interventions in both service delivery and demand generation. As a result, our health facilities now serve more than 2,000 clients each month including 200-300 LARC clients."
Dr. Shah Muhammad Sheikh

Dr. Shah Muhammad Sheikh

District Health Officer, Korangi

"The Department of Health, in collaboration with TCI-GSM, has implemented multiple initiatives in District Korangi to increase family planning uptake. The most notable among these has been a comprehensive capacity-building plan for both clinical and non-clinical staff. Service providers were trained on advanced family planning methods and effective techniques to address myths and misconceptions contributing to improved maternal and child health outcomes."
Dr. Amina Azeem

Dr. Amina Azeem

Deputy District Population Welfare Officer, Malir

"TCI-GSM introduced the TCI University platform, which offers a comprehensive package of knowledge and learning to strengthen capacities in family planning, maternal and child health, and youth-friendly services. The platform enables continuous learning by refreshing knowledge through advanced studies and global best practices. Master coaches trained by TCI-GSM actively use this resource to stay updated and to cascade new learning to frontline and support staff."

Story Details

EVENTS, PHOTOS & VIDEOS

Key Events

World Contraception Day 2025
Event Photo 2

Ministry of Health, FP 2030 and Greenstar Lead Successful Commemoration of World Contraception Day 2025

Date: 26 September 2025

Location: Multiple locations across Pakistan

Purpose: To commemorate World Contraception Day and promote family planning awareness across Pakistan through collaborative efforts with government and international partners.

2 Photos
Youth Power for FP2030

Youth Power for FP2030: Voices That Shape the Future!

Date: 26 September 2025

Location: Islamabad

Purpose: Greenstar Social Marketing under the leadership of the Ministry of Health and in collaboration with UNFPA, FP2030 and other partners proudly hosted the Youth Policy Dialogue for FP2030.

1 Photo
World Contraception Day Pakistan
World Contraception Day Pakistan

World Contraception Day 2025 – Pakistan

Date: 26 September 2025

Location: Nationwide

Purpose: Today, Pakistan joins the global community in reaffirming that family planning is not just a health choice, but a leadership priority. Strong leadership at every level.

2 Photos
Health Facility Inauguration
Facility Opening
Facility Opening

Inauguration of Upgraded Health Facility in Bilal Colony

Date: 9 September 2025

Location: Bilal Colony, Karachi

Purpose: Greenstar- The Challenge Initiative (TCI) and Department of Health, RMNCH Sindh, inaugurated the Upgraded Sindh Government Dispensary (SGD) 500 Quarter, Keamari.

3 Photos
World Contraception Day Lahore
Event Activities

Greenstar–TCI Punjab World Contraception Day Commemoration

Date: 29 September 2025

Location: Lahore, Punjab

Purpose: Greenstar–TCI Punjab, in collaboration with the Health & Population Department, Punjab, commemorated World Contraception Day in Lahore under the theme "Breaking Barriers, Building Bridges: Contraceptives' Access for All."

2 Photos
TCI Annual Meeting
Pakistan Presentation

Celebrating Impact: Pakistan's Family Planning Efforts Spotlighted at TCI Annual Meeting

Date: 3 November 2025

Location: Bogotá, Colombia

Purpose: During the Annual Meeting held in Bogotá, Colombia on November 2, 2025. Pakistan's family planning achievements were showcased at the global platform.

2 Photos
ICFP 2025
Research Presentation
Research Presentation

TCI-GSM Showcased Data-driven Research at ICFP 2025

Date: 02-05 November 2025

Location: Bogotá, Colombia

Purpose: TCI-GSM presented data-driven research work at the International Conference on Family Planning (ICFP) 2025, showcasing Pakistan's progress in family planning interventions.

3 Photos
Partners Forum
Partners Forum
Partners Forum

Punjab Sets Up Family Planning Partners Forum to Drive Collaborative Action

Date: 20 August 2025

Location: Lahore, Punjab

Purpose: Establishment of collaborative platform to drive coordinated action across stakeholders for family planning initiatives in Punjab.

3 Photos

PUBLICATIONS & KNOWLEDGE PRODUCTS

TCI Pakistan Program Overview 2025

Type: Program Report

Year: 2025

Geography: Pakistan

Comprehensive overview of TCI's implementation, achievements, and impact in Pakistan's urban family planning landscape.

View Publication

Pakistan Journal of Public Health: Family Planning Special Edition

Type: Journal Edition

Year: 2025

Geography: Pakistan

Special edition featuring research articles and case studies on family planning interventions and outcomes in Pakistan.

View Publication

Data-Driven Decision Making in Urban Family Planning: TCI Pakistan Case Study

Type: Research Preprint

Year: 2025

Geography: Pakistan

Analysis of how data-driven approaches have transformed family planning service delivery in urban Pakistan.

View Publication

PARTNERS & DONORS

Implementation Partners

Federal, provincial, and district health & population departments
Public sector health facilities
Community-based organizations
Local governments and municipal authorities

Technical Partners

The Challenge Initiative (TCI) Global
Greenstar Social Marketing–Pakistan
Ministry of National Health Services, Regulations & Coordination
Health & Population Department Punjab
Department of Health, Sindh
Population Welfare Department, Sindh

Donors/Funders

Bill & Melinda Gates Foundation Primary global donor to The Challenge Initiative
Bayer Foundation Global partner supporting family planning initiatives

CONTACT & OWNERSHIP

Ghazunfer Abbas

Chief of Party, TCI-GSM

+92-51-111-123-456 Dummy telephone
Greenstar Social Marketing Pakistan
Karachi, Pakistan