Lauren R. Rutherford, FHI 360
Giuliana Morales, FHI 360

Young people think differently. They are disruptors. They spark innovation.

patriciah jeckonia, country director, mosaic kenya

To accelerate access to new pre-exposure prophylaxis (PrEP) products, the global USAID- and PEPFAR-funded MOSAIC project centers the needs and perspectives of PrEP users—namely adolescent girls and young women (AGYW)—and engages them as collaborators and partners early and throughout the project. During the first two years of MOSAIC, engaging in intentional, principled partnerships with young people has transformed our typical way of working, changing hearts and minds and improving project processes and outcomes. 


The NextGen Squad (NGS), a dynamic group of young women embedded in partner organizations in nine African countries, is an advisory board that keeps MOSAIC inclusive of and accountable to AGYW. Since the beginning of the project, the demands of the NGS have been “no decisions about us, without us,” and MOSAIC teams have worked closely with NGS members to shape PrEP introduction research, research uptake, and policy and programming. However, engaging young people and paving the way for transformative change is not always easy or comfortable. It is an iterative process. We are continuously learning what it means to share power and value all contributions, adapting our ways of thinking and working as MOSAIC progresses. 


Working with NGS members has helped MOSAIC country directors reframe their roles as allies and mentors in young people’s lives, motivating them to bring curiosity into their work with young people to better understand their unique needs, experiences, and aspirations. “We realized that we don’t know their lived experiences,” says Imelda Mahaka, country director of MOSAIC Zimbabwe. “We realized we must listen to them, recognizing that they come from different backgrounds and that they don’t all think in one way.” This approach extends to welcoming young people not only for their youth lens but also for their technical expertise and trusting that, with support, they can deliver high-quality work. Leading with curiosity and respect has prompted shifts in how the project operates and creates opportunities for creative thinking and constructive discussions.  

Working with MOSAIC country directors has changed how youth staff members view their roles, navigate the workplace, and develop as leaders. These partnerships have enabled them to reflect on what they want to achieve now that they’re at the table and have increased their skills and confidence to take on more complex responsibilities.  

Learn more about one NGS-director partnership from Helen Anyasi and Adaobi Olisa of MOSAIC Nigeria: 


Working with NGS members, including recognizing their expertise and being open to change, has also enhanced MOSAIC’s global efforts. For example, rather than relying solely on marketing experts, MOSAIC co-created a PrEP category positioning strategy for AGYW—a roadmap that determines the direction of marketing materials—with NGS members and other young women. Young women were well-positioned to engage in this process, and their engagement was planned intentionally. To stay current with youth perspectives, particularly in the wake of societal shifts caused by COVID-19, MOSAIC collaborated with NGS members as advisors throughout the process and validated the strategy with over 120 young women in Kenya, South Africa, and Zimbabwe. NGS members advised on whether the positioning was relevant to them and their peers and challenged assumptions about what matters to AGYW today.  

“The NGS pushed us on [romantic] relationships not being the primary focus of the strategy,” notes Emily Donaldson, MOSAIC’s global demand and marketing lead. “We heard from young women in our discussion groups that romantic relationships are the context of young women’s lives, but not the emotional driver of PrEP use.”  

Another noticeable change to the strategy was a move toward bolder language. For the team and stakeholders, gaining these insights confirmed that working with the NGS added legitimacy to the positioning strategy. They knew from the start how potential PrEP users would respond to their work, rather than involving PrEP users solely at the conclusion. 


MOSAIC leaders and NGS members have created mutually beneficial partnerships. Based on two years of practice, they emphasize that these adult-youth partnerships require: 

  • Showing commitment to meaningful engagement by investing in young people and championing equitable partnerships. 
  • Being flexible and adaptable to how processes and outcomes may change.  
  • Planning engagement intentionally by defining why engagement is critical, who to engage, and how to engage them. 
  • Leading with mutual respect and curiosity, including listening to each other and questioning one’s assumptions. 
  • Learning from each other and giving and receiving constructive feedback. 

You can hear directly from NGS members on the mark they have made on PrEP research and policy development. Look for a series on how to meaningfully engage AGYW in HIV prevention research and programming on the MOSAIC blog in 2024. 

Featured Image: NextGen Squad members, Chantel and Luwi, take a stroll with NextGen Squad support team member, Sasha, in Johannesburg, South Africa (David Penney/MOSAIC).