Fig. 1

M&E tools, approaches, and activities used at different stages of programme design and implementation. a All stakeholders at national, district, sub-county and community (village) level as well as researchers were involved at planning and during the implementation phase. b National policy-makers were involved in biannual stakeholders’ meetings conducted at national level and quarterly presentation at Ministry of Health reproductive health steering committee. c Theory of Change (ToC) was performed during design stage and was revised during the implementation through data collection and meeting with stakeholders at different levels. d Mapping was conducted during the design phase and included all stakeholders at national, district, sub-county and community (village) level. e The most significant change (MSC) approach was performed quarterly throughout the implementation period, with (f) participatory impact pathway analysis (PIPA) performed twice and involving only district stakeholders, sub-county stakeholders, implementing partners and researchers. This approach collected data through formal meetings. g Surveys, key informant interviews (KIs) and focus group discussions (FGDs) were performed at the beginning of implementation (baseline), quarterly/midterm and at the end of the implementation (end line). h Health facility assessments were performed at the beginning of implementation (baseline), quarterly/supportive supervision and at the end of the implementation (end line). i During formal meetings, for instance, quarterly review meetings, we collected data on significant changes and conducted PIPA workshops