Learning Dashboard 

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In Ethiopia, through “Smart Start,” we introduced targeted financial messaging designed to help adolescent rural couples plan for the families, and lives, that they want.

Young Ethiopian couples want their children to have better quality lives—a factor that leads them to desire financial stability and smaller families. 

But across A360 Ethiopia’s target region, there are 581 thousand married 15-19-year-old girls who do not want to get pregnant. Yet at the start our work, 228,000 girls did not have access to modern contraception.

A360’s Smart Start uses financial planning as an entry point to engage young married couples in planning their futures, positioning contraception as a tool to achieve their goals. Through Smart Smart’s “baby calculator,” married adolescent girls aged 15-19 alongside their husbands map out how much a child would cost in contextually relevant terms (e.g. sacks of grain), a component developed in partnership with Smart Start’s young designers.

It’s leading to change—and fast.

From the ground up: Shifting population behaviors

A360 Ethiopia’s activities are shifting population behaviors, potentially indicating a shift in beliefs and social norms reflecting that what matters most for girls, their husbands and their communities can change, prioritizing the ability to plan for the lives and the smaller families that young couples evidently desire. Across our highest performing kebeles (sites), Smart Start appears to be catalyzing productive conversations about finances and contraceptives between young wives and their husbands

Earlier insights into the lives of adolescent girls revealed pressure to submit to the cultural expectation that newly married girls must immediately prove their fertility. Programmatic data since design inception shows that 1 in 2 girls who takes up a method through Smart Start does not have any children.

Leaving behind a stronger health system 

A360 Ethiopia engages kebele leaders to build empathy for couples struggling in changing economic times and reduce the pressure for couples to have children right away.

The program partners with government Health Extension Workers to identify, reach, and serve young couples —and supports government efforts to ‘catch-up’ by serving all young married couples in a community. Smart Start helps to close a gap of unmet need while leaving behind a health system capable of continuing to provide coverage for new couples who subsequently join the cohort. A360’s Smart Start has actively expanded from 2 pilot sites in mid-June 2017 to 76 implementation sites by the end of May 2018. A360 Ethiopia furthers its reach to new kebeles every week.

Learn more

Explore the Smart Start story in this two-pager.  

Dive into our Emerging Insights for Design in Ethiopia by reading this A360 report.

There is a lack of evidence on the health impact of HCD-inspired projects. That is, until now. Learn how A360 Ethiopia is being evaluated here.






This document is intended to capture what we learned during the inspiration phase in Ethiopia. It reflects the voices of the people the team spoke with and provides the A360 Consortium with a springboard for design opportunities.

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