Using responsive feedback from routine monitoring data to guide course corrections for a family planning intervention in Nigeria

Background: This paper aims to promote the use of interrupted time series analyses of routine data as a responsive feedback tool to improve public health programs on an ongoing basis. This methodology is demonstrated by measuring the effect of a radio campaign to promote a family planning call center in Nigeria on the demand for family planning information and explains how the results were used to adapt the program.   Methods: We used a single group interrupted time series design (ITS) as a responsive feedback mechanism to determine whether the radio campaign influenced use of the Honey&Banana call center. ITS is ideal when a control group is not available and assumes that an interruption of the trend in the outcome measure occurs after the intervention starts. ITS uses the pre-intervention trend to predict what would have happened if the intervention were absent.   Results: After conducting ITS analyses, the results show that the number of calls requesting family planning information increased throughout the campaign period, with a gain of about 500 additional calls per month, and then decreased after the campaign ended. However, the number of calls gained from the campaign was substantially lower than anticipated.   Conclusions: While end-of-project impact evaluations are necessary, there should be regular feedback system to provide program implementers with information about the status of the project, such as failures, successes, and areas of improvements. This would allow implementers to make necessary adjustments as needed throughout the intervention period. The finding that the radio campaign was not living up to expectations helped program implementers to end the campaign prematurely and re-allocate resources to a more promising activity. Our research shows that basic ITS analysis of routine data can be a useful tool for receiving regular feedback to guide programming improvements.