Using Responsive Feedback in Scaling a Gender Norms-Shifting Adolescent Sexual and Reproductive Health Intervention in the Democratic Republic of Congo

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) dur-ing piloting and scale-up. Responsive Feedback Mechanisms: The program engaged stake-holders via quarterly learning meetings to review monitoring data, evaluation results, and practice-based knowledge and to subse-quently 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 pro-gram to address community concerns by intensifying orientation activities with parents and schools, shifting the calendar of activi-ties to increase male engagement, and increasing facilitator train-ing length to improve facilitation quality. Using RFMs during scale-up prompted further adaptations for program sustainability, including recommendations for task-shifting from NGO facilita-tors to community health workers. Conclusion: GUG used RFMs from pilot through scale-up to foster a learning culture among local partners, implementers at headquar-ters, and global research partners. Using responsive feedback (RF) en-abled 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 pan-demic in educational strategies for program beneficiaries.