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Adolescent Health

TESFA+ aims to capitalize on seven years of research and program experience from TESFA ("hope" in Amharic) to unlock the power and futures of adolescent girls at scale.


CARE launched TESFA (which means “hope” in Amharic) in 2010, to mitigate the challenges faced by married adolescent girls in the South Gondar zone of the Amhara region of Ethiopia. TESFA reached 5,000 girls and worked to improve their economic empowerment and sexual and reproductive health status. TESFA combined CARE’s successful Village Savings and Loan Association (VSLA) model within peer-led girls’ groups, and Social Analysis and Action (SAA) with adult community members to address the social and normative barriers faced by adolescents, especially married girls.


TESFA+ was designed to scale and amplify the impact of TESFA. Borrowing from design-thinking and scaling frameworks, CARE is employing a systematic and phased approach to exploring, creating, and testing a new TESFA+ model.

During the TESFA+ design phase in 2019, CARE identified components from the original model to build from as well as new prototypes that will contribute significantly to scaling the model. In holding to design-thinking principles, CARE carried out the design process in partnership with original TESFA participants, their communities, and government stakeholders to ensure the new TESFA model works for them and takes their unique insights, needs, and priorities into account, laying the foundation for the new model’s success.


Program achievements

The original implementation of TESFA from 2010-2013 achieved:

increase in the proportion of girls having their own savings

increase in the proportion of girls having their own savings

increase in the use of modern family planning methods

increase in the use of modern family planning methods

The importance of TESFA+

With TESFA+, CARE made an intentional shift from direct implementation (or geographic expansion) to facilitating the scale-up of the model. We are using two mechanisms to do this: 1) integrating the model into government structures and 2) diffusing and replicating it through community groups.


TESFA+: Investigative Research Brief

TESFA+ seeks to apply the lessons learned from seven years of the TESFA experience by embarking on a 4-phase path to scale up the model.

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TESFA+: Investigative Research Final Report

This investigative study (TESFA+) was designed to identify elements of the TESFA model that have contributed to the sustainability and auto-replication.

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TESFA+ Scale Up Investigation Report Summary

As part of phase I, the scale up investigation seeks to engage CARE’s peers, government partners, potential end-users of the model and potential donors to answer our research questions in a systematic fashion as to inform phases II-IV of TESFA+.

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