This dissertation examines a case of an international development initiative funded by the United States Agency for International Development (USAID) in the United States and implemented in North Macedonia. The specific initiative was a youth development program including a substantial career counseling component called the Macedonia Youth Employability Skills (YES) Network. Historically, international development initiatives funded by USAID have struggled with implementation with fidelity to policy prescriptions and sustainability (AKIpress, 2020; Drummond & DeYoung, 2003; Gubser, 2017; Stromquist, Klees, & Miske, 2000). While the United States continues to fund numerous international initiatives through USAID, at a substantial cost to American taxpayers, projects are typically implemented and sustained with highly variable, and often disappointing, success in the recipient nation (AKIpress, 2020; Drummond & DeYoung, 2003; Gubser, 2017; Stromquist, Klees, & Miske, 2000; USAID, 2022). Consequently, in this dissertation, I trace the development of a specific career counseling program, the extent to which it was implemented with fidelity, and the extent to which it was sustained over time in order to illuminate rationales for the variable degrees of success experienced by this particular initiative in each of the aforementioned areas. Drawing from institutional theory, specifically, the concepts of institutional logics, institutional complexity, and institutionalization, I assess the components of a new educational initiative, the process by which it was implemented, and the extent to which the initiative was sustained. The dissertation is based on interviews with 62 stakeholders located in both the United States and in North Macedonia, 11 months of fieldwork in North Macedonia, and substantial document analysis. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]