INSTITUTIONALIZING GIRL-CENTERED PROGRAMMING–AT SCALE

By Dionne Oguna, A360 Associate Communications Manager, PSI and Fifi Ogbondeminu, Acting 360 Project Director, PSI  

When girls have the tools – like contraception – to take charge of their lives, they have the power to achieve their goals. A360’s girl-centered approach to contraceptive programming supports girls’ voluntary uptake of contraception and helps them to choose the lives they want to live.  

A360 is partnering with governments across Ethiopia, Nigeria and Kenya to help incorporate this girl-centered model into their health systems.  

PSI’s flagship adolescent sexual and reproductive health (ASRH) program, A360, aims to increase voluntary, modern contraceptive use among adolescent girls (15-19 years old) in Ethiopia, Nigeria, and Kenya. A360 country projects utilize an aspirational program approach, tapping into what adolescent girls say they want and need and positioning contraceptive use as relevant to achieving their goals.  

Since its inception in 2016, the project has reached over 600,000 girls with contraceptive services and supported over 400,000 girls to voluntarily adopt a modern method of contraception. 

But we know we can do more. And that starts by integrating the model into health systems – supporting governments to advance their ASRH goals, and girls to access girl-centered ASRH services. 

WITH A360, KADUNA STATE HAS WORKED TO STRENTHEN ASRH SYSTEMS AND SUPPORT ADOLESCENT GIRLS IN TAKING CHARGE OF THEIR LIVES 
Mrs. Jemimah Menwyah, Kaduna State Primary Health Care Agency/Board Adolescent Desk Health Officer in Nigeria 

Kaduna state has a rampant and fast-growing population, of which 40% are adolescents and young people. Our government has recognized adolescent pregnancy as a significant health problem and the introduction of the A360 project in 2018 helped them take action.  

The A360 project helped the State effectively reach adolescent married girls and provided them with the much-needed ASRH services. Based on the project’s success, the state was able to decisively sustain the model and take steps to institutionalize the Matasa Matan Arewa (MMA) program, an off-shoot A360 program in Northern Nigeria that works to support adolescent married girls in their SRH journey.  

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As part of this program, ASRH counseling and training has been integrated throughout government health systems to offer safe, youth friendly services in primary care. The MMA model has also been implemented to support families and communities in creating safe environments for girls to access ASRH services. To measure the success of these programs, A360 partners supported the disaggregation of the national health data systems by age to help isolate adolescent health metrics.   

With A360, Kaduna state has worked to strengthen ASRH systems and support adolescent girls in taking charge of their lives. By institutionalizing the A360 model, we are able to multiply our impact on the adolescent girls in Kaduna.  

The A360 model has been incorporated into state family planning and annual operational plans since 2018. As part of the institutionalization effort, government stakeholders worked closely with the A360 team to strengthen the Adolescent Technical Working Group (ATWG), which includes other partners, ministries, departments and agencies with similar goals in improving adolescent girls’ health outcomes. 

The state has also signed a letter of commitment and Memorandum of Understanding (MOU) to enshrine MMA intervention into state systems. In this letter, the state committed to the domestication of the Adolescent Health and Young Person Policy which reflects critical components of the A360 model.  

YOUNG PEOPLE ARE AT THE CORE OF THE PROGRAM DESIGN, OWNERSHIP AND IMPLEMENTATION 
Hannatu John, Program Assistant A360, Kaduna State, SFH Nigeria  

A360’s primary focus is creating an enabling environment and safe space for young people to access ASRH services. The program has a meaningful youth engagement framework that deliberately ensures that young people are at the core of the program design, ownership and implementation.  

Before the A360 program, state efforts to drive young people to access SRHR services in health centers were limited. The commencement of A360 strengthened youth access to ASRH counseling sessions focused on life, family, and health. The sessions allow peers to discuss personal hygiene, nutrition and SRHR and address myths and misconceptions through quality ASRH services and information.  

Within the system, those interested in taking up a contraceptive method are referred to a trained youth-friendly provider in the health facility for access to further quality ASRH information and services. In some cases, married adolescent girls are linked directly to the facility through the male interpersonal agent who engage their husbands within the community, creating support and an enabling environment for their wives to access SRH care. The husbands, in turn, refer their wives to access SRH services at the health care centers. 

Overall, the A360 program is helping meet youth where they are and supporting adolescents in their ASRH journeys.    

To learn more about how you can work with A360, drop us a note: [email protected] 

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This article is a part of PSI’s ICFP 2022 Impact Magazine. Explore the magazine here.

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