Table 1. Description of Adolescents 360 program components by site.

Item no.	Item	Nasarawa, Nigeria	Ogun, Nigeria	Oromia, Ethiopia	Mwanza, Tanzania
1	Intervention name.	Matasa Matan Arewa (MMA)	9ja Girls	Smart Start	Kuwa Mjanja
2	Geographies where it occurred.	Seven selected LGAs in two states: Nasarawa (Doma and Karu LGAs) and Kaduna (Chikun, Igabi, Sabon gari, and Zaria LGAs) [8]	19 LGAs in seven states in Southern Nigeria: Ogun (Abeokuta south and Ado-Odo/Ota LGAs), Lagos (Agege and Alimosho LGAs), Osun (Iwo LGA), Oyo (Akinyele and Ibadan north-east LGAs), Edo (Ikpoba Okha and Oredo LGAs), Akwa Ibom, and Delta (Warri south LGA) [9] It was also implemented in some areas of Kaduna state, in Northern Nigeria.	39 Woredas (districts) in four regions: Amhara, Oromia, Southern Nations Nationalities and Peoples, and Tigray [10]	20 Regions: Arusha, Dar es salam, Dodoma, Geita, Iringa, Kagera, Katavi, Kilimanjaro, Lindi, Manyara, Mara, Mbeya, Morogoro, Mtwara, Mwanza, Pwani, Rukwa, Ruvuma, Shinyanga, Simiyu, Songwe, Tabora, and Tanga.
3	Timing of intervention.	In Karu LGA: from April 2018 in 2% (n = 5/261)1 of all health facilities in the LGA; the intervention program was delivered over a period of 31 months in total. In Doma LGA: from June 2019 in 9% (n = 5/54)1 of all health facilities in the LGA; for 18 months.	In Ado-Odo/Ota: from December 2017 in 9% (n = 13/147)1 of all health facilities in the LGA; for 36 months.	In Fentale woreda: from April 2018; the intervention program was delivered in different kebeles within the woreda over a period of 31 months in total. In Ada’a woreda: from June 2018; for 29 months. In Lome and Wara Jarso woredas: from August 2018; for 27 months. 2 Implementation was conducted in a staggered way across kebeles and by the end of 2020, all kebeles were expected to have receive the intervention.3,4	In Mwanza, the intervention program was delivered from January 2018 to September 2020; for 32 months.
4	Reach by end of September 2020	45,371 adolescent girls	172,517 adolescent girls	75,237 adolescent girls	314,155 adolescent girls
5	Rationale, theory, or goal of the elements essential to the intervention.	Establishes the relevance of contraception for married adolescent girls and their husbands by linking birth spacing to family health and girls’ life goals. Female mentors deliver life and vocational skill sessions to girls, and male mobilizers start conversations with husbands to encourage referrals to walk-in counselling	Combines walk-in contraceptive counselling with life-skill sessions for unmarried girls. Uses life and vocational skills as an entry point to engage unmarried adolescent girls in conversations about contraception and how it can be a tool to help them achieve their life goals.	Engages married adolescent girls and their husbands, using financial planning as an entry point to discuss contraception and help them understand how delayed first birth and spaced pregnancies facilitate improved savings and capital and financial security to pursue their shared life goals.	Engages mainly unmarried adolescent girls around their life aspirations. Provides them with low-intensity vocational skills sessions and contraceptive service delivery. Aims to give them the tools they need to balance their growing responsibility and navigate the social transition to adulthood.
6	Physical or informational materials used in the interventions, including those provided to participants or used in intervention delivery or in training of intervention providers.	(a) Life, Family and Health (LFH)—Four mentored group sessions whose curriculum focuses on nutrition, sexual and reproductive health, life skills and vocational skills. (b) Contraceptive counselling through an ‘opt-out’ moment at the end of each LFH session or to walk-in clients.	(a) Life, Love and Health (LLH)—One facilitated group session whose curriculum features vocational skills, future-planning exercises, and discussions about love, sex and dating. (b) Contraceptive counselling through an ‘opt-out’ moment at the end of each LLH session or to walk-in clients.	Girls engage in a Smart Start session guided by: (a) Discussion aide which introduces concepts around financial planning through easy to understand visuals and links these concepts to delayed first birth and spaced pregnancies. (b) Goal card it was used for married adolescent girls to record the aspirations they discuss in the counselling session and use as a conversation starter with their husbands or family members. (c) Contraceptive counselling through an ‘opt-out’ moment at the health post.	(a) Single group session implemented as part of in and out-of-clinic events. During the sessions, girls participate in a life and vocational skills induction session where they learn an entrepreneurship skill from a trained provider–e.g. jewellery or soap making. (b) ‘Kuwa Mjanja Queens’ use interactive games about contraceptive choices and side effects, with the help of tablets containing the ‘Mjanja Connect’ app, to engage girls between activities. (c) Contraceptive counselling through an ‘opt-out’ counselling moment at each event.
7	Description of each of the procedures, activities, and/or processes used in the intervention.	(a) Female mentors conduct door-to-door recruitment of girls into cohorts for LFH sessions (b) Male Interpersonal Communicators start conversations with groups of men in public spaces or traditional joints. Mobilizers use the health of the baby and mother to encourage married men to refer their adolescent wives to a clinic for counselling. (c) Girls referred by their husbands then attend a health clinic for a one-to-one appointment with a provider [8]	(a) Girls are reached and recruited for LLH sessions or signposted to walk-in appointments through community mobilizers, their friends—through peer to peer referrals—or their mothers. (b) Health providers engage mothers of adolescent girls through two sessions. The aim of these is to help mothers understand that contraception can be a tool to help girls achieve their dreams. These sessions also aim to dispel myths and misconceptions around contraception. (c) Girls LLH sessions or attend a health clinic for a one-to-one appointment with a provider [9]	(a) Members of the Women’s Development Army, Health Extension Workers, Youth Champions (peer volunteers) or A360-employed Smart Start Navigators mobilize girls and their couples through door-to-door visits. Health Extension Workers conduct financial and contraceptive counselling.	(a) Girls are mobilized through public announcements delivered by A360 personnel or community mobilizers, through school-based mobilization, through peers (‘Kuwa Mjanja Queens’) who visit girls in their homes, and/or through their parents or friends. (b) Parents are invited to attend a single session to start conversations about contraception and encourage participants to support their daughters to attend events. (c) Community engagement: Early and frequent engagement with government officials, advocacy meetings and sharing data and results.
8	For each category of intervention provider, description of their expertise, background and any specific training given.	(a) Female mentors who moderate LFH sessions are trained by the A360 approach. (b) Contraceptive counselling is delivered by A360 Young Providers, who are recruited by A360, and work full time in public health clinics. It may also be delivered by government health workers. All providers are trained in youth-friendly service provision and use counselling protocols that focus on issues that are of most concern to girls.	Same as for MMA	The Session is delivered by the Smart Start Navigators or Health Extension Workers, who are trained to host conversations about financial planning and provide contraceptive services in an approachable way to rural, married girls and their husbands.	(a) ‘Kuwa Mjanja Queens’ are trained by A360 on reaching their peers. (b) Community Development Officers or Youth Development Officers (a government personnel at the district level) coordinate and provide entrepreneurship skills during events. (c) Contraceptive counselling and services are delivered by government health care workers. They receive a short orientation on Kuwa Mjanja but no direct training
9	Description of delivery models (e.g. face-to-face) of the intervention and whether it was provided individually or in a group.	(a) LFH sessions are conducted through face-to-face sessions, in groups of 12. (b) Contraceptive counselling is provided individually after each session if a girl does not ’opt-out’. (c) Girls can also access walk-in appointments with trained providers at any time at their nearest clinic	(a) LLH sessions are conducted face-to-face; provided in groups of 15–20 girls. (b) Contraceptive counselling is provided individually after each session if a girl does not ’opt-out’. (c) Girls can also access walk-in appointments with trained providers at any time at their nearest clinic (d) Mothers’ sessions are conducted in groups.	The session is conducted face-to-face, to the girl (individually), or to the couple.	(a) Sessions are implemented face-to-face and events are conducted in groups. (b) Contraceptive counselling is provided individually unless a girl wishes to ’opt-out’
10	Description of the type(s) of location(s) where the intervention occurred, including any necessary infrastructure or relevant features.	(a) The two first LFH classes happen at the traditional leader’s house, in the community, or at the primary health centre. The 2nd and 4th sessions happen at the primary health centre. (b) Contraceptive counselling is offered at service delivery points at health facilities. (c) Male Interpersonal Communicators reach husbands of adolescent girls in private outdoor spaces such as traditional joints and places where men gather to relax. Interested husbands are given referral cards for their wives to either join a LFH class or visit a provider at the facility.	(a) After hearing about 9ja Girls, the girl can drop in to a LLH class at primary healthcare clinics or choose to go directly to a nearby public healthcare clinic for a walk-in appointment.	(a) The session is conducted at the girl’s household, in convenient locations at the community, or at the health post. (b) Contraceptive counselling is offered at the health post. (c) Community engagement sessions are conducted at the community.	Kuwa Mjanja events happen either at a health facility (in clinic event) or in pop-up tents within the community spaces or other community facilities (out of clinic event).
11	Description of the number of times the intervention was delivered and over what period of time including the number of sessions, their schedule, and their duration, intensity or dose.	Mentored sessions consist of four sessions conducted every two weeks. Walk-in appointments are available at any time the clinic is open.	One single LLH session is conducted for each group of girls, on Saturdays. Walk in appointments are available at any time the clinic is open	One single Smart Start session is conducted for each girl or couple. After an initial 6-week implementation period, Smart Start Navigators move on to a different community, leaving Health Extension Workers and Women’s Development Army to continue implementing the program with the support of regional A360 and government staff.	Kuwa Mjanja session is delivered once per community. Outreach teams work on a rotating schedule: out-of-clinic and in-clinic events are implemented in one district in one month and again approximately three months later.
12	If the intervention was planned to be personalised, titrated or adapted, then describe what, why, when, and how.	The intervention is subjected to continuous quality programme improvement through adaptive implementation. This involves the use of routine mixed methods data to identify real time areas for adaptation for improved effectiveness.	Same as for MMA	Same as for MMA	Same as for MMA
13	If the intervention was modified during the course of the study, describe the changes (what, why, when, and how).	Some of the intervention adaptations are captured in the process evaluation reports; others are captured in program reports and adaptation audits [7].	Same as for MMA	Same as for MMA	Same as for MMA
14	Description of how and by whom intervention adherence or fidelity was assessed.	Use of insights from the process evaluation, client-exit interviews, program monitoring metrics and periodic quality of care assessments.	Same as for MMA	Same as for MMA	Same as for MMA
15	Actual: If intervention adherence or fidelity was assessed, describe the extent to which the intervention was delivered as planned.	These can be found in the process evaluation reports and the program reports submitted to the donors.	Same as for MMA	Same as for MMA	Same as for MMA
16	Similar interventions in study areas	In Doma LGA, Nasarawa State, there were no further interventions in place besides MMA. In Karu LGA, also in Nasarawa State, Marie Stopes International [11] and Planned Parenthood Federation of Nigeria [12] were conducting outreach activities on family planning counseling and services for White Ribbon Alliance [13]. 4	Ado-Odo/Ota LGA, Ogun State, had The Challenge Initiative intervention in place since 2018. The intervention implemented community demand generation of adolescent sexual and reproductive health services especially with their ‘Life Planning Ambassadors’ targeting adolescent girls/youths aged 15–24 years.	Oromia Development Association in association with The David and Lucile Packard Foundation, developed a sexual and reproductive health program aimed at reducing early marriage in the Oromia region of Ethiopia. It was a school-based program delivered by trained teachers [14]. In Fentale woreda, Oromia Development Association targeted girls aged 15–19 years. It used Behavior Change Communication and Information, Education and Communication. The program also included community engagement, referral linkage to facilitate provision of contraceptive methods at health centers, as well as training of staff from health centers for youth-friendly sexual and reproductive health services [14]. In Lome woreda, Oromia Development Association developed school-based learning activities to empower girls and boys aged 12–15 years (primary; grade 5 to grade 8) with relevant sexual and reproductive health awareness [15]. The program included game-based learning activities focused on menstrual hygiene and management concerns of schoolgirls and it was in place since 2009 [15, 16]. In Wara Jarso and in Ada’a woredas, we are not aware of any additional interventions which were targeting adolescent girls besides A360.	In addition to A360, in Mwanza region, the Marie Stopes Tanzania, a part of Marie Stopes International, provided contractive and sexual health services. Marie Stopes Tanzania provided a range of contraceptives according to the clients’ needs along with the provision of sexual and reproductive health counselling. In Mwanza, Marie Stopes Tanzania, has set clinics were people can get information about their reproductive choices and access high quality family planning services. Another such program was the Beyond Bias initiative in Tanzania. Beyond Bias was an initiative funded by the Bill & Melinda Gates Foundation that is working towards ensuring judgement-free and quality counselling along with the provision of contractive to young people in Tanzania. Led by Pathfinder International, in Tanzania, Pathfinder is working with the Ministries of Health. Beyond bias aims to identify different types of healthcare provider biases that compromise the successful dissipation of family planning services. With the human-centred design, these solutions to address these biases are identified to ensure equitable and judgement-free access to contraceptives.

¹ Source of information: Population Services International (PSI), 03/03/2021.

² Start dates were defined using PSI reports and monitoring data. PSI revised and confirmed these start dates with the on 09/02/2021.

³ ‘Specifically, all kebeles in Fentale received the interventions by May 2019, in Ada’a by January 2020, in Lome by December 2020 and in Wara Jarso by May 2020’.

⁴ Source of information: Document entitled “A360 OE site mapping” shared by PSI, on 12/11/2020.

Note: PSI led the overall design and implementation of Adolescents 360 and worked in partnership with IDEO.org and the Center for the Developing Adolescent at the University of California at Berkeley. Country work was led by PSI Ethiopia, PSI Tanzania, and Society for Family Health, a non-governmental organisation in Nigeria. Implementation was accompanied by a monitoring and evaluation component to examine process level indicators such as the number of girls reached. MMA, Matasa Matan Arewa, LGA, local government area, LFH, Life Family and Health, LLH, Life Love and Health, A360, Adolescents 360 intervention