1. Table 1- Smart Start Performance
Increasing mCPR among years old married adolescents
Community based demand creation for family planning services among married adolescents in rural Ethiopia: Evidence from PSI's Smart Start Model  
Seyoum Atlie, Deputy Program Director, A360, PSI Ethiopia 
Table 1- Smart Start Performance
1. BACKGROUND
Indicator
Performance
# of girls counseled
17,541
# of girls adopting a modern contraceptive method
8,977
% of eligible girls (not pregnant and not already using) adopting a modern contraceptive method
77%
# of sites (kebeles) reached 
300
Adolescents 360 (A360), is a 4.5 year program implemented by Population Services International (PSI) in Ethiopia, Tanzania, and Nigeria with financial support from the Bill & Melinda Gates Foundation and the Children's Investment Fund Foundation with the objective of reaching adolescent girls  aged 15-19 with contraceptive information and services
In Ethiopia, married adolescent girls years report 32% modern contraception use, and an unmet need of 20.5% 
In Ethiopia, A360 is implemented in partnership with the FMOH of Ethiopia in Oromia, Amhara, SNNPR and Tigray regions; the most populous regions in the country
A360 project intervention maps, identifies, mobilizes and links far and scattered married adolescent girls using community structures 
The major intervention of the project in Ethiopia is to create demand for and uptake of family planning services through the Smart Start model; a health education and counseling model tailored to the needs of married adolescents 
2. METHODS
The A360 project has been implemented in 300 kebeles in four regions of Ethiopia 
Individual client data was collected from the field through the project's monitoring and evaluation system. Service data was weekly collected, compiled, analyzed, interpreted and used by the project staff 
Data was collected using Smart Start Navigators, the project's frontline health educators using Smart Start session tracker, a paper-based data collection tool.
Data on each client's sociodemographic profile, session type, location and family planning method received were recorded on the session tracker
The completed session tracker was submitted to the M&E unit on a weekly basis
M&E data from June 2017 to September 2018 is analyzed and presented 
4. CONCLUSION
Community based demand creation through Smart Start has helped reach girls where they live and work and shown that family planning can be appealing to girls and couples even before first birth
While additional support to the public health system (Smart Start Navigators) is desirable and supports mobilization, communities are willing to mobilize married girls for family planning counselling
The Smart Start approach, which uses financial planning as the entry point to discuss family planning, is galvanizing support across the socio-ecological model. In addition to spouses, mothers-in-law, gatekeepers, and community leaders report support for girls’ method uptake
Community based demand creation has improved awareness and uptake of contraceptive  among married adolescent girls 
Additional research is recommended to learn the effect of the intervention among married adolescents in the study area, particularly beyond contraceptive uptake and examine if social norms are changing around method use for married girls in the intervention areas
3. RESULTS
During the 15-month project implementation period, a total of 17,541 married adolescent girls were reached with information on family planning through Smart Start sessions 
Of the total number of girls reached, 11,648 (66%) were neither currently using a method nor pregnant. Of these 8,977 (77%) became method adopters  
Method mix amongst adopters was: 68.4% injectable, 24% implant, 7% oral contraceptive pills, 0.4% IUD. 0.1% condom and 0.1% emergency  contraception, respectively
Adopters by age were: 19 (34%) and 18 (33%), followed by 17 (18%),16 (9%) and 15 (5%), respectively
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