- There is strong potential to scale programs by building on pre-existing government programs, e.g., building on national social safety net programs to create “cash-plus” programs, using school infrastructure or adapting existing curriculum to implement new programs, etc.

- The use of digital technology is critical to overcome capacity constraints and improve program management, e.g., the use of digital payment systems, mobile phone-based monitoring systems, biometric smart cards, creation of digital platforms to access programs, online training programs, use of government databases to create registries.

- Strong partnerships with communities and NGOs are integral: engagement of community groups and local governments is crucial (especially for program delivery), while technical assistance from NGOs can be very beneficial.

- Understanding the basic cost structure of programs (e.g. spending on aid/services received by beneficiaries vs. delivery costs vs. staff costs, etc.) is a vital starting point for analyzing scalability (of course, extrapolating cost structure of small-scale programs to large-scale programs is difficult due to economies of scale and differences in implementation strategy, but this should at least provide guidance on whether programs are likely to involve a lot of overhead costs). The <u>Partnership for Economic Inclusion Costing Dashboard</u> is an excellent tool for providing information of cost structure for various economic inclusion programs.

- Program flexibility is integral - the ability to adapt and alter programs based on context and new research is crucial for the successful implementation of programs in new settings.

- Finally, as noted in Cull and McKenzie (2020), it is important to pay attention to the quality and capability of the bureaucracy when considering whether an intervention could be successfully scaled in a given context (the World Bank’s Bureaucracy Lab is useful for these purposes).

Based on this guidance, we believe the interventions in Table 1 that can be more easily scaled are (a) those that can build/expand on existing government programs, infrastructure, or networks, such as (but not limited to) expanding pre-existing cash transfers to adolescents, expanding pre-existing SRH and FP services to adolescents (if the context allows), and adapting interventions to be offered at schools; (b) those that can be implemented with widespread, low-cost technology such as (but not limited to) cash transfers delivered through mobile banking, mobile phone-based information interventions, or smart-phone/tablet SRH apps for trained health care professionals; and (c) programs that are not overly intensive for the setting and do not involve large overhead costs. For example, UCTs may be more appropriate than CCTs in settings where monitoring and enforcement of conditions are prohibitively costly (e.g., SSA). Moreover, we believe girls clubs and other complex, multifaceted programs not offered through schools or other existing, safe facilities are unlikely to be easily scalable (especially given the mixed results when replicating small-scale versions of girls’ clubs).

Finally, two other pre-existing structures come to mind for delivering services, especially SRH, to outof-school adolescents in communities. First, in performance-based financing systems (PBF), facilities can be incentivized to reach adolescents in their catchment areas but not clients of the facility. Second, decentralized systems like Social Action Funds, such as NUSAF in Northern Uganda or TASAF in Tanzania, can be used to deliver services like cash transfers or “cash plus” programs to women’s groups through existing structures, while utilizing local officials and community health extension workers to deliver services in a flexible manner suited to the local community’s needs. As mentioned above, NGOs that are active in the communities can partner in implementation, but group-based training and financial support programs for adolescent girls and young women that utilize existing structures, such as PBF or Social Action Funds, will have a better chance of scaling up successfully.

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