Programa Geração Biz, Mozambique: how did this adolescent health initiative grow from a pilot to a national programme, and what did it achieve?

Abstract

Adolescent sexual and reproductive health gained particular traction in Mozambique following the 1994 International Conference on Population and Development leading to the inception of Programa Geração Biz (PGB), a multi-sectoral initiative that was piloted starting in 1999 and fully scaled-up to all provinces by 2007. We conducted a systematic review of the literature to gather information on PGB and analyzed how it planned and managed the scale-up effort using the WHO-ExpandNet framework. PGB’s activities comprised a clear and credible innovation. Appropriate resource and user organizations further facilitated national scale-up. Challenges relating to the complex nature of the multi-sectoral approach and resistance due to norms about adolescent sexual and reproductive health hindered scaling-up in some geographic areas. The national government exhibited commitment and ownership to PGB through budgetary support and integration into multiple policies. This study adds to the documentation of successful scaling-up strategies that can provide guidance for policy makers and programme managers.

Scaling Up a Strengthened Youth-Friendly Service Delivery Model to Include Long-Acting Reversible Contraceptives in Ethiopia: A Mixed Methods Retrospective Assessment

“…Notwithstanding contributing influencers and barriers to scaling up a tested intervention model, scaling-up efforts must always be accompanied with research documenting planning and implementation processes, health-related outcomes, and impact to communicate lessons learned and opportunities for strengthening scale-up. 32,34 Study findings are largely consistent with existing literature, [5][6][7][8][9][10][11][13][14][15] indicating that mobilizing financial resources and quality of care are of paramount importance for effective scale-up and sustainability of interventions that aim to improve RH outcomes among adolescents and youth nationally. In other words, support for adolescent and youth RH was on paper, but there was limited financial allocation.…”

“…national scale-up. [4][5][6][7][8][9][10][11][12][13][14][15] For example, in Ethiopia, Kyrgyzstan, and Bangladesh, strong political commitment aligned with good governance, coordinated donor support, and the ability to adapt to resource limitations and competing priorities within constrained and weak health systems have contributed to improving health outcomes. 6,12 In Nigeria, there was near nation-wide scale-up of a school-based comprehensive sexuality education program supported by strong political leadership, although lack of a predictable funding source and competing priorities for available human resources were recognized as major impediments for sustainability.…”

Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania

“…Inter-sectoral coordination committees involving the health, education and youth ministries were set up at national, provincial and district levels. These committees were mandated and supported to bring together the three sets of activities into one coherent whole (Chandra-Mouli et al 2015 ).…”

“It is challenging… oh, nobody likes it!”: a qualitative study exploring Mozambican adolescents and young adults’ experiences with contraception

“…However, it did not sufficiently address social norms contributing to adolescent SRH. As well, inadequate gender sensitivity of the PGB lead to limited effects on preventing unprotected sexual activity especially among girls [ 34 ]. Moreover, barriers related to availability, accessibility, acceptability and equity of these types of services have already been documented in the literature [ 15 , 35 ].…”