FIG. 1 – CONTRACEPTIVE ADOPTION RATES (16 months) “If You’re Not at the Table… You’re on the Menu” Positive Youth Development (PYD) in A360” CHALLENGES: Girls need safe physical, emotional and online spaces. A clear lesson is that this approach takes time, resources and a consistent effort to build untapped capacities. We continue to test creative ways to collaborate with adolescents to redefine the way SRH programs are designed, delivered, measured and evaluated. A360 is moving from an optimization phase to full scale and anticipates continued growth of outcome measures. Current optimization efforts are looking to deepen the workforce component in Tanzania through key private sector partnerships. Community engagement in Nigeria may need to be expanded to mutually advocate for improved adolescent SRH policies. And integration with slow moving government systems in Ethiopia may mean adjusting program goal posts. Amy Uccello, Sr. AYSRH Technical Advisor, 1. BACKGROUND FIG. 1 – CONTRACEPTIVE ADOPTION RATES (16 months) Too often AYSRH projects aim for “youth-centeredness,” yet interventions remain adult-led, single-sectored and ignore adolescents’ cognitive, social and emotional development trajectories. PYD is a thirty-year evidence-based validating a holistic youth development approach. Modern contraceptive prevalence and unmet need for contraception remains low among girls aged 15-19 in Ethiopia (32%/21%)1, Nigeria (5%/6%), and Tanzania (9%/11%) suggesting that many girls are not seeking contraception. Formative research indicates that girls from all three contexts desired greater autonomy and prioritize non-health issues. A360, funded by BMGF and CIFF, revolutionizes adolescent access to contraception using a transdisciplinary approach of public health, HCD developmental neuroscience, cultural anthropology, and youth engagement. At all stages, A360 applied a PYD lens, highlighting youth voice & decision-making, building their intrinsic skills, fostering healthy relationships, strengthening their environment & seeking systems change. 2. METHODS From its inception, A360 focused on adolescents’ environment, holistic development, non-health needs and abilities. Young people were hired as designers, implementers and data collectors, analyzing research, shaping prototypes, defining their influencers, and monitoring progress. Routine monitoring data, qualitative interviews, mystery client and exit survey data validate adopters, method uptake, client satisfaction, and provider quality. Data on program components representing all 7 of the PYD features is also informally collected to illustrate program resonance and trigger adaptive implementation, such as the Pearson’s chi-square test to evaluate the association between husband involvement in Ethiopia’s counseling with contraceptive adoption. 3. RESULTS 4. CONCLUSION Build skills/assets: 12,677 girls got entrepreneurship training (NG/TZ). 1,041 young married couples got financial planning (ET). Healthy relationships: 15 girl/mother groups formed and 6131 husbands engaged leading to 52% of couples to adopt (ET). Youth engagement: 260 youth hired as mobilizers, mystery clients, designers & staff. Annual MYE Strategy Plans ensure accountability. Belonging/membership: Girls co-created 3 youth-powered brands, 1 girl-written song + video, countless testimonials. Safe spaces: S. Nigerian girls trust boyfriends “less than thieves,” 14 sites in 10 states are girl-only safe spaces; Ethiopian girls desired safety of husbands & 6131 husbands are engaged. Integrated YFHS: Stigma-free opt-out services with job skills (NG/TZ) and financial planning (ET) led to 73,806 adopters in a single contact. Positive norms: Consistent & thoughtful adult-youth partnerships builds empathy & challenges negative associations. 60 providers were assessed in TZ as ‘positive deviants’. A360 inspires girls to dream, set goals and plan, before talking contraception. A360 turns the traditional model of boardroom-based program design inside-out, putting youth voices at the center of research, activity design and monitoring. By fusing the principles of PYD with HCD, AYSRH programs can go beyond the traditional focus on service delivery to work with and for adolescents in new areas and achieve rapid, breakthrough results in high adoption rates, rapid service uptake and strong method mix. A360’s PYD approach recognizes that having youth at the table to co-design & implement is the programmatic ingredient essential to not only reach A360 outcomes but ensure the sustainability and resonance of our efforts. Including youth not only makes them feel more connected—it holds us accountable. A360LearningHub.org auccello@psi.org Adolescents 360 @Adolescents360