The Challenge Initiative (TCI) is a five-year urban reproductive health program funded by the Bill & Melinda Gates Foundation.

According to the United Nations, 66% of people around the world will be living in urban areas by 2050—2.5 billion more people than today. Ninety percent of this increase will be in cities in Asia and Africa. Despite increasing urbanization, the poorest people living in cities rarely have adequate access to health information and services.

TCI builds on the former Urban Reproductive Health Initiative (URHI), which the Bill & Melinda Gates Foundation initiated to test a comprehensive approach to improve contraceptive access in cities in India, Kenya, Nigeria, and Senegal. IntraHealth led the Senegal URHI project, or Initiative Sénégalaise de Santé Urbaine (ISSU), and partnered with international NGOs, local community-based organizations, municipal health teams, and religious leaders to promote the benefits of family planning, dispel myths and rumors about contraceptives, encourage male involvement, and improve the quality of family planning services.

As an agent of TCI and member of the TCI Consortium, IntraHealth will act as an “accelerator hub” and serve as a catalyst, advocate, and source for technical expertise to scale up family planning in Francophone West Africa. IntraHealth will again work in Senegal, as well as expand its reach via TCI to the eight other countries of the Ouagadougou Partnership: Benin, Burkina Faso, Cote D’Ivoire, Guinea, Mali, Mauritania, Niger, and Togo.

The Johns Hopkins Bloomberg School of Public Health leads The Challenge Initiative. Two Hopkins-affiliated institutions, Jhpiego and the Center for Communication Programs, and the India office of Population Services International (PSI) are also serving as in-country accelerator hubs.