{ "meta": { "title": "Projects - Pivot Collective", "description": "Explore Pivot Collective's projects in participatory research, knowledge translation, and community-led action." }, "hero": { "badge": "Co-Creation", "title": "Our", "title_gradient": "Projects", "description": "An archive of our collaborative knowledge production and public engagement initiatives — participatory research, community action, and transformative partnerships across the global South and North." }, "grid_heading": "What We Work On", "projects": [ { "id": "centres-for-exchange", "title": "Centres for Exchange", "category": "Current Project", "image": "/images/projects/cfe-cover.webp", "partner": "Wellcome Trust", "tagline": "A global initiative exploring how equitable knowledge exchange can reshape health research through community-researcher partnerships.", "keywords": [ "Knowledge Exchange", "Learning Partnerships", "Research Ecosystems", "Equity" ], "modal": { "subtitle": "Building community-rooted infrastructures for equitable knowledge exchange", "sections": [ { "heading": "Project Overview", "paragraphs": [ "Centres for Exchange (CfE) is a global learning initiative funded by the Wellcome Trust that explores how health and climate research systems can become more equitable, inclusive, and responsive to the communities most affected by health and climate challenges. The programme brings together researchers, practitioners, and community organisations to experiment with approaches to equitable knowledge exchange, where community expertise meaningfully shapes research questions, processes, and outcomes.", "The initiative emerged from growing recognition that while community engagement is widely promoted in health research, the structures of knowledge production often continue to privilege institutional expertise over lived experience. Centres for Exchange seeks to address this challenge by supporting place-based collaborations that bring researchers and community actors into long-term relationships of shared inquiry and learning.", "The programme is unfolding across multiple phases:\n\nPhase 1 (2023-2024): An initial global landscaping and design phase explored existing practices of community-engaged research and knowledge exchange across several regions.\n\nPhase 2 (2025-2027) The current second phase supports eight organisations across India, Kenya, and South Africa to experiment with and strengthen community-driven approaches to knowledge exchange within their own research ecosystems.", "Together, these efforts aim to generate practical learning about how research institutions, funders, and community organisations can work differently to build more equitable and accountable research systems." ] }, { "heading": "Our Role", "paragraphs": [ "During the programme's first phase (2022-2024), Pivot led a global landscaping and co-design process, examining how community engagement and knowledge exchange are currently practiced across diverse research contexts. Working with partners Eh!woza, Fiocruz, Praxis, Restless Development, and Vocal, we gathered diverse perspectives through case studies, convenings, and facilitated co-design processes, and brought them together to craft a vision for change. This work shaped the conceptual foundations, guiding principles, and strategic investment approach for the Wellcome Centres for Exchange programme.", "Following this phase, Pivot also supported an interim ecosystem mapping process to identify organisations already advancing aligned approaches to community-engaged research. This work informed the selection of organisations invited to participate in the current phase of the programme.", "In Phase 2 (2024-2027), Pivot Collective leads the programme's Learning and Evidencing partnership, working closely with Wellcome and a multidisciplinary team that includes Southern Hemisphere and the Health Equity Action Lab at the George Institute for Global Health. We work with funded organisations to co-develop learning agendas, facilitate reflection and adaptation through workshops and dialogue spaces, and steward cross-project learning across regions.", "Our team also leads the programme's knowledge sharing work, including designing and maintaining the Centres for Exchange website and curating learning outputs such as blogs, reflections, and synthesis pieces. Alongside this, we work with Wellcome to translate emerging evidence into strategic learning that can inform future funding decisions and contribute to broader transformation in the global health research ecosystem." ] }, { "heading": "What We're Learning", "paragraphs": [ "Learning from Centres for Exchange continues to surface important tensions and possibilities in community-engaged health research.", "Early work in the programme highlighted a central challenge: while community engagement is widely recognised as essential, it is often practiced in ways that leave existing research hierarchies intact. The issue is rarely a lack of participatory methods, but rather limited institutional recognition, resourcing, and support for community leadership within research systems.", "In response, the first phase of Centres for Exchange focused on designing a different kind of infrastructure for knowledge exchange. Working with partners across the Global South, the programme developed a model based on place-based knowledge communities: locally rooted collaborations that bring together community organisations, researchers, practitioners, and activists to shape research agendas, exchange diverse forms of knowledge, and build long-term relationships of trust and care. These communities aim to centre the priorities and capabilities of those most affected by health challenges, supporting more reciprocal and context-responsive forms of research collaboration.", "As Phase 2 projects unfold across India, Kenya, and South Africa, learning is revealing how equitable knowledge exchange is shaped through process rather than predefined methods. Across projects, partners are finding that shared meaning does not automatically emerge through participation. Concepts that seem familiar in research, from community engagement to vulnerability, often carry different meanings in different contexts. Through co-design and dialogue, teams are working to surface these differences and reshape research questions and approaches in ways that reflect lived experience and local priorities.", "At the same time, partners are exploring how power is embedded in research processes themselves. Decisions about who defines research questions, when participation begins, and how much time is available for reflection all influence whose knowledge carries authority. As projects experiment with approaches that move participation earlier in the research cycle, they are also navigating tensions with institutional structures such as funding timelines and research governance. These experiences reinforce that shifting power in knowledge exchange is ongoing, relational, and negotiated through everyday research practice.", "Across the programme, learning is therefore being approached not as a fixed set of indicators but as a collective and evolving process stewarded by the organisations and communities involved. The Centres for Exchange website offers a space to follow this journey, sharing reflections, resources, and insights as learning develops across the network." ] } ], "link": { "label": "Visit the Centres for Exchange website", "url": "https://www.centresforexchange.org/" } } }, { "id": "climate-health", "title": "Climate and Health Systems Transformation in South Africa", "category": "Current Project", "image": "/images/projects/afd-cover.webp", "partner": "Agence Française de Développement (AFD)", "tagline": "A national scoping study and systems analysis exploring how climate action can strengthen South Africa's health system while advancing a just transition.", "keywords": [ "Just Transition", "Investment Strategy", "Systems Research" ], "modal": { "subtitle": "Positioning health at the centre of South Africa's just climate transition.", "sections": [ { "heading": "Project Overview", "paragraphs": [ "Climate change is already reshaping health risks and health system performance across South Africa. Rising temperatures, floods, droughts, air pollution, and shifting disease patterns are increasing the burden of illness while also disrupting the delivery of care. At the same time, the health sector is both affected by and contributing to climate change. Building climate-resilient and low-carbon health systems is therefore not only a matter of environmental responsibility, but a central part of protecting population health and ensuring a just and equitable transition.", "Commissioned by the Agence Française de Développement (AFD), this project examines how climate change and health intersect in South Africa and explores how climate action can strengthen health systems while advancing equity and resilience. The study maps the emerging climate-health landscape, identifying key system vulnerabilities, institutional barriers, and strategic opportunities for transforming the health sector. The aim is to support policymakers, development finance institutions, and health system leaders to identify pathways where climate action can improve both health outcomes and health system sustainability.", "By positioning health at the centre of South Africa's climate transition, the project highlights how climate action in the health sector can strengthen system resilience, reduce emissions, and ensure that the benefits of the just transition reach people's lives." ] }, { "heading": "Our Role", "paragraphs": [ "Pivot Collective was commissioned by AFD to lead a national scoping study on the climate-health nexus in South Africa. The study examined how climate change is affecting health outcomes, health system infrastructure, governance arrangements, and investment priorities.", "Our team conducted an extensive landscape analysis combining policy and literature review with interviews and dialogues involving stakeholders across government, research institutions, civil society organisations, and development finance institutions. This work included convening a national stakeholder dialogue and facilitating participatory sense-making workshops to surface shared priorities and practical pathways for action.", "The resulting analysis synthesised evidence across multiple domains, including health system governance, infrastructure resilience, climate-related disease risks, financing mechanisms, and cross-sector coordination. It also identified strategic opportunities for aligning climate adaptation, health system strengthening, and decarbonisation.", "The findings informed AFD's evolving investment strategy on climate-resilient health systems in South Africa and were shared publicly through a national webinar hosted by the South African Presidential Climate Commission. They are synthesised in the report Positioning Health at the Heart of the Just Transition, which outlines key system challenges and proposes integrated pathways for strengthening climate-resilient and low-carbon health systems in South Africa.", "The work also contributes to ongoing dialogue between policymakers, development finance institutions, and health system actors about how climate-health priorities can translate into concrete investment strategies and institutional reform." ] }, { "heading": "What We're Learning", "paragraphs": [ "The scoping study highlights that climate resilience in the health sector is fundamentally a systems challenge. Across policy analysis and stakeholder dialogues, participants emphasised that progress on climate and health is often slowed not by a lack of ideas or policy commitments, but by structural barriers within the health system itself. Fragmented governance, unclear mandates across national and provincial levels, and limited mechanisms for coordination make it difficult to translate climate-health ambitions into operational programmes and investments.", "A second insight is that many of the most promising opportunities for climate-health action lie within existing systems and investments, rather than entirely new initiatives. Infrastructure grants, facility revitalisation programmes, workforce training systems, and procurement frameworks already shape how the health system evolves. Integrating climate resilience and decarbonisation into these mechanisms can strengthen core health system functions, rather than treating climate adaptation as a stand-alone programme.", "The research also highlighted the importance of aligning climate-health priorities with the realities of public finance and institutional capacity. Rigid procurement processes, centralised financial systems, and uneven provincial readiness often constrain innovation and local adaptation. Strengthening the ability of provinces, facilities, and frontline actors to access and manage climate-related resources will therefore be essential for translating national commitments into practical change.", "Finally, the study underscores that effective climate-health action must be grounded in equity and community leadership. Climate-related health risks and system vulnerabilities are unevenly distributed across South Africa, with poorer and historically marginalised communities facing the greatest exposure and the least adaptive capacity. Ensuring that climate action strengthens health systems therefore requires approaches that prioritise underserved areas and centre community knowledge and frontline health workers in planning and decision-making.", "Taken together, these insights suggest that the challenge is not simply to design new climate-health programmes, but to align governance, financing, and learning systems so that climate and health priorities can be implemented at scale across the health system." ] } ], "link": { "label": "Read the scoping study report: Positioning Health at the Heart of the Just Transition", "url": "/documents/afd-positioning-health-just-transition.pdf" } } }, { "id": "engaged-research", "title": "Advancing Engaged Health Research", "category": "Current Project", "image": "/images/projects/engaged-research-cover.webp", "partner": "Wellcome Trust", "tagline": "Developing shared frameworks and learning resources to support more participatory, accountable approaches to health research.", "keywords": [ "Research Culture", "Community Participation", "Research Ethics" ], "modal": { "subtitle": "Supporting more participatory, inclusive, and accountable approaches to health research", "sections": [ { "heading": "Project Overview", "paragraphs": [ "Health research has long struggled with a fundamental imbalance: the people most affected by health inequities are often the least involved in shaping the research intended to address them.Community engagement has increasingly been recognised as an important response to this problem. Yet engagement activities alone do not necessarily shift who defines research questions, whose knowledge counts, or how power operates within research relationships.", "Engaged research is an approach that seeks to address this imbalance by ensuring that research is shaped in partnership with the people and communities it aims to serve. Rather than treating engagement as an add-on activity, engaged research asks how participation, shared decision-making, and accountability can be embedded throughout the research lifecycle: from defining priorities and shaping methods to interpreting findings and translating knowledge into action.", "To support this shift, Wellcome Trust commissioned a collaborative project to consolidate learning from across the field of engaged research and develop a resource that could support researchers to strengthen participatory and equitable approaches in their own work. The goal was not to produce another toolkit, but to create a structured learning resource grounded in the realities of research practice and informed by the perspectives of researchers, engagement practitioners, and community partners working across multiple contexts." ] }, { "heading": "Our Role", "paragraphs": [ "This work was carried out through a partnership between Vocal Collective, Pivot Collective, and Mabadiliko. Together, the partners designed and facilitated a year-long developmental learning process to explore how engaged research is currently understood, practiced, and supported across different research contexts. The process combined stakeholder interviews, collaborative sense-making workshops, and a structured review of existing frameworks and approaches to engaged research.", "These insights informed the development of Purpose, Power, Practice: A Primer for Engaged Research, commissioned by Wellcome as a resource to support researchers seeking to integrate engaged approaches across the research lifecycle.", "The Primer is organised around four interconnected pathways:\n\n\tWHY? – exploring the ethical and practical foundations for engaged research\n\tWITH WHOM? – identifying and building equitable research partnerships\n\tHOW? – designing and implementing engaged approaches across the research lifecycle\n\tSO WHAT? – understanding and evaluating the impacts of engaged research", "We are currently working with Wellcome teams to help integrate project insights into how the organisation supports researchers and designs funding approaches that enable more engaged research practices. Building on this work, we're also exploring a potential second phase that will expand the focus from supporting individual researchers to examining how research institutions and funding systems can better enable engaged research." ] }, { "heading": "What We're Learning", "paragraphs": [ "One of the clearest insights from this collaboration is that engaged research cannot be reduced to a checklist or toolkit. Many engagement resources already exist, yet researchers consistently emphasised that what they really needed was support in navigating the deeper relational, ethical, and practical challenges of working collaboratively.", "Engaged research requires researchers to develop new capacities, including reflexive practice, relational skills, and the ability to share power within research partnerships. Meaningful collaboration takes time, trust-building, and openness to uncertainty. At the same time, this work cannot be carried by individual researchers alone. Engaged research is inherently collective, requiring shared commitment across research teams, community partners, institutions, and funders to create the conditions for genuine collaboration.", "The learning process also reinforced the importance of starting with purpose. Rather than asking first how to do engagement, researchers must begin by asking why: why engagement matters in a particular context, whose knowledge is needed, and what responsibilities research carries toward the communities it seeks to serve. The Primer therefore begins with a section called Starting with Self, encouraging researchers to reflect on their own positionality, assumptions, and power before designing engagement processes, while recognising that meaningful engagement ultimately unfolds through relationships and partnerships.", "These insights shaped the design of the Primer itself. Instead of offering prescriptive steps, the resource is structured as a reflective learning guide that supports researchers to think through questions of purpose, partnership, practice, and impact, helping them build more thoughtful, accountable, and collaborative approaches to research." ] } ], "video": { "embed_url": "https://streamable.com/e/7n3xlq?v=2", "label": "Watch the launch video" }, "link": { "label": "Read the Engaged Research Primer", "url": "https://cms.wellcome.org/sites/default/files/2026-04/Primer%20for%20Engaged%20Research.pdf?_gl=1*hojoy6*_gcl_au*NTQ0MTYzODk3LjE3NzM2NzA3ODk.*_ga*MTE5Mzk0NTE3MS4xNzczNjcwNzkw*_ga_SR4SNCD7KD*czE3NzU5MzE4NTAkbzE3JGcwJHQxNzc1OTMxODU2JGo1NCRsMCRoMA" } } }, { "id": "lens-matters", "title": "Our Lived Experience Navigating Science (LENS) Matters", "category": "Current Project", "image": "/images/projects/lens-cover.webp", "partner": "Wellcome Trust", "tagline": "A participatory research and learning initiative exploring how researchers' lived experience of mental health shapes knowledge production, research culture, and expertise in mental health science.", "cta_sticker": { "link": "/projects/lens-matters/get-involved", "text_top": "", "text_main": "GET", "text_sub": "INVOLVED", "text_cta": "Click here!", "aria_label": "Get involved with the LENS research — click here" }, "keywords": [ "Mental Health Research", "Lived Experience Leadership", "Research Culture" ], "modal": { "subtitle": "A participatory research and learning initiative exploring how lived experience shapes mental health research.", "sections": [ { "heading": "Project Overview", "paragraphs": [ "Our Lived Experience Navigating Science (LENS) Matters (2025-2028) is a South Africa-based research and learning initiative exploring how researchers' own lived experiences of mental distress, trauma, neurodivergence, and other forms of psychosocial adversity shape the way mental health knowledge is produced.", "The project begins from a simple but often overlooked premise: many of the people conducting mental health research also live with the realities that the field seeks to understand. Rather than positioning lived experience as something external to research, the project recognises that researchers themselves often navigate complex and overlapping identities as scholars, clinicians, activists, and individuals with lived experience.", "Across mental health science, lived experience is increasingly recognised as important for producing research that is ethical and socially grounded. Yet it is most often incorporated through advisory roles that leave dominant hierarchies of expertise intact. Our LENS Matters instead asks what becomes possible when lived experience is understood as a lens through which research itself is shaped, influencing how questions are asked, how ethics are approached, and how knowledge is interpreted.", "Commissioned by Wellcome as part of its Lived Experience Innovation Fund within the Mental Health priority area, the project contributes to a broader programme exploring new ways of recognising and supporting lived experience within mental health research.", "Grounded in the South African context but globally relevant, the project examines how lived experience operates within research systems themselves, challenging assumptions about neutrality, expertise, and authority in scientific knowledge production." ] }, { "heading": "Our Role", "paragraphs": [ "Our LENS Matters is led by Pivot Collective in collaboration with researchers from Stellenbosch University and King's College London, and in partnership with the McPin Foundation, The Banyan, and United for Global Mental Health.", "The project combines empirical research with participatory learning. Initial work includes a national survey of mental health researchers with lived experience, stakeholder interviews across the research ecosystem, and landscape analysis of how lived experience is currently recognised within mental health science.", "Central to the project is the LENS Learning Collective: a cohort of approximately 15–20 researchers with lived experience who participate in a facilitated learning process. Through storytelling workshops, methods labs exploring participatory and decolonial approaches, and small-scale co-learning projects within their own research contexts, the Collective creates space to reflect on identity, disclosure, research culture, and ethical practice.", "Pivot leads the participatory design and facilitation of this learning journey, drawing on our expertise in trauma-informed facilitation, adaptive learning processes, and participatory approaches to knowledge production. Members of the project team also bring their own lived experience into the work, shaping the ethos of the project and the way we approach questions of safety, disclosure, and care." ] }, { "heading": "What We're Learning", "paragraphs": [ "Early learning from the project highlights how many mental health researchers navigate multiple and shifting identities, as scholars, clinicians, activists, and individuals with lived experience. These identities shape how researchers approach their work, influencing research questions, ethical commitments, methodological choices, and relationships with communities.", "At the same time, researchers with lived experience often occupy liminal positions within research institutions. They may be recognised as researchers but not as legitimate holders of experiential expertise, or valued for their lived experience while their scientific authority is questioned. Decisions about whether and how to disclose lived experience frequently involve navigating stigma, professional expectations, and concerns about career risk within academic environments that continue to privilege ideals of neutrality and detachment.", "The project is also revealing how lived experience can meaningfully shape research practice when it is recognised as a form of epistemic authority rather than an external perspective. Experiential knowledge can influence how research questions are framed, how ethical dilemmas are understood, how relationships with communities are built, and how findings are interpreted and shared.", "Finally, the project is demonstrating that supporting lived experience within research is not only about individual researchers but about the institutional and relational infrastructures that surround them. Issues such as supervision, research governance, disclosure norms, workload expectations, and support structures all shape whether lived-experience-led research can be practiced ethically and sustainably. By creating a structured space for collective reflection and experimentation, the project is exploring how research institutions might move beyond symbolic inclusion toward research cultures that genuinely value experiential knowledge alongside professional expertise." ] }, { "heading": "Emergent Insights", "paragraphs": [ "This project is still in motion, and what follows is not a set of conclusions. It is a record of noticing: things that have surfaced, unsettled us, or opened up new questions as the work has unfolded.", "The team doing the work is part of the work. One of our earliest and most persistent realisations is that the preparation required to hold this project — the internal conversations, tensions, and relational labour within the team — is not separate from the research itself. We have come to understand ourselves as a kind of embedded autoethnographic collective: researchers, participants, facilitators, and observers simultaneously. The work to do the work is the learning.", "Lived experience in research carries costs that are rarely named. Researchers with lived experience often navigate impossible-seeming choices about whether and how to disclose. These are not simply personal decisions, they are shaped by institutional cultures that reward performance of objectivity and treat vulnerability as incompetence. We have noticed that even within spaces explicitly designed for this kind of openness, disclosure remains risky.", "What gets called a \"mental health challenge\" is often an institutional one. A recurring insight has been that distress frequently resides not in the individual but in the structures around them. Insulin injections are accommodated; therapy appointments are questioned. Some bodies and conditions are legible within academic culture; others are expected to adapt invisibly. This is structural ableism, and it runs through research environments in ways that are rarely surfaced.", "Hierarchy and lived experience are in tension and that tension is productive. University systems are built around rank, credential, and institutional authority. Lived experience operates differently, it destabilises fixed hierarchies of expertise. These are not necessarily opposing forces, but institutions struggle when authority becomes multi-dimensional. This project is sitting with that discomfort rather than resolving it prematurely.", "Sometimes you have to go forward to go backward. We are learning that the safest and most generative routes into difficult material are not always direct. Approaching hard things (trauma, disclosure, institutional risk) by first imagining the life one is building beyond them can open up what confrontation closes down. This has implications for how we hold the Learning Collective.", "Inclusion is not enough. Researchers with lived experience are often included in name but not in authority. And our LENS Matters itself cannot claim to represent all lived experience; there are many people whose knowledge never makes it into academic spaces at all. Centering researchers with lived experience is not a substitute for community-led knowledge production; it is a different and complementary intervention. We are holding this carefully.", "Care and rigour are not opposites. We are wary of a framing in which centring care means abandoning the drive and discipline that research requires. Productivity and reflexivity can co-exist. The question is not whether to care, but how institutions might be restructured so that caring is not a form of resistance but simply how the work gets done." ] } ] } }, { "id": "even-ground", "title": "Strengthening Ecosystems of Care for Children and Families", "category": "Current Project", "image": "/images/projects/even-ground-cover.webp", "partner": "Even Ground", "tagline": "Strategic partnership supporting equitable philanthropy, partner learning, and long-term support for community organisations working with children and families in South Africa.", "keywords": [ "Community Partnerships", "Learning & Impact", "Organisational Development" ], "modal": { "subtitle": "Participatory strategy, learning, and storytelling to support community-rooted organisations in South Africa.", "sections": [ { "heading": "Project Overview", "paragraphs": [ "Even Ground is a philanthropic organisation that partners with community-based organisations across South Africa working in early childhood development, education, health, disability inclusion, and youth leadership. For more than two decades, its partners have supported thousands of children and families through programmes rooted in long-term community relationships and local leadership.", "Pivot Collective began working with Even Ground in 2024 to support the organisation through a period of strategic reflection and organisational development. The collaboration focuses on strengthening Even Ground's ability to support its partner organisations while advancing more equitable and effective approaches to international giving.", "Together, the work aims to strengthen Even Ground as both a funder and ecosystem steward, supporting community-based organisations not only through financial investment, but also through learning, knowledge sharing, and long-term relationships grounded in trust." ] }, { "heading": "Our Role", "paragraphs": [ "Pivot works closely with the Even Ground board and partner organisations to support the organisation across several interconnected areas of strategy, learning, and communications.", "The collaboration began with an initial phase focused on addressing urgent organisational needs, including partner engagement, development of storytelling and media assets for a major fundraising campaign, and strengthening Even Ground's website and communications materials. Subsequent phases have focused on deeper organisational development work, including facilitating a participatory strategic planning process, developing donor engagement systems, and working with partner organisations to design a more meaningful approach to impact measurement and learning.", "A central part of this work has involved building stronger relationships across Even Ground's partner network. Pivot facilitated site visits, partner consultations, and a multi-organisation retreat designed to create space for shared reflection, peer learning, and collaborative problem-solving across the network.", "Alongside this work, the Pivot team has supported Even Ground in developing storytelling and communications strategies that highlight the voices and experiences of partner organisations and the communities they serve. These narratives help demonstrate how sustained investment in community organisations creates an \u201cecosystem of support\u201d in which care, knowledge, and opportunity ripple across families and communities over time." ] }, { "heading": "What We're Learning", "paragraphs": [ "This collaboration has surfaced important lessons about how philanthropic organisations can better support community-based partners working in complex social contexts.", "One key insight is that support is multidimensional. Partners consistently emphasised that meaningful support extends beyond financial resources to include relational trust, opportunities for learning, practical infrastructure support, and spaces where organisations can speak openly about challenges without fear of jeopardising funding relationships.", "The work has also reinforced the importance of shifting from compliance-driven reporting toward learning-focused reflection. Partners highlighted that reporting processes are most valuable when they support adaptation and shared understanding rather than simply documenting activities. Approaches such as learning conversations, reflective check-ins, and storytelling can often generate deeper insights than traditional reporting formats.", "Finally, the collaboration is highlighting the potential for philanthropy to act as a connector within ecosystems of care, facilitating peer learning and collaboration across organisations facing similar challenges. By creating space for organisations to exchange experience, reflect together, and support one another, philanthropic actors can help strengthen the resilience and sustainability of the wider community development ecosystem." ] } ] } }, { "id": "social-impact-designers", "npc_initiative": true, "title": "Social Impact Designers Programme", "category": "Current Project", "image": "/images/projects/sid-cover.webp", "partner": "Pivot Collective NPC", "tagline": "A youth-led learning and incubation platform supporting emerging changemakers to design community-driven responses to social challenges in South Africa through participatory learning and creative practice.", "keywords": [ "Youth Leadership", "Participatory Learning", "Community Innovation" ], "modal": { "subtitle": "A youth-led platform for cultivating community-rooted changemakers and strengthening grassroots social innovation.", "sections": [ { "heading": "Project Overview", "paragraphs": [ "The Social Impact Designers (SID) Programme is a youth-led platform developed by Pivot Collective NPC to support emerging changemakers in South Africa to explore social challenges and design community-driven responses.", "At its core, SID is grounded in a simple premise: some of the most important thinking and action on social change is already happening within communities. Across South Africa, young people are actively responding to issues such as inequality, health, climate change, and social injustice, often through informal or under-recognised initiatives rooted in their lived experience.", "SID creates space for this work to deepen and grow. Through participatory learning, creative practice, and collaborative experimentation, the programme supports young changemakers to develop ideas, build skills, and connect with peers, mentors, and wider networks of support.", "Rather than positioning young people as recipients of training, the programme recognises them as knowledge holders and innovators. Their experiences, insights, and practices form the foundation for how the programme is shaped and how learning unfolds within it." ] }, { "heading": "How the Programme Emerged", "paragraphs": [ "The Social Impact Designers programme emerged through an initial Social Impact and Participatory Research Internship, a year-long, cohort-based process that brought together emerging changemakers to co-design the foundations of the initiative.", "Launched in 2022 with seed support from the Centre for Social Science Research at the University of Cape Town, the internship created space for a small cohort of young people to explore their own pathways into social change while developing community-based projects grounded in their lived realities. The process combined skills-building in participatory research, facilitation, and project design with ongoing reflection, creative experimentation, and collective learning.", "Participants worked across a range of themes, including community healing, indigenous identity and heritage, youth leadership, and food security. Alongside developing their individual initiatives, they engaged in shared processes such as reading groups, arts-based workshops, and collaborative research, drawing on both critical theory and lived experience to inform their work.", "This phase was not only a space for project development, but for shaping the principles and practices that underpin SID today. Through co-design, dialogue, and experimentation, the cohort contributed to an approach grounded in youth-led inquiry, creative practice, and non-hierarchical learning.", "Early engagements with the broader activist community, through spaces such as the Pivot Mobiliser and through collaborations with other like-minded organisations, further informed the programme's development, surfacing key questions around what enables or constrains young people's ability to organise, lead, and sustain social change efforts.", "These experiences laid the foundation for SID as it exists today: not as a pre-defined programme, but as a platform that continues to evolve in response to the insights, needs, and practices of the young people it brings together." ] }, { "heading": "How the Programme Is Evolving", "paragraphs": [ "The Social Impact Designers programme continues to evolve as a platform for participatory learning, incubation, and community-building.", "While earlier iterations of the programme worked with dedicated cohorts of young changemakers, the current phase is focused on sustaining and deepening the ecosystem that emerged through this work. This includes ongoing experimentation with formats, partnerships, and approaches that can support young people to engage in social change in ways that are meaningful and sustainable.", "One key strand of this work is Pivot Mobilisers: participatory workshops and dialogues that bring together young activists, organisers, and practitioners. These spaces create opportunities to share experiences, surface common challenges, and build connections across different areas of social change work.", "Through these engagements, the programme continues to explore what kinds of support young people need to initiate and sustain their work—from access to resources and networks, to spaces for reflection, learning, and care." ] } ], "link": { "label": "Explore emergent insights from co-design sessions with young changemakers", "url": "/documents/mobiliser-learning-insights.pdf" } } }, { "id": "creative-practice-childrens-mental-health", "title": "Community of Creative Practice for Children's Mental Health", "category": "Past Project", "image": "/images/projects/iuh-cover.webp", "partner": "Impact on Urban Health", "tagline": "Supporting creative practitioners to generate new insights into children's mental health and reimagine support systems with families and young people.", "keywords": [ "Creative Methods", "Children's Mental Health", "Community of Practice" ], "modal": { "subtitle": "", "sections": [ { "heading": "Project Overview", "paragraphs": [ "Between 2022 and 2024, Pivot Collective partnered with Impact on Urban Health as the Learning Partner for a programme exploring how creative practice can reshape research and evidence-building around children's mental health in South London.", "The programme brought together community practitioners, artists, and grassroots organisations working closely with families and young people. Through a Community of Creative Practice, participants developed and tested creative approaches to exploring children's wellbeing and the social conditions shaping mental health.", "Across the programme, seven community-led projects used methods including participatory photography, creative movement, radical participatory design, forum theatre, and collaborative arts practice to generate new insights into children's mental health experiences and support systems. At the heart of the programme was a shared principle: that families, young people, and communities should play a central role in shaping the knowledge and evidence used to design mental health support." ] }, { "heading": "Our Role", "paragraphs": [ "Pivot Collective worked as the Learning Partner, supporting both the development of the programme and the collective learning emerging across the participating projects.", "We helped design and facilitate the Community of Creative Practice, bringing together practitioners from across South London to exchange methods, reflect on their work, and learn from each other's experiences. Through workshops, mentorship, and ongoing dialogue, we supported practitioners as they developed and implemented creative approaches to community-based research on children's mental health.", "The programme also experimented with a more collaborative approach to funding. Instead of competing for grants through a traditional selection process, practitioners worked together to develop and refine their proposals, with funding decisions emerging through dialogue and shared learning. Pivot supported this process by facilitating proposal development sessions, providing methodological guidance, and helping teams strengthen their project ideas.", "Alongside this facilitation work, we documented and synthesised learning from across the seven projects. This included capturing reflections from practitioners, identifying common themes across the different methodologies being tested, and developing a learning playbook to support researchers, practitioners, and funders interested in more participatory approaches to children's mental health." ] }, { "heading": "What We Learned", "paragraphs": [ "Working across seven diverse creative projects revealed how participatory and arts-based approaches can transform how research and engagement around children's mental health takes place.", "Creative methodologies often enabled participants to explore difficult or sensitive experiences in ways that felt safer and more accessible than direct questioning. By working through photography, movement, theatre, and other creative practices, children, young people, and families were able to express perspectives that might otherwise remain unspoken. These forms of \u201ccreative distance\u201d helped participants maintain control over how much of their personal experiences they chose to share while still contributing meaningfully to collective understanding.", "The projects also demonstrated how creative methods can shift traditional power dynamics in research and service design. When communities, families, and young people are positioned not as research subjects but as collaborators and co-creators of knowledge, new forms of insight emerge. Participants were able to articulate their needs, critique existing systems, and imagine alternative forms of support in ways that are rarely possible within conventional research processes.", "Another key lesson was the importance of sustained engagement. Trust, confidence, and meaningful collaboration developed gradually over time, often through regular sessions that combined creative practice with shared reflection. As relationships deepened, many projects moved from more structured facilitation toward increasingly collaborative and participant-led forms of inquiry.", "Finally, the programme highlighted the value of creative documentation and collective outcomes. Exhibitions, performances, publications, and public events helped recognise the expertise of participants and share their insights more widely with families, practitioners, and decision-makers. These moments of public sharing not only amplified community voices but also helped strengthen connections between grassroots practice and institutional systems responsible for shaping children's mental health support." ] } ], "link": { "label": "Read the project playbook", "url": "/documents/iouh-childrens-mental-health-playbook.pdf" } } }, { "id": "peer-led-hiv-care", "title": "Peer-Led HIV Care and Adaptive Learning Systems", "category": "Past Project", "image": "/images/projects/yimlo-cover.webp", "partner": "Population Services International (PSI)", "tagline": "Supporting the design, learning, and adaptation of a peer-led HIV programme for men who have sex with men in South Africa.", "keywords": [ "HIV & SRHR", "Adaptive Learning", "Participatory Evaluation" ], "modal": { "subtitle": "Designing and learning from a peer coaching model to strengthen HIV prevention, care, and support for men who have sex with men in South Africa", "sections": [ { "heading": "Project Overview", "paragraphs": [ "The Yim\u2019lo Project was a lived experience-led HIV service delivery programme supporting men who have sex with men and transgender women across three geographies in South Africa. The programme was led by Population Services International (PSI) South Africa, in partnership with The Aurum Institute, Matchboxology, and Pivot Collective.", "At its core, Yim\u2019lo centred a peer-led model, in which trained peer coaches provided tailored support to individuals navigating HIV prevention, testing, and treatment services. Grounded in shared lived experience, the model aimed to build trust, reduce stigma, and strengthen engagement with health services among communities often underserved by traditional systems. Coaches played a critical role as bridges between communities and the health system, supporting individuals to access services, navigate disclosure, and advocate for their health needs. The programme emphasised dignity, empathy, and non-judgemental engagement as foundational to effective service delivery." ] }, { "heading": "Our Role", "paragraphs": [ "Pivot Collective partnered on the Yim\u2019lo Project as the learning and evaluation partner, designing and stewarding an adaptive learning approach that enabled the programme to evolve in response to real-time insights from implementation.", "Our work was grounded in the principle that effective service delivery models, particularly those working within complex and shifting social contexts, require ongoing cycles of reflection, learning, and adaptation. Rather than positioning evaluation as a retrospective or external process, we embedded learning within implementation, creating structures for continuous feedback and programme refinement.", "This adaptive approach was operationalised through a co-design and co-learning process, recognising coaches and implementers as central contributors to knowledge generation. We invested in building the capacity of coaches as peer researchers, developing tailored training curricula and facilitating participatory workshops focused on qualitative and participatory research methods. Through this, coaches were able to engage directly in data collection, reflect on their own practice, and contribute to interpreting emerging insights.", "Working alongside PSI, Aurum, and other partners, we facilitated iterative learning cycles across the pilot, including mixed-methods data collection, rapid analysis, and participatory sense-making processes. These cycles created structured opportunities for coaches, service providers, and programme teams to collectively interpret findings and translate them into concrete adaptations.", "This approach ensured that learning was not extracted from the programme, but co-produced within it, enabling timely adjustments to key components of the model, including coach support systems, digital tools, and participant pathways.", "The process culminated in the co-development and authorship of an adaptive implementation guide, which captures the core components of the model, key learning from the pilot, and practical guidance to support future adaptation and scale across different contexts." ] }, { "heading": "What We Learned", "paragraphs": [ "Learning from the Yim\u2019lo pilot highlights that peer-led models of care operate as deeply relational systems shaped by trust, identity, and lived experience.", "At the centre of the model is the role of the peer coach. Coaches do far more than facilitate access to services. They build relationships grounded in shared experience, empathy, and non-judgement. This relational foundation enables forms of engagement that are often difficult to achieve through formal health systems alone, particularly for men who have sex with men and transgender women navigating stigma and exclusion. The effectiveness of the model depends not only on what coaches do, but on who they are and how they are supported to show up in these roles.", "This has important implications for how peer-led programmes are designed and resourced. The pilot highlighted the extent to which coaches carry significant emotional and relational labour, often navigating complex situations alongside the individuals they support. Sustaining this work requires structured investment in mentorship, psychosocial support, and collective spaces for reflection. Without this, the very qualities that make peer models effective can also place strain on those delivering them.", "The project also surfaced the importance of identity and representation within peer models. Shared identity, whether in terms of gender, lived experience, or social context, plays a critical role in building trust and enabling meaningful engagement. At the same time, the diversity within communities means that no single model of \u201cpeer\u201d is sufficient, reinforcing the need for flexibility and responsiveness in programme design.", "From a systems perspective, the pilot demonstrated the value of embedding adaptive learning within implementation. Rather than treating evaluation as a retrospective exercise, iterative cycles of data collection, rapid analysis, and participatory sense-making enabled the programme to respond to emerging challenges and opportunities in real time. This shifted evaluation from a tool of accountability alone to a mechanism for ongoing programme improvement and shared ownership across partners.", "Finally, the development of the implementation guide reinforced that scaling such models is not about replication, but about adaptation. What matters is not reproducing a fixed approach, but carrying forward its underlying principles (relational care, community leadership, and responsiveness to context) into new settings. The Yim\u2019lo pilot highlights that effective scale depends on maintaining these principles while allowing the model to evolve in response to the realities of different communities and health systems." ] } ], "link": { "label": "Read the implementation guide", "url": "/documents/yimlo-implementation-guide.pdf" } } }, { "id": "youth-climate-health", "title": "Young People as Changemakers in Climate Change and Health", "category": "Past Project", "image": "/images/projects/restless-cover.webp", "partner": "Restless Development", "tagline": "A participatory research and scoping study exploring how young people in South Africa are understanding, navigating, and leading action at the intersection of climate change and health.", "keywords": [ "Climate & Health", "Youth Leadership", "Participatory Research" ], "modal": { "subtitle": "Exploring how youth-led knowledge, advocacy, and action can shape more just responses to the climate and health nexus in South Africa.", "sections": [ { "heading": "Project Overview", "paragraphs": [ "This project explored the growing intersection of climate change, health, and youth advocacy in South Africa. Developed in partnership with Restless Development, the work set out to better understand how climate change is affecting health and wellbeing, how these issues are currently being addressed in research and policy, and how young people are already engaging this nexus as advocates, organisers, and changemakers.", "The project combined a rapid evidence review with a participatory inquiry process designed to centre youth perspectives. Alongside reviewing published and grey literature, the team facilitated a participatory workshop with young people working across climate, health, and advocacy spaces; conducted key informant interviews with young leaders in policy and advocacy; and developed a stakeholder map of actors working in climate and health in South Africa.", "Together, these processes created an early scoping picture of a fast-growing field. They highlighted both the urgency of linking climate and health more explicitly in South Africa, and the critical role that young people can play in shaping more grounded, just, and locally responsive approaches to research, policy, and action." ] }, { "heading": "Our Role", "paragraphs": [ "Pivot Collective designed and led the research and learning process for this project. Our work included a rapid evidence review on the climate-health nexus in South Africa, with particular attention to the role of young people in advocacy and change-making. We also designed and facilitated the participatory research components of the project, including a day-long workshop with youth participants, key informant interviews, and the collaborative development of a stakeholder map of organisations and institutions working across climate, health, and youth mobilisation.", "The workshop drew on creative and participatory methods to support collective reflection and analysis. Participants mapped climate-related health challenges across South Africa\u2019s provinces, shared their own understandings of how climate change is shaping health in different contexts, and reflected on the forms of support, knowledge, and infrastructure needed for young people to act more meaningfully in this space. The interview process then helped deepen and validate these insights, particularly around policy, advocacy, and resourcing." ] }, { "heading": "What We Learned", "paragraphs": [ "One of the clearest insights from this work was that climate change and health cannot be meaningfully understood in isolation from broader questions of justice and inequality. Young participants consistently highlighted how historical and structural inequalities shape people\u2019s ability to respond to climate change, and how issues such as poverty, unemployment, food insecurity, and uneven access to information can make it difficult for many young people to participate in climate action, even when they are deeply affected by it.", "The project also showed that young people are already playing important roles in climate and health advocacy, but that their participation is constrained by limited access to resources, knowledge, and decision-making spaces. Participants pointed to the need for stronger climate and health literacy, more practical and locally grounded forms of education, and greater support for youth-led advocacy, including the material resources needed to sustain this work over time.", "A further learning was the importance of linking research more directly to action. The inquiry surfaced significant gaps in public understanding of the climate\u2013health nexus, limited access to policy and research processes, and a need for more effective knowledge translation that can help young people and communities engage with evidence in usable ways. Across the report, this pointed to the value of community-engaged research, accessible learning processes, and stronger infrastructures for youth-led participation in shaping climate and health responses." ] } ] } }, { "id": "young-and-curious", "npc_initiative": true, "title": "Young and Curious", "category": "Past Project", "image": "/images/projects/young-curious-cover.webp", "partner": "Pivot Collective NPC", "tagline": "A youth-led creative inquiry exploring mental health, identity, and social change through participatory arts and collective reflection.", "keywords": [ "Youth Leadership", "Mental Health", "Creative Methods" ], "modal": { "subtitle": "A youth-led creative inquiry into mental health, identity, and social change in South Africa.", "sections": [ { "heading": "Project Overview", "paragraphs": [ "Young and Curious was a youth-centred initiative led by Pivot Collective, creating a space for reflection, imagination, and shared inquiry among young South Africans aged 18\u201329.", "Initially supported through seed funding from Wellcome, the project evolved over time into a locally grounded and iterative core NPC programme, shaped by both opportunity and constraint. At its core, it brought together a diverse group of young collaborators through an open call, inviting them into a co-creative process rooted in their lived experiences and everyday realities.", "Together, participants explored what it means to come of age in a context shaped by inequality, uncertainty, and possibility. Using creative methods (including mural art, photography, poetry, and storytelling) the group explored mental health and wellbeing as experiences shaped by social, cultural, and structural forces, rather than as isolated or individual conditions.", "In this process, young people were recognised as knowledge producers in their own right, bringing critical insight into the conditions shaping their lives. Through creative and participatory approaches, Young and Curious created space for participants to construct and share their own narratives, while also questioning whose knowledge is typically recognised, and whose is left out, in conversations about mental health.", "Public-facing moments such as Doodle Nights extended this work into the community, using art and dialogue to challenge dominant framings of mental health and open up alternative, more contextually grounded ways of understanding distress and wellbeing." ] }, { "heading": "Our Role", "paragraphs": [ "Young and Curious was developed and led by Pivot Collective NPC as an exploratory initiative at the intersection of participatory research, creative practice, and youth engagement.", "Our role was to design and facilitate a process that brought together research, engagement, and creative expression as a single, integrated and co-created practice. This involved working collaboratively with participants to shape the direction of the project, while creating the conditions for reflection, dialogue, and experimentation.", "We facilitated workshops, creative sessions, and ongoing reflective spaces that supported participants to explore their experiences, develop their creative practices, and engage critically with questions of mental health and social change. This included holding space for difficult and often deeply personal conversations, grounded in an ethic of care, trust, and mutual accountability.", "We also connected participants to a broader network of artists, researchers, and practitioners, creating opportunities for exchange across disciplines and ways of knowing. Throughout, the focus remained on supporting young people not only to express their experiences, but to shape how those experiences are understood and communicated.", "As the project unfolded, particularly in the context of COVID-19, we adapted the structure and scope of the work to remain responsive to participants\u2019 needs and realities. This resulted in a more locally rooted and sustained engagement, with an emphasis on continuity, relationship-building, and collective ownership." ] }, { "heading": "What We Learned", "paragraphs": [ "Young and Curious offered important insights into how we understand mental health, knowledge, and participation\u2014particularly in a South African and broader global South context.", "One key learning is that how we create knowledge matters as much as what we create. In many mental health research contexts, knowledge is still produced at a distance, where young people are positioned as subjects of study rather than active contributors. This project showed that when young people are meaningfully involved in shaping the questions, methods, and outputs, the knowledge that emerges is more nuanced, relevant, and grounded in lived reality.", "Related to this, the project highlighted the importance of challenging dominant frameworks of mental health, many of which are rooted in Euro-American, biomedical models. While these frameworks can be useful, they often fail to capture the complexity of young people\u2019s experiences in contexts shaped by inequality, violence, and historical injustice. Through creative and collective exploration, participants articulated more relational and contextual understandings of mental health, ones that connect emotional wellbeing to social conditions, community dynamics, and everyday lived experience.", "This points to a broader insight around decolonising knowledge: questioning whose knowledge is recognised as valid, and creating space for different ways of knowing to shape research and practice. In Young and Curious, creative expression became a way to surface forms of knowledge that are often overlooked, including embodied, emotional, and narrative ways of understanding the world. These forms of knowledge are essential, alongside traditional scientific knowledge, to build a fuller picture of mental health and wellbeing.", "Rather than treating South Africa as a site where knowledge is extracted or applied, Young and Curious positioned it as a site of insight, innovation, and theory-building in its own right. The experiences of participants, shaped by intersecting forms of inequality, resilience, and social change, offer important contributions to global conversations about mental health, particularly in highlighting the links between structural conditions and individual wellbeing.", "Finally, Young and Curious underscored the importance of care, continuity, and collective ownership in participatory work. Creating spaces where young people feel safe to share, reflect, and create takes time and intention. It requires building relationships, holding complexity, and recognising the emotional labour involved in this kind of work. When these conditions are in place, participation moves beyond consultation. It becomes a process of shared learning, critical reflection, and, ultimately, transformation." ] } ] } }, { "id": "contraceptive-self-care", "title": "Centring Women's Experience in Contraceptive Self-Care", "category": "Past Project", "image": "/images/projects/disc-cover.webp", "partner": "Population Services International (PSI)", "tagline": "Supporting PSI's self-care programme in Nigeria and Uganda through research, learning, and the development of contextually grounded approaches to measuring women's empowerment.", "keywords": [ "SRHR & Self-Care", "Adaptive Learning", "Participatory Research" ], "modal": { "subtitle": "", "sections": [ { "heading": "Project Overview", "paragraphs": [ "The Delivering Innovations in Self-Care (DISC) programme was a multi-country initiative led by Population Services International (PSI) to expand access to contraceptive self-injection and strengthen broader self-care approaches in sexual and reproductive health. Pivot Consulting served as the Evidence and Learning Partner for the project.", "Implemented across Nigeria and Uganda, the programme focused on supporting women, particularly young women and mothers, to take greater control over their reproductive health. This included enabling the safe and informed use of self-injectable contraception, while strengthening the health systems, provider practices, and community-level dynamics that shaped women\u2019s ability to access and sustain self-care.", "The programme sought to address a set of interconnected challenges: how women experienced and made decisions about self-care; how provider interactions and health system structures influenced those decisions; and how concepts such as agency, choice, and empowerment could be understood and measured in ways that reflected women\u2019s lived realities.", "Within this broader programme, Pivot Collective was engaged to support key components of the evidence and learning agenda." ] }, { "heading": "Our Role", "paragraphs": [ "Pivot Collective partnered with PSI as an evidence and adaptive learning partner on the DISC programme, supporting the design, implementation, and evolution of its learning systems across multiple phases.", "A central component of this work focused on the development of contextually grounded empowerment metrics. Across Uganda and Nigeria, Pivot designed and led a participatory research process to explore how women understand and experience power, agency, and decision-making in relation to their sexual and reproductive health. Using creative, dialogic methods, including participatory workshops, theatre, and visual mapping, the research centred women\u2019s lived experiences and enabled participants to actively interpret and analyse their own insights.", "This work was accompanied by a strong focus on capacity strengthening, with Pivot designing and delivering both online and in-person training for DISC teams in qualitative and participatory research methods. These processes supported programme staff and in-country teams to actively engage in data collection, reflection, and interpretation, embedding learning within the programme rather than positioning it as an external function.", "Insights from this process informed the development of locally relevant, theoretically grounded empowerment metrics, designed to be integrated into DISC\u2019s tracking systems. Iterative feedback loops with participants and programme teams ensured that these metrics remained responsive to context and grounded in lived experience.", "Building on this foundation, Pivot also supported a major implementation-focused innovation and learning process, known as the \u2018Moment of Truth\u2019 study. This work aimed to strengthen the provider\u2013client interaction at the point where women decide whether to take up self-injection, addressing key behavioural and relational barriers within service delivery.", "Rather than a standalone study, this was designed as an embedded adaptive learning process, combining innovation design, real-time evidence generation, and iterative refinement. Pivot co-developed and tested different models of provider support, focusing on strengthening provider confidence, empathy, and counselling practices. The study used a mixed-methods implementation design, including observation, interviews, training assessments, and analysis of routine service data, with findings continuously fed back into programme adaptation.", "Across both workstreams, Pivot played a key role in evidence synthesis and knowledge translation, supporting the DISC team to interpret emerging insights, adapt interventions in real time, and translate learning into practical tools, technical outputs, and contributions to the wider field of self-care and women\u2019s empowerment." ] }, { "heading": "What We Learned", "paragraphs": [ "Work across the DISC programme highlighted how complex it is to support and understand women\u2019s experiences of power, choice, and care within self-care interventions.", "One key insight was that these experiences are deeply shaped by context. Participatory research across Uganda and Nigeria showed that women\u2019s experiences of power are shaped by their relationships, life stage, and social context, and can shift over time. Decisions are often made within constraints, and can involve negotiation, compromise, or risk. Rather than a straightforward progression toward greater autonomy, what emerged was a more relational and situated understanding of power, one that is shaped by social expectations, economic realities, and the dynamics of care and responsibility. This challenged more simplified ideas of \u201cempowerment\u201d as something that can be easily achieved or measured, and reinforced the importance of starting from lived experience.", "The work also showed the limits of standard measurement approaches. While established frameworks and indicators are useful, they often miss the relational and social dynamics that shape how decisions are actually made. Combining quantitative data with qualitative, participatory research made it possible to see a fuller picture, including how programmes are experienced on the ground, and where unintended effects might emerge.", "The \u2018Moment of Truth\u2019 study further demonstrated that provider\u2013client interactions are pivotal, but not sufficient on their own to drive change. Strengthening provider confidence, empathy, and counselling practices improved the quality of engagement with clients and supported increased uptake of self-injection in some contexts. At the same time, broader system factors, including commodity availability, cost, space for private counselling, and community dynamics, continued to shape outcomes. This points to the need for integrated approaches that address both interpersonal and structural dimensions of service delivery.", "Across both workstreams, the importance of adaptive learning and structured sense-making emerged as a key insight. Different forms of evidence often revealed different, and sometimes competing, perspectives on programme performance. Creating space for teams to engage collectively with these insights allowed for a more nuanced understanding of what was working, for whom, and under what conditions. This process supported more grounded decision-making and helped to identify where adaptation was needed.", "Finally, the work reinforced that implementation rarely unfolds as planned. Gaps between design and reality are inevitable, particularly in complex systems. Approaches that allow for ongoing learning, reflection, and adaptation are better able to respond to these dynamics and support programmes that are more attuned to the contexts in which they operate." ] } ] } }, { "id": "adolescent-srhr", "title": "From Evidence to Practice in Adolescent SRHR", "category": "Past Project", "image": "/images/projects/a360-cover.webp", "partner": "Population Services International (PSI)", "tagline": "Supporting PSI's Adolescents 360 programme through learning processes, adaptation analysis, and research on knowledge translation in adolescent sexual and reproductive health.", "keywords": [ "Adolescent SRHR", "Knowledge Translation", "Adaptive Learning" ], "modal": { "subtitle": "Supporting more inclusive and adaptive approaches to learning and knowledge in adolescent SRHR", "sections": [ { "heading": "Project Overview", "paragraphs": [ "Adolescents 360 (A360) is a multi-country initiative led by Population Services International (PSI) to increase access to and uptake of voluntary modern contraception among adolescent girls. Implemented across several countries in sub-Saharan Africa, the programme combines human-centred design, youth engagement, and adaptive implementation to develop and refine approaches that respond to the needs and realities of young people.", "A360 places a strong emphasis on learning, generating a significant body of evidence through implementation. At the same time, the programme operates within complex and rapidly changing contexts, where interventions are continuously adapted in response to new insights, operational challenges, and shifting priorities.", "Within this context, a central challenge has been how to ensure that learning is not only generated, but meaningfully interpreted, shared, and used. This includes questions about who participates in knowledge production, how programme adaptations are documented and understood, and how evidence travels across teams, countries, and global platforms." ] }, { "heading": "Our Role", "paragraphs": [ "Pivot Collective partnered with PSI as a learning and research partner on Adolescents 360 (A360), supporting how evidence was produced, interpreted, and used across different phases of the programme.", "Our work began with a focus on broadening participation in knowledge production. We designed and facilitated a conference abstract development process that supported youth partners and early-career practitioners to translate their experiences into formal research outputs. This included mentoring first-time authors through the process of developing, writing, and submitting abstracts, with a particular emphasis on supporting those who had not previously had access to global research platforms.", "Building on this, we worked with A360 teams to document and make sense of programme adaptation over time. Through a cross-country adaptation audit, we traced how interventions evolved across implementation contexts, capturing the often non-linear and context-specific ways in which programmes were refined. This work highlighted how adaptation is shaped not only by formal evidence, but by the everyday realities of implementation, and supported programme teams to reflect on and carry forward these insights into subsequent phases of scale-up and integration.", "In parallel, we led a scoping review and qualitative study on knowledge translation in adolescent sexual and reproductive health. This work combined a review of global literature with key informant interviews to explore how evidence is produced, accessed, and used in practice, and to identify the factors that enable (or constrain) its uptake within programmes and policy processes.", "Across these strands, our role was not only to generate insight, but to support processes of reflection, synthesis, and knowledge exchange, helping programme teams to engage more critically with their own evidence, and to strengthen how learning informed ongoing decision-making." ] }, { "heading": "What We Learned", "paragraphs": [ "Work across Adolescents 360 reinforced that the challenge is not only generating evidence, but ensuring it can move, adapt, and be used within the realities of programmes and systems.", "Findings from the knowledge translation research highlighted that knowledge systems are often misaligned with implementation contexts. Practitioners operate under constraints of time, access, and competing priorities, while much of the available evidence is difficult to access, highly technical, or not immediately applicable. Paywalls, limited infrastructure, and gaps in capacity to interpret and apply research further restrict use. As a result, even when evidence exists, it is not always usable in practice.", "This work also showed that knowledge translation is not a neutral or purely technical process. Decisions about what knowledge is trusted and taken up are shaped by relationships, institutional cultures, and power dynamics. Disconnects between researchers, policymakers, and implementers, alongside differing incentives and timelines, mean that knowledge often struggles to move across these spaces.", "Alongside this, the abstract development process highlighted the importance of who gets to participate in knowledge production. Supporting youth partners and early-career practitioners to contribute to conference abstracts revealed both the barriers and the possibilities in opening up global knowledge spaces. While there is increasing emphasis on participation, access to authorship and visibility remains uneven. Creating more inclusive knowledge systems requires intentional support, mentorship, and a willingness to rethink whose knowledge is recognised as legitimate.", "Insights from the adaptation audit underscored that programme implementation is inherently adaptive, but not always recognised as such. Across contexts, interventions evolved continuously in response to operational realities, shifting contexts, and emerging learning. Many of these adaptations were critical to programme effectiveness, yet were not systematically documented or valued as part of the evidence base. At the same time, teams had to navigate ongoing tensions between adaptation and fidelity, as well as pressures to demonstrate results, scale, and cost-efficiency.", "The findings also point to misaligned incentives within programme and knowledge systems. Short policy and funding cycles often do not align with the slower pace of research, while programme metrics can prioritise immediate, quantifiable outcomes over longer-term or less visible changes. This shapes both what is learned and what is prioritised in implementation.", "Across all strands of work, a consistent lesson was the importance of embedding learning within programmes, rather than treating it as a separate activity. One-off products or dissemination efforts are rarely sufficient. Instead, learning needs to be supported through ongoing reflection, exchange, and adaptation, grounded in relationships, and sustained over time." ] } ], "link": { "label": "Read the scoping review article", "url": "#" } } } ], "cta": { "lead": "Interested in collaborating with us on a project?", "detail": "We are always looking for partners who share our commitment to justice, equity, and community-led change. If you have a project in mind or want to explore how we might work together, we would love to hear from you.", "button": { "label": "Get in Touch", "url": "contact.html" } } }