Evaluation of Adolescents 360

2016-2020; Ethiopia, Nigeria, Tanzania; BMGF, CIFF

In sub-Saharan Africa each year, adolescent girls account for 16% of all births, an estimated 2,200,000 unintended pregnancies, and 25% of all unsafe abortions.

Repositioning access to high quality contraceptive services to reach adolescent girls is potentially one of the most effective ways for countries to achieve their health and development goals, with current public-sector family planning programmes often not being well designed to address the complex barriers that adolescent girls face.

Adolescents 360 (A360) is a $30 million programme jointly funded by the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation to encourage modern contraceptive use and reduce unplanned pregnancy among young girls aged between 15-19 in Ethiopia, Tanzania and Nigeria. The A360 programme is being implemented by a Population Services International (PSI)-led consortium and aims to identify youth-driven solutions through user-centered design processes and market segmentation to increase both demand for, and access to, a full range of quality, voluntary contraceptive services among adolescent girls in the three countries.

Itad is working in collaboration with the London School of Hygiene and Tropical Medicine and Avenir Health to monitor, evaluate, and develop learning from the A360 programme. Data and evidence will be used to support accelerated introduction and scale-up of interventions across multiple countries. The evaluation has been commissioned to:

  • Provide timely evaluation data to course correct the program during implementation as necessary, and to maximize the effectiveness and impact of efforts (the evaluation approach to achieve this objective will be further refined in collaboration with the implementing partner to ensure that the design is complementing existing efforts that the implementation partner will be undertaking during the rapid prototyping process);
  • Assess the impact of the program on reducing the number of unintended pregnancies among adolescent girls;
  • Provide a robust evidence base on what does and does not work to reach adolescent girls at scale, cost-effectively and to what extent the program is replicable.

During the evaluation we anticipate on-going collaboration with the programmatic partners which will maximize synergies, improve the linkages between evidence, insight and action, and manage the burden of data collection for all stakeholders. Our approach has been structured around four output areas which comprise a process evaluation, an outcome evaluation, cost effectiveness analysis, and engagement and research uptake:

  • At the outcome level we will evaluate the extent to which the program has had effects on modern contraceptive prevalence, unintended pregnancy and age at first birth (where applicable) among adolescent girls;
  • At the process level we will examine how, why, and in what contexts the user-centred approach and model works best to deliver quality service to adolescent girls;
  • We will evaluate the cost-effectiveness of the user-centred approach on modern contraceptive prevalence;
  • We will determine to what extent the program can be replicated, taken to scale, and sustained within key geographies and other countries and settings.

This evaluation will ensure that credible, accumulated findings are available to feed into programmatic decision-making and for dissemination with key country, regional and global-level stakeholders including Family Planning 2020 communities and other donors, and will provide a clear understanding of how much it would cost to scale and replicate in different contexts and countries.

Image © Abuja Street Portrait. Photo Credit: Mark Fisher