By Ahna Suleiman, Coordinating Director for the Center on the Developing Adolescent
In 2016, PSI invited the Center on the Developing Adolescent to join Adolescents 360 (A360) saying:
We’re working on developing a concept for a large-scale program to expand reproductive health services for adolescents in several places in sub-Saharan Africa. We’re looking to incorporate the latest insights into adolescent cognitive development, including issues of impulse control and perceptions of risk.
Since then, I have seen the A360 team integrate the developmental science of adolescence in two key ways.
First, the team has moved beyond the frame of cognitive development – how people control impulses, contemplate risk, and make decisions. They are now thinking in terms of social, emotional, and cognitive development. For 15-19 year olds, this is a critical part of the story
In calm situations, most 15-19 year olds make decisions similar to adults. What is different from adults is how adolescents make decisions when emotions are high and/or when they are influenced by friends or family. In addition, romantic and sexual relationships emerge during this time so adolescents are making many new decisions in new contexts where they lack experience. It is not cognitive development in isolation that is important, but instead the complex, reciprocal interactions between shifts in brain development, motivation, experience, and context. Everyone is influenced by feelings, not just facts, and for adolescents, this may be even more true.
In A360, the solutions focus on changing how adolescents feel about contraception – not only how they think about it. This aligns well with the goal of human-centered design to build empathy. The A360 solutions move beyond providing skills and information about contraception to helping young women make informed, powerful choices, in partnership with people who influence them, that align with who they want to be in the world. Knowing how to use birth control and where to get it is fundamentally different than feeling like using birth control is an important part of a young woman’s self-image.
Second, the teams have mapped the different pathways that adolescents travel, related to romantic and sexual relationships. Developmental science pushes us to think about the path adolescents take when they enter and leave the A360 target-age group. No one can design a single solution to serves every adolescent’s diverse needs, so these maps helped us refine the target. For example, among young women in rural Ethiopia, the strong value of demonstrating fertility early in marriage helped identify a key intervention moment right after marriage. This allowed the team to develop the best intervention to meet the specific needs of these young women at a key time: contraceptive counseling within financial planning for young married couples.
I continue to be impressed by the thoughtful ways in which the country teams leverage the insights from the developmental science. It has changed their questions, their thinking, and, most importantly, their solutions.