PT  - JOURNAL ARTICLE
AU  - Barker, Kathryn M.
AU  - Gayles, Jennifer
AU  - Diakité, Mariam
AU  - Diantisa, Florentine Gracia
AU  - Lundgren, Rebecka
TI  - Using Responsive Feedback in Scaling a Gender Norms-Shifting Adolescent Sexual and Reproductive Health Intervention in the Democratic Republic of Congo
AID  - 10.9745/GHSP-D-22-00208
DP  - 2023 May 10
TA  - Global Health: Science and Practice
4099  - http://www.ghspjournal.org/content/early/2023/05/09/GHSP-D-22-00208.short
4100  - http://www.ghspjournal.org/content/early/2023/05/09/GHSP-D-22-00208.full
AB  - Key FindingsThe use of responsive feedback mechanisms (RFMs) and a theory of change enabled necessary program adaptations during piloting and scale-up of the Growing Up GREAT! project.These adaptations allowed the program to respond in meaningful ways to local communities, leading to improvements in implementation and in response to system shocks such as election-related instability and COVID-19–related school closures.Donors, researchers, and implementing institutions fostered a culture of learning at all levels in the programmatic ecosystem to ensure that those most knowledgeable about needed course corrections were able to voice them.Key ImplicationRFMs should be prioritized for course corrections to strengthen program sustainability.Program Description:Growing Up GREAT! (GUG) is a sexual and reproductive health (SRH) program for adolescents aged 10–14 years in Kinshasa, Democratic Republic of the Congo (DRC). The multilevel program takes an ecological approach to foster community examination of gender inequitable norms and to increase adolescents’ SRH knowledge, skills, and gender-equitable attitudes. GUG design, piloting, and scale-up were informed by a theory of change and responsive feedback mechanisms (RFMs) during piloting and scale-up.Responsive Feedback Mechanisms:The program engaged stakeholders via quarterly learning meetings to review monitoring data, evaluation results, and practice-based knowledge and to subsequently identify challenges and develop solutions. The program commissioned rapid research on specific intervention elements to improve implementation and documented scale-up learnings using the World Health Organization/ExpandNet framework.Achievements:RFMs used in the pilot period allowed the program to address community concerns by intensifying orientation activities with parents and schools, shifting the calendar of activities to increase male engagement, and increasing facilitator training length to improve facilitation quality. Using RFMs during scale-up prompted further adaptations for program sustainability, including recommendations for task-shifting from NGO facilitators to community health workers.Conclusion:GUG used RFMs from pilot through scale-up to foster a learning culture among local partners, implementers at headquarters, and global research partners. Using responsive feedback (RF) enabled timely response to the evolving implementation context, resulting in strategic program adaptations that fostered increased community support of the project. Other successes due, at least in part, to this RF approach include incorporation of the program into DRC’s national adolescent health strategy, and rapid response to the COVID-19 pandemic in educational strategies for program beneficiaries.