What does it take? Operational, cultural, and structural ingredients necessary to design for girl-centered care. Sexual and Reproductive Health and Rights Among Adolescents and Youth Edwin Mtei, SBCC-Youth Manager, PSI Tanzania PICTURE 1- Environment and Workspaces 1. BACKGROUND Traditional SRH programming has left 252 million adolescents currently with unmet need, suggesting there is room for improvement. In 2016, Population Services International’s (PSI) Adolescents 360 (A360) project began with funding from the Bill & Melinda Gates Foundation and Children’s Investment Fund Foundations, aiming to turn this model ‘inside-out’, by placing girls at the center of programming. PSI uses a transdisciplinary approach, joining adolescent developmental science, public health, socio-cultural anthropology, social marketing and human-centered design (HCD). A360 interventions are designed with girls by revisiting evidence; leading with questions, curiosity and empathy; and getting out into her world. There is a growing call among the adolescent and youth reproductive health (AYSRH) community—and beyond—for this kind of approach, one that is more responsive to clients’ needs, puts users at the center, and co-creates with them; but there is still a gap in practical knowledge and guidance about how to marry this with the way implementing organizations traditionally operate. Workspace requirements vary depending on the project phase, and require appropriate spaces that promote collaboration and creativity. 2. METHODS PICTURE 2-Project Structure Changes in Different Phases Took a continuous learning approach to evolving managerial procedures in line with iterative intervention design process with girls. Worked with a range of experts from various sectors including design experts, behavioral scientists, reproductive health technical experts and youth experts Integrated evidence-based practices, and gained cross-sectoral insights to inform the process. Prioritized flexibility in systems, reflection on process, and ongoing support from technical and operational experts Documented key milestones and operational decisions, including tools that were used during the process Design teams structured to test design & test prototypes Design teams structured to generate ideas for specific objectives 3. RESULTS Analysis of the A360 Tanzania management experience during iterative design and prototyping suggest six overarching categories of process considerations to support this work. Staffing & recruiting Technical & supervisory advisors Procurement & cash Conducive environment Preparation & framing Organizational culture & design fidelity Design team partly integrated into operations structure for pilot Design team fully integrated into operations structure Projects undertaking this transdisciplinary approach will move through several different structures as they progress, and so must have a team with a wide range of skills to support these various structures. 4. CONCLUSION In recent years, the development community has increasingly prioritized two distinct conversations: 1) the importance of participatory programming that joins with beneficiaries to advance improved outcomes—particularly in the adolescent and youth SRH sector, and 2) adaptive programming capable of recognizing and responding to shifts in implementation and epidemiological contexts.A360’s experience offers a logistical response to both of these conversations. In Tanzania, A360 has identified, analyzed, and addressed many of the traditional structures that have long upheld development programming, but which have also remained indifferent to our global community’s calls for more nimble and responsive program design and management Today, A360 is working to create global good to help others replicate this process, enabling additional implementers and partners to benefit from the conceptual, structural, and managerial tenets of A360 project design and implementation A360LearningHub.org EMtei@psi.or.tz Adolescents360 @Adolescents360