To reach the Sustainable Development Goals by 2030—and to ignite a world in which every young person can access modern contraception when and how they say they want—we need to get youth-powered.
Learn how PSI is applying that approach through our flagship adolescent reproductive health and rights project, Adolescents 360 (A360).
Globally, two in five people are under the age of 25, and nearly half of this segment lives in sub-Saharan Africa. Young people have the potential to catalyze development outcomes in their countries and around the world, including economic and social progress, but only when governments and organizations prioritize inclusion and holistic youth development. When we build positive assets, protective factors and resiliency in young people, and reduce their access barriers to information and services, they will have the power to help us unlock the challenges ahead.
However, many young people still experience interlocked forms of discrimination, limited political inclusion, high levels of poverty and limited access to health systems, educational opportunities and decent jobs. In sexual and reproductive health, a persistent unmet need for reproductive health services exists among young people directly contributing to cycles of poverty based on economic and social exclusion.
We believe that one reason young people have unequal representation, care and support is due to a lack of inclusion and shared power, particularly in the design, implementation and evaluation of services created for their health and well-being. We need their voice to be a part of the solutions that serve them through meaningful youth engagement, participation and leadership. Young people have the right to be included, and we have the responsibility to build their capacity for greater impact. To do so, we are honoring young girls and boys as the experts of their own lived experiences and elevating them as co-decision makers for the health solutions that serve them. We are prioritizing their voice, choice and agency in our work because if we are to achieve the Sustainable Development Goals (SDGs)—and nations are to achieve a demographic dividend that will propel their economies—the health and well-being of young people will be critical to their meaningful contribution and leadership to solve these challenges. By prioritizing our youngest consumers we can not only build lifetime contraceptive users but create healthy, educated and economically productive adults that can lift their families, communities and countries out of poverty.
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By 2030, PSI pledges to identify, train and deploy a corps of 500 young people from around the world with the skills to co-design and implement adolescent sexual and reproductive health and rights programs alongside technical experts. These youth fellows will be employed as practitioners in programs within and beyond PSI, working as researchers, analysts, advocates and community-level champions who can counsel teams on how to apply meaningful youth engagement and design youth-powered programs. And, through inter-generational and peer-to-peer mentorship, they will be supported to develop the confidence and skills needed to successfully influence and deliver public health programming.
Human Centered Design (HCD) is one approach to design-thinking, and is often paired with other health systems approaches to develop deep and nuanced understanding about what matters to people, on a deep, emotional level. There’s power in working with young people for the solutions that serve them. But that partnership must include protocols to ensure we protect young people’s integrity, dignity and wellbeing throughout our work.
That’s why PSI alongside A360 and the HCD Exchange—a representative group of implementers, designers and funders—developed the Commitment to Ethics in Youth-Powered Program Design to honor and uphold ethical principles when conducting HCD with adolescents and young people. Three pillars ground the Commitment’s principles: respect; justice; and do no harm to the young people we work with and for.
Adolescents 360 (A360) joined its young designers with a diverse consortium of experts to collect, interpret and analyze data—from formative research through implementation and beyond. Young designers support A360 to step deep into girls’ lives, to understand what matters to them today—and lend new and fresh insight from a youth lens. The result was interventions that girls perceive as resonant and relevant to their lives.
Youth self-segment, often in ways far more nuanced than the reproductive life stage approach often found in sexual and reproductive health programming. PSI’s youth programs aim to align the way young people tell us they want to be segmented, considering their own perception of the life trajectories available to them from childhood to adulthood—and the milestones along the way.
We’ve learned that young people have many joys and aspirations over the course of their lives. But adverse socio-economic and gender realities bring them to narrow this list to aspirations that feel achievable—and for girls, motherhood is often at the top of the list. In this case, other dreams may be perceived as competing with this chief achievable joy. We position contraception in service of both achievable and aspirational goals, both as a way to protect fertility and attain financial stability.
Engaging powerful brands can help to build trust and credibility. Trusted brands communicate that “you are worthy” and can help motivate youth to not only seek care but continue returning to it. We understand and tap into compelling concepts that already have their own social momentum. This eases the pathway for young people and their communities to get behind our messages and programming.
We find and leverage youth-defined and identified safe spaces, whether they’re physical or emotional, both online and offline. These spaces bring providers and staff together with youth during counseling, which builds empathy so that providers see young people as equals, not just as clients. Youth contributions during our project implementations have increased empathy with and between providers, while data collection and analysis with girls has helped to refine the user experience using adaptive implementation techniques.
By December 2018, we reached over 14 million young people under the age of 25 with modern contraception.
Girls told PSI’s Adolescents 360 (A360) project that they didn’t see the relevance of contraception to their lives. If anything, they saw it as a threat—particularly to their dream of motherhood.
These insights fueled A360’s youth-powered model, delivering four adolescent sexual and reproductive health projects in Tanzania, Ethiopia and two in Nigeria. In these projects, A360 offers opt-out service delivery moments through a variety of models, starting with the issues most important to girls such as job skills training, financial planning, social-emotional learning and life skills.
In Mozambique, PSI’s Ignite program brings peer mobilizers to schools to motivate students through life planning and immediate goal setting. With this critical first step, peers can serve as a bridge for young people to link their goal setting with contraceptive counseling, while school nurses provide the service delivery.
In Côte d’Ivoire, Project Ignite segmented girls according to their fertility intentions, which matched with national and local data, highlighting where interventions would have the greatest impact on contraceptive uptake according to girls’ motivations. This project matches with PSI’s Transform PHARE project, which has done similar segmentation with young men in the informal sector to impact discussions and behaviors around sexuality, contraception, relationships and more.
In Ethiopia, PSI’s A360 “Smart Start” project uses financial planning to initiate targeted contraceptive counseling with rural, married couples who desire financial stability and smaller families—a message that both aligns with young people’s internal motivations and expands upon existing national dialogue for responsible stewardship of resources, all the while easing girls’ pathway to contraceptive access across the socio-ecological framework.
Developed for young people by young people, the Aquele Papo (which means “The Talk” in Portuguese) social behavior change campaign aims to spark dialogue among Mozambican youth aged 10-24 around topics that young people have said matter to them. From peer pressure to contraception to what it takes to have “the talk” with parents, the campaign’s feature film, corresponding music video, website and Facebook page, spotlights young Roberto and Maria as they navigate the woes and joys of being adolescents, including the pressures and questions young people often experience regarding their love life.
In Tanzania, A360 engages youth “SWAT” teams, namely young people who serve as on-site “eyes” during A360 events. Leveraging their own youth perspective, they tell us what’s working and flag what’s not, allowing us to make programmatic adjustments in real-time.
With our Commitment to Ethics in Youth-Powered Program Design, we’ve dedicated ourselves to open, nuanced and constructive dialogue about the best ways to scope, carry out and collaborate with young people for the solutions that serve them. This commitment ensures that we uphold young people’s integrity, dignity and well-being, and that we provide them with the respect and balance of power they deserve.
From Jeune S3 in Benin and Cameroon to Adolescents 360 across Ethiopia, Tanzania and Nigeria, we support youth advocates to use their voices for policy change.