Background
In adolescent sexual and reproductive health (ASRH) programs, a clear need exists — particularly in developing countries — for well-documented evaluations (process and impact) linking program intervention, changes in youth behavior and health outcomes. Evidence or program impact is mixed in literature reviews of HIV/AIDS programs, with evaluations suffering from “inadequacies in study design, analytic techniques, outcome indicators and reporting of statistics” (UNAIDS, 1997). Commonly, programs lack a focused conceptual framework showing intersecting processes through which program strategies aim to achieve impact. Without this program theory, the choice of intermediate and impact indicators (the basis of evaluation) is haphazard (Shepard, 2001).

For the ASRH field, with little evidence of best practices, the current focus should be the testing of innovations; yet few projects include evaluation and those that do are too new to allow assessment of quantitative outcomes (Senderowitz, 1994). Scaled-up youth programs, widely acknowledged as important to reach youth in need, are still rare. Other research identifies two basic reasons evaluations
have only demonstrated limited results: many have been short term and therefore unable to show results, and most programs that have been evaluated apply a limited set of strategies that are insufficient to change behavior (Adamchak, et al, 2000). In this regard, evaluation of AYA — its design, approach, strategies and impact — is critical to

Policy and Advocacy	An improved, enabling and supportive environment for ASRH
Behavior Change Communication	Increased knowledge, skills, norms and positive attitudes towards adoption of safer sexual practices
Youth-Friendly Services	Increased access to and use of quality, youth-friendly ASRH services
Livelihood Development Programs	Integration of ASRH into livelihood programs
Coordination and Dissemination	Established and/or strengthened coordination and dissemination mechanisms for improved ASRH partnerships
Institutional Capacity Building	Strengthened implementing partner institutional capacity to sustain ASRH outcomes

Partnership	Establish internal and external partnerships for effective and integrated program design and implementation
Youth Participation	Maintain active participation of youth in program design and implementation
Gender and Sexuality	Design AYA programs to reflect and address issues of gender equity and sexuality (including ASRH rights)
Sustainability	Increase sustainability of ASRH programs
Scaling Up	Increase number of youth reached in a broader geographic area by institutionalizing effective programs

AYA will aggressively seek these results (goals and program objectives) and practice results-oriented
management of its initiatives and activities. Monitoring and evaluation will be an on-going process to regularly assess and report on progress towards achievement of these results. Successes, best practices and lessons learned, as identified by this process, will be disseminated through various
knowledge sharing mechanisms. AYA works to ensure processes of monitoring, evaluation, documentation and dissemination occur sequentially. Dissemination serves both a knowledge sharing and partnership strengthening function with various stakeholders, including other donors, implementing partners, NGOs, host communities, host governments and youth.

Program Design
AYA recognizes that its ability to monitor and document the program in a high quality and meaningful way is inextricably linked to the design and implementation of the program itself. In recognition of this, AYA has identified and defined “what” the program aims to do (goal and program objectives) and “how” AYA will accomplish its aim (strategies and activities). AYA will also “show” the progress of these strategies and activities towards the goal and program objectives (indicators). Program design is evidence-based, drawing on documented successes and lessons learned and applying state-of-the-art approaches, to the extent possible, from ASRH evaluations.

Monitoring and Evaluation Challenges
Partnerships like AYA play an important role in the achievement of positive sexual and reproductive health outcomes. But such partnerships also face unique challenges that have an effect on — and may even shape — the results-oriented programming approach —

Monitoring and Evaluation Approach
Characteristics of the AYA monitoring and evaluation process include —

Design
• Baseline and endline surveys, a mid-term assessment, annual school surveys, as well as qualitative and formative research to inform program design and to support and enrich population-based quantitative data.
• A dose response evaluation of AYA implementation and control sites (as part of the endline evaluation), based on variances in time, intensity, quality, and levels of integration and partnership attained, and their subsequent effect on the program goal and objectives.

Responsibility
Specific partner responsibility for monitoring and evaluation of respective program areas according to program objectives.

Monitoring
On-going monitoring to ensure that all activities in all sites are implemented as designed and according to joint workplans.

Documentation
Process evaluation and documentation of the partnership/alliance management process to show how a multi-site, multi-approach program is coordinated to go to scale.

Research
Operations research studies that will be determined based on maximizing opportunities in which AYA is best suited to contribute to the body of ASRH knowledge. Primarily, AYA is not an operations research project and therefore, to the extent possible, will leverage external resources to achieve
monitoring and evaluation objectives through external partnerships and technical assistance.

Structure
• Technical advisory committees at the global and country level to advise AYA on development and implementation of a monitoring and evaluation plan.
• An internal advisory and technical group made up of partner agency monitoring and evaluation staff, to provide technical assistance for practical implementation and support.

Process
• Participatory, consultative and inclusive approaches that ensure the involvement of stakeholders at the different operating levels.
• On-going capacity building for AYA implementing partners and staff. As appropriate, maximize opportunities to use and/or strengthen existing monitoring and evaluation systems (e.g. research and data collection systems).

Dissemination
• Dissemination of evaluation findings, identification of best practices and lessons learned and knowledge/information sharing using existing systems, with ASRH stakeholders. Promotion of the dissemination effort through various fora at global, national and district levels.