We're scaling girl-centered contraceptive programming.

When girls have the tools – like contraception – to take charge of their lives, they have the power to achieve their goals.

But through insight gathering, we’ve heard girls say that they don’t see the connection between contraception and their future.

Adolescents 360’s girl-centered approach to contraceptive programming­ shows that we can increase girls’ voluntary uptake of contraception and support girls to choose the lives they want to live. And through Adolescents 360’s next phase – A360– we’re supporting health systems across Nigeria, Ethiopia, Kenya and Tanzania to do just that, with girls and governments leading the way.

But this impact is merely a drop in the ocean.

To achieve a world in which every girl can reach her goals, girls need health systems to integrate girl-centered approaches into policy and practice. Join us to sustain the change we’ve already made, and scale it to bring more health impact to girls.

About A360

When we start the conversation with girls’ goals, we can support girls to see the value of contraception to their lives. When health systems take that approach to scale, we can drive closer to a reality in which every young person has the tools to reach their goals.

And when girls can achieve their life plans, they have the power to dream of – and achieve– a better future.

Girls need us to get there. We can amplify this approach, together.

Click the below breakouts to explore all things A360.

Why here? Why now?

When we speak to girls’ priorities, we can support girls to see how tools like contraception can help them to achieve their goals.

It’s a girl-centered approach that supports girls to decide their futures and contribute to the welfare of their family, community and country.

But most girls don’t have access to a girl-centered approach.

We start the conversation with girls’ goals to reframe how girls view, value and choose contraception – on their own terms.

When we start the conversation with girls’ dreams, girls can reimagine how they view, value and choose contraception – on their own terms.

When we build girls’ and their families’ understanding of how contraception can help girls to achieve their goals, we can generate demand for contraception.

And when we work in partnership with health systems to deliver adolescent-friendly services on the community-level—and when we take it further by amplifying the approach at scale— we can support governments to support girls in taking charge of their lives.

Through Adolescents 360’s next phase – A360 – we’re supporting health systems across Nigeria, Ethiopia, Kenya and Tanzania to do just that, with girls and governments leading the way.

We apply a user-centered, empathetic and responsive approach to:

  • Support girls to identify their goals
  • Explore what stands between girls and their ability to achieve their goals
  • Identify how we can make contraception relevant to girls’ lives

 

We work in tandem with young people and health actors.

We work in tandem with young people and health actors to deliver programs that adapt to girls’ and health systems’ needs and allow for continuous program improvement both as we implement programs in static sites and as we journey toward scale.

  • We aim to work in partnership with health systems and non-health experts to serve girls’ holistic needs, within and beyond their reproductive health.

Since 2016, we've catalyzed impact at scale, within and beyond A360's original countries.

From A360’s implementation launch in Jan. 2018 through Sept. 2020, 400K+ girls have voluntarily adopted modern contraception through A360.

  • We’ve scaled A360 programs in Nigeria and Tanzania, integrated our model into Ethiopia’s national health extension program and replicated our approach in Mozambique and Kenya.
  • We’ve invested in learning; we document and disseminate our successes and failures – this allows us to both continuously improve A360 programming, while supporting others across our sector to learn what has and hasn’t worked for A360, and put that work into practice.

Together, we've created an evidence-based user journey intended to speak to and stay with girls - throughout their health journey.

The evidence that informed the user journey? You can explore it here.

Our 5-year plan.

Over the next 5 years, A360 will:

  • Design solutions to strengthen support for contraceptive continuation.
  • Provide more substantive economic empowerment opportunities for adolescent girls.
  • To support adoption and continuation, strengthen engagement with girls’ key influencers
  • Better reach harder to reach populations within A360 geographies (e.g. Ethiopia pastoralist).
  • Integrate services to respond to girls’ holistic needs, beyond just their reproductive health.
  • Institutionalize A360 programs into government health systems, to build the evidence for what it takes to scale girl-centered programs at the national-, district- and state-levels.

Join the work.

To achieve a world in which every girl can reach her goals, girls need health systems to integrate girl-centered approaches into policy and practice.

Join us to sustain the change we’ve already made, and scale it to bring more health impact to girls.

  • Integrate girl-centered approaches into your health systems.
  • Invest in A360.
  • Partner with us to support governments to harness the demographic transition and achieve a demographic dividend.
    • Deliver girl-centered programming – and positive youth development approaches – at large scale.
    • Support governments to include girls in policy and decision making.Apply A360’s learnings to global AYSRH learnings – and incorporate them into co-authored research. In doing so, we can continue building the evidence for what it takes to:
      • Deliver girl-centered programming – and positive youth development approaches – at large scale.
      • Support governments to include girls in policy and decision making.
      • Support governments to be adaptive and responsive to girls’ needs and experiences with national ASHR programming.
      • Support government agencies to own cross-sectoral work.

A360's Girl-Centered Approach

Diverse team

We work with a diverse team, including young people.

  • We work in partnership with health systems and non-health experts to serve girls’ holistic needs, within and beyond their reproductive health.
  • 280+ young designers informed A360’s design and continue to lead the direction as A360 pursues scale through health system integration.
  • Adolescent developmental science delivered a lens to understand adolescents’ cognitive development and resulting evolving motivations.
  • Cultural anthropology allowed us a framework to understand the societal and cultural influences that shape girls’ self-perception, and view of the world around them.
  • Meaningful youth engagement/PYD allowed us to engage young people as not just clients but core partners and experts of their own lived experiences.
  • HCD set the framework for how our array of disciplines could work together to bring insights into action.
  • Economic empowerment allows us to meaningfully support girls to develop financial security – a component that allows us to deliver on our promise to girls beyond their initial engagement with A360’s SRH services.

Aspirational programming

Through programming models that start the contraceptive conversation with girls’ goals, we support girls to see the relevance of contraception to their lives and decide if contraception is for them.

  • Young people have shared that they see contraception as a threat to their dreams of motherhood, and irrelevant to their lives. We reframe the narrative by leading with her goals for her.
  • We build girls’ skills to decide if contraception is for them.
  • Without a support system, girls’ choices and opportunities are constrained. We respond by building support among her key influencers – her family and her community– to remove barriers and create enablers that support her to choose the life she wants to live.

A 360° approach

We take a holistic, 360° approach to the design, delivery and scaling of our programs.

  • Girls’ voices and experiences inform continuous improvements to strengthen our programs. We take an adaptive, insight-driven approach to implementation to ensure girls’ priorities and concerns inform our journey to scale.
  • Our long-term vision is bold: we aim to work alongside health systems and diverse partners to see, reach and serve girls’ holistic needs, within and beyond their reproductive health. We believe we can achieve that goal by supporting governments to integrate girl-centered approaches to policy and programming – at scale.

Economic empowerment

To support governments to support girls to take charge of their lives, we’re committing to leaning into the complexity.

That’s why A360 works in partnership with health systems and non-health experts to serve girls’ holistic needs, including their desires for stable and secure futures.

WHAT WE’VE LEARNED

1. HER PRIORITIES

Whether it’s our life skills training, vocational skills practice sessions or financial planning support, A360’s skills building activities speak to girls’ interests and helps A360 to establish the relevance of contraception to girls and their families.

A360 programs incorporate economic empowerment components. This allows us to meaningfully support girls to develop financial security and to deliver on our promise to stay with girls beyond their initial engagement with A360’s contraceptive services.

2. BUY-IN

The inclusion of skills building activities also fosters the approval of girls’ key influencers and mobilizes girls for services. In northern Nigeria, husbands of MMA participants find the income generating skills their wives learn a highly compelling reason to support their wives to attend MMA.

3. WE CAN – AND ARE – DOING MORE

Girls have high expectations for the vocational skills component of the program and for some the reality falls short of their expectations. Girls for example expressed a desire to learn more than one skill, and to return to classes to practice the skills they had learnt. When expectations are not met, girls report diminished support from their influencers. We’re strengthening our program components to provide girls with more substantive economic empowerment opportunities.

A bold commitment to ASRH

To support governments to support girls to take charge of their lives, we’re committing to leaning into the complexity. A360 will:

  • Design solutions to strengthen support for contraceptive continuation.
  • Adapt to provide more substantive economic empowerment opportunities for adolescent girls.
  • Adapt to expand and strengthen engagement with adolescent girls’ key influencers (i.e. partners, mothers, mothers-in-law), in support of adoption and continuation.
  • Adapt A360 interventions to broaden our reach – including engaging and serving younger adolescent girls and girls living in harder-to-reach rural areas.
  • Use digital solutions to expand A360 intervention reach, where relevant.
  • Integrate services to respond more effectively to girls’ holistic needs, beyond just their reproductive health.
  • Institutionalize A360 programs into government health systems, to build the evidence for what it takes to scale girl-centered programs at the national-, district- and state-levels.

A learning journey

We’re documenting our learnings for application in future, similar ASRH programming. Explore our learnings, our failures and our treasure trove of ASRH resources.

Girls' Insights

A360’s solutions respond to what girls say they want and need. Click the below breakouts to explore the insights that shaped how A360 is changing the conversation around contraception.

Girls express anxiety about their uncertain and, at times, unpredictable futures.

“My parents give me N100 for [all meals]. It’s not enough. Not even enough for breakfast. So how do I eat? I need to take care of myself.”

Unmarried girl, Nigeria

Girls don't always identify as, even if they are sexually active.

I’m not having sex. He had sex with me!”

-Unmarried girl, Nigeria

Many girls view motherhood as an immediate, desired and achievable dream.

“If you don’t have a job and can’t continue your education, then having a child is the only profit you have.”​

-Married girl, Ethiopia

Many girls perceive contraception as a threat to their dreams.

“They say contraception is good, but not for me it’s not good. It will destroy your womb.

-Unmarried girl, Nigeria

Community acceptance is integral. Still, girls feel a deep sense of social isolation.

“If an [unmarried] girl is sexually active, the community will hate her 
and isolate her.” 

-Unmarried girl, Ethiopia

Girls trust their mothers most. That relationship, however, remains complex.

“My mom would understand, but she would scold me.” 

-Unmarried girl, Nigeria

Our Team

Consortium

  • PSI
  • IDEO.org
  • Society for Family Health Nigeria
  • Center on the Developing Adolescent

Donors

  • Bill & Melinda Gates Foundation
  • Children’s Investment Fund Foundation

External Evaluation Team

  • Itad
  • Avenir Health
  • London School of Tropical Hygiene

Related Resources

You can get girl-centered, too.

Dive into the A360 Open Source, a treasure chest of learnings and tools that you can apply as we work, together, to drive youth-powered sexual and reproductive health breakthroughs.

It’s all just a click away.