Scaling Up AYSRH Programs: Increasing Impact Without Affecting Quality

Strong legal and governmental frameworks are essential to support programming, as highlighted by Adenike Esiet, executive director of Action Health Incorporated. She emphasized the importance of national policy frameworks, evaluation mechanisms, access to curriculum development and classroom resources, and extensive training for those delivering the curriculum to students. Evidence-based interventions are also crucial for effective program implementation, as noted by Dr. Galina Lesco, head of the National Resource Centre for Youth-Friendly Health Services. She stressed the need for interventions to be grounded in research and data, and for programming to be designed with a supportive legal framework, sustainable financing mechanism, quality control system, and promotion to the relevant population. Sustainable financing is a critical component of scaling up AYSRH programs, as discussed by Brendan Hayes, senior health specialist at the Global Financing Facility. He highlighted the need for governments to take a more robust role in financing these programs, and for utilizing local and national governments to ensure that programs deliver interventions that are free at the point of care. Stakeholder engagement is also essential for scaling up AYSRH programs, particularly involving youth in all steps of program design and implementation. Dr. Lesco emphasized the importance of involving youth in planning, organization, program evaluation, implementation, and promotion of services to the community. Engaging with groups that may oppose AYSRH is also necessary, as highlighted by Ms. Esiet, to ensure that programs are responsive to the needs of all stakeholders. The most cost-effective intervention points for governments to improve AYSRH outcomes vary greatly based on the different contexts of AYSRH service provision. Strategies should be devised at the country level, taking into account the diversity of multi-sectoral partners involved in the implementation of AYSRH programs. Reaching consensus among these stakeholders is often a cost-effective strategy for improving program outcomes, as emphasized by Mr. Hayes. The COVID-19 pandemic has introduced competing priorities for international donors and has placed additional financial restraints on already limited health budgets. Aligning programs with the work already being conducted at the country level, integrating service provision into existing systems, and managing the scope of programs to ensure cost effectiveness are critical considerations for scaling up AYSRH programs in this context. In conclusion, scaling up AYSRH programs requires a comprehensive approach that takes into account the complex interplay of factors that influence program success. Strong legal and governmental frameworks, evidence-based interventions, sustainable financing, stakeholder engagement, and cost-effective intervention points are all critical components of effective program implementation. By prioritizing these factors, governments and program implementers can work towards improving AYSRH outcomes and ensuring that impact is far-reaching across youth populations and geographies.