Enhancing Human-Centered Design With Youth-Led Participatory Action Research Approaches for Adolescent Sexual and Reproductive Health Programming

This is the accepted manuscript version of the work published in its final form as Fakoya, Ibidun; Cole, Claire; Larkin, Chris; Punton, Melanie; Brown, Eleanor; Ballonoff Suleiman, Ahna. Health Promotion Practice; Volume: 13; Issue: 1; Pages: 25-31; https://doi.org/10.1177/15248399211003544 Deposited by shareyourpaper.org and openaccessbutton.org. We've taken reasonable steps to ensure this content doesn't violate copyright. However, if you think it does you can request a takedown by emailing [email protected]

Effect and cost-effectiveness of human-centred design-based approaches to increase adolescent uptake of modern contraceptives in Nigeria, Ethiopia and Tanzania: Population-based, quasi-experimental studies.

Around half of adolescent pregnancies in low- and middle-income countries are unintended, contributing to millions of unsafe abortions per year. Adolescents 360 (A360), a girl-centred initiative, aimed to increase voluntary uptake of modern contraceptives among adolescents in Nigeria, Ethiopia and Tanzania. We evaluated the effectiveness and cost-effectiveness of A360 in increasing modern contraceptive use in selected geographies. We used before-and-after cross-sectional studies of adolescent girls in four settings. Two Nigerian settings had purposefully selected comparison areas. Baseline and endline household surveys were conducted. The primary study outcome was modern contraceptive prevalence rate (mCPR). Secondary outcomes mapped onto the A360 Theory of Change. Interpretation was aided by a process evaluation along with secular mCPR trends and self-reported A360 exposure data. Incremental design and implementation costs were calculated from implementer systems, site visits, surveys, and interviews. mCPR change was modelled into maternal disability-adjusted life years (DALY) averted to calculate incremental cost-effectiveness ratios. In Oromia, Ethiopia, mCPR increased by 5% points (95% CI 1-10; n = 1,697). In Nigeria, there was no evidence of an effect of A360 on mCPR in Nasarawa (risk ratio: 0·96, 95% CI: 0·76-1·21; n = 5,414) or in Ogun (risk ratio: 1·08, 95% CI: 0·92-1·26; n = 3,230). In Mwanza, Tanzania, mCPR decreased by 9% points (-17 to -0.3; n = 1,973). Incremental cost per DALY averted were $30,855 in Oromia,$111,416 in Nasarawa, $30,114 in Ogun, and$25,579 in Mwanza. Costs per DALY averted were 14-53 times gross domestic product per capita. A360 did not lead to increased adolescent use of modern contraceptives at a population level, except in Oromia, and was not cost-effective. This novel adolescent-centred design approach showed some promise in addressing the reproductive health needs of adolescents, but must be accompanied by efforts to address the contextual drivers of low modern contraceptive use

Evaluating the adolescents 360 approach in Ogun (Nigeria), Nasarawa (Nigeria), Oromia (Ethiopia) and Mwanza (Tanzania) – Study data

Adolescents 360 (A360) was an approach in the field of adolescent sexual and reproductive health programming, with the intention of being implemented at scale in Nigeria, Ethiopia and Tanzania. We present here the data for the outcome evaluation of A360. The primary objective of the outcome evaluation was to evaluate the effectiveness of the A360 programme in increasing the uptake of voluntary modern contraception among sexually active girls aged 15–19 years