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World-renowned thought leader and speaker Larry Cooley admits that he “isn’t an expert” in comprehensive sexuality education (CSE). Rather, he calls himself the “scaling guy”. But Larry has spent the past three decades working on successful scaling programmes involving water systems, immunisation, early childhood education and sexual violence all around the world. He says that the same approach can be applied to CSE in order to reach a larger proportion of those who need it, effectively and sustainably.
Larry will provide a brief insight into this via video at this week’s International Conference on Family Planning (ICFP). He will speak at the side event “Scaling up access to CSE: Successful strategies from Ghana, Indonesia and DRC”. The goal of the session is to explore what NGOs and CSOs could do differently to more effectively contribute to this through the school system. The ICFP panel will be led by Rutgers International, with speakers from Planned Parenthood Association of Ghana, Save the Children, and Rutgers Indonesia.
Larry’s presentation will offer an overview of what organisations need to think about and do if they’re to scale successfully. The panel is linked to the findings of an in 2021 launched CSE scaling framework by the Centers of Excellence on Comprehensive Sexuality Education, aimed at encouraging civil society organisations to support its scale-up in schools, colleges, and involving other stakeholders, for instance education ministries.
“There is overwhelming evidence that CSE works. However, programmes are mostly delivered via temporary short-term small donor-funded initiatives. These mostly end when money runs out and are not sustained by governments”Ardan Kockelkoren
Ardan Kockelkoren, senior programme officer at Rutgers, who led the Centers of Excellence scaling study, emphasises that although there is overwhelming evidence that CSE works, programmes are mostly delivered via a myriad of temporary short-term small donor-funded initiatives. These mostly end when money runs out, as the approach is not being sustained by governments. There is not enough focus by implementers and funders to have these initiatives handed over to governments to keep them running. Those putting programmes in place are mainly focused on strengthening programmes and making them more effective for communities. Scale-up is only thought of at the end of a project aimed at receiving more funding.
“This has implications for the young people we are aiming to support as many are left behind, it also affects contraceptive use and teenage pregnancy rates.”
“Donors, NGOs and the development sector as a whole is and will simply never be able to sustainably fund and deliver CSE at the scale that is needed. So we have to find other solutions to give more young people access to it.”
As the president emeritus and senior advisor at Washington-based MSI, Larry has worked in more than 50 countries and on a range of programmes from homelessness in the United States to early childhood programs for Syrian refugees. He also founded and runs the Global Community of Practice on Scaling (CoP).
At the ICFP he will speak about the application of CSE, ensuring that there is a viable and effective ‘doer’ at scale and a sustainable at scale”.
“If your programme is delivering CSE to 300 young people, but your vision is to extend it to the three million young people who need it, who would be delivering it?” Would it be teachers? Would it be community workers? How would that work?”
“If it ended up reaching those three million people, would it still be funded by that donor forever,” said Larry. “Or would there be some other way to have it carry on indefinitely at that same scale?”
Larry pointed out that generally only governments and markets can deliver education or services sustainably at scale. Philanthropy alone rarely scales.
“In most cases the only way that a CSE intervention is going to scale is by it becoming part of the healthcare or education system.So trying to figure out what it takes to get this incorporated into either is often what’s necessary.”
Caesar Kaba, project coordinator of The Planned Parenthood Association of Ghana (PPAG), says that the development community, including CSOs, must strategically put in place measures that improve community and national acceptance, and ownership, of CSE, while shifting responsibility to state institutions to scale up programmes.
Security commitment and developing scale up plans are two other areas to focus on. Jennifer Gayles, an advisor in adolescent sexual and reproductive health at Save the Children US, said that it was important to research this. “Conversations about budgets and resource dedication with government stakeholders are sensitive,” she said. “But we learned we shouldn’t avoid them and start them earlier.”
Amala Ramah, from Rutgers Indonesia, said that scaling up CSE could involve different steps being taken by different authorities. “There is no one solution for all problems. The crucial point is to demonstrate to the governments how CSE solves their problems and increases their performance achievement,” she said. “A programme can have any name, but the important thing is the content.”
Pointing out that it takes successful programmes an average 15 years to reach scale, Larry said it was important “not to expect a quick fix”. “Keep thinking of the ‘doer’ and the ‘payer’,” he said.
Jennifer said that programmes wishing to scale should convene key government and civil society stakeholders to discuss joint priorities immediately after launch. They should continue to engage them meaningfully in learning and evaluation.
“A scale-up mindset and formal engagement of scale-up stakeholders were crucial to the successful scale up of Growing up Great! in DRC,” she said. “In order to develop a scalable CSE programme, Save the Children aligned the project with government priorities and linked to national policy and programmes, including Family Life Education.”
“From all the interventions I've worked on to scale, CSE has been one of the more challenging. But the problem that you’re trying to solve is critical and, with the right strategies, I think ambitious scaling goals are achievable.”Larry Cooley
The Centers of Excellence on Comprehensive Sexuality Education are funded by Global Affairs Canada.