From Evidence to Practice in Adolescent SRHR

Project Overview

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.

Our Role

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.

What We Learned

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.