In Dar es Salaam, Tanzania, Rena Greifinger, Population Services International’s technical adviser for youth and girls, stood before a nyakanga, who leads girls through ceremonies that marks their transition from girlhood to womanhood. Draped in fabric, she acted out a scene in which a teenager asked questions about her health. Afterward, Greifinger sat at the table with the nyakanga and, with the help of a translator, got her feedback about an early stage idea the PSI team had developed in partnership with medical providers, teenagers, and the nyakangas so often left out of conversations on how to reduce teenage pregnancy in Tanzania.