Engage adolescents and youth

The ICPD Programme of Action calls for ensuring that all people, everywhere, without discrimination,  have access to sexual and reproductive health care information and services including family planning. The Convention on the Elimination of all forms of Discrimination Against Women (CEDAW article 16) guarantees women equal rights in deciding "freely and responsibly on the number and spacing of their children and to have access to the information, education and means to enable them to exercise these rights". Young people, however, particularly adolescent girls and young women, continue to struggle to access contraceptives in many countries and regions. Legal, policy, programmatic, sociocultural and gender barriers limit access to family planning information and services. 

Despite global recognition of these rights, adolescents are often denied the information and skills to make informed decisions and act upon them. Adolescents and youth must be empowered and their agency and choices enhanced to enable them to exercise their sexual and reproductive health and rights, especially through the delivery of youth-responsive contraception and comprehensive sexuality education.UNFPA will work with partners to enhance adolescent and youth information and access to, and use of SRHR by creating a conducive legal and policy environment, facilitating demand, and improving the quality and availability of youth-responsive SRHR services, including modern methods of contraceptives. 

Programmatic options

6.1.1 Disaggregated data: Improve availability of disaggregated data on mCPR, unmet need for unmarried women, adolescents (aged 10–14 and 15–19) and youth (aged 19–24), particularly regarding the most vulnerable.

6.1.2 Adolescents and youth plans: Support the development of regional and national plans to improve adolescents and youth access, acceptability and use of modern contraceptives, especially long-acting reversible contraceptive methods (LARCs).

6.1.3 Laws and policies: Monitor implementation of legal and policy frameworks on adolescent and youth sexual and reproductive health and rights (AYSRHR) and advocate and mitigate restrictive consent laws such as those related to sexual activity or access to services.

6.1.4 Social norms: Mobilize community support to address social norms inhibiting access to contraceptive services by unmarried adolescents and youth.

6.1.5 Enabling environment: Build the capacity of youth-led organizations and youth networks to advocate for conducive legal and policy environments to facilitate access by young people to AYSRHR, contraception, life skills or comprehensive sexuality education (CSE) in-school and out-school, and skills development, etc. 

6.1.6 End child marriage: Work with the Ministries of Education and Health to implement policies to eliminate the practice of child marriage, and support programmes that prevent child marriage and/or address the needs of married adolescents.

Programmatic options

6.2.1 Barrier analysis: Promote analysis of barriers and proposals for actions based on the socio-ecological framework (individual, relationships, community and society) to improve adolescents’ access to sexual and reproductive health services, including contraception.

6.2.2 Demand and use: Support generation and use of qualitative and quantitative evidence/tools on the links between demand generation and contraceptive uptake, and their eventual impact on the reduction of adolescent pregnancy, early unions, maternal and child mortality, prevention of unsafe abortion and the prevention of sexually transmitted infections (STIs) and HIV.

6.2.3 CSE: Strengthen efforts to implement evidence-based life skills or comprehensive sexuality education (CSE) in-school and out-of-school at the country level, including community engagement strategies.

6.2.4 CSE capacity: Strengthen health services and health provider capacity to support implementation of CSE and referral linkages for contraceptives and family planning among young people.

6.2.5  Community and youth-led initiatives: Support community engagement and youth-led initiatives targeting young people using sports, arts and music to stimulate the interest of young people and create demand for contraceptive information and services. Ensure availability of contraceptive services responsive to youth and other reproductive health services during youth events.

6.2.6  Digital platforms: Promote development of interactive youth-friendly digital platforms to enhance information and facilitate access to contraceptive services, or expand already existing UNFPA-led digital solutions such as TuneMe.org.

6.2.7 Media campaigns: Co-create mass media campaigns targeting adolescents and youth to promote access to contraceptive information and services. This may include use of digital technology, social media and/or more traditional strategies such as community events.

6.2.8 Private sector: Promote the participation of the private sector, for example private pharmacies, to improve access to information, counseling and modern contraceptives for adolescents and youth.

6.2.9 Social marketing: Encourage partners and support advocacy to implement social marketing strategies for modern contraceptives information and distribution, through strategic points/shops/facilities such as beauty parlors, shops that recharge mobile phones, fast food eating spots and/or food delivery services.

6.2.10  Misconceptions: Address knowledge gaps or misconceptions among adolescents about contraception including its effects on fertility or pleasure.

 6.2.11 Empowerment: Empower adolescents and youth, especially adolescent girls, to access available services and to participate in the design and delivery of services, enhancing their agency and choices to exercise their sexual and reproductive health and rights.

6.2.12 Cross referral: Link health systems to education systems, life skills or comprehensive sexuality education, empowerment programmes, and social and behaviour change programming (and vice versa).

6.2.13 Operational research: Conduct operational research to better understand the changes in aspirations, concerns and attitudes of young people, changing patterns of sexual and reproductive transitions, and how contraception can help young people attain their education and employment aspirations, have autonomy over their body and their life and make safe transitions.

6.2.14 Channels: Support partner countries to diversify the channels they use to reach young people, going beyond public and private health facilities to embrace community-based distribution, mobile services, school-based services, direct to consumer and self-care models. 

Programmatic options

6.3.1 Assess gaps: Undertake structural and capacity assessments at national and subnational levels to identify gaps in service delivery including responsiveness to youth, quality and accessibility.

6.3.2 Quality counseling: Support the review and/or development of guidelines and protocols to ensure quality counseling and information along with the offer of modern contraceptives to adolescents, including in postpartum and post-abortion contraceptive use.

6.3.3 Person-centred services: Support the design and implementation of person-centred service delivery models to ensure access to quality contraceptive services and information respecting the diversity of adolescents and young people, e.g. leave no one behind (LNOB), rural, urban, slums, LGBTIQ+ people, youth with disabilities, young sex workers, etc.

6.3.4 Integrated services: Promote the integration of contraceptive products and services into other health services (as opposed to stand-alone models) through free, informed choice and quick-start of the contraceptive methods of choice in accordance with the World Health Organization medical eligibility criteria, including in humanitarian response and innovative approaches such as self-care.

6.3.5 Partnerships: Establish partnerships with associations, organizations and networks of adolescents and youth left behind (e.g. youth with disabilities, young sex workers and LGBTQI+ people) to ensure reach and facilitate co-creation of initiatives aiming at increasing access to contraceptive services and information.

6.3.6 Financial barriers: Include modern contraceptives access for adolescents and youth in Universal Health Coverage (UHC) and national insurance schemes and/or use other approaches such as offering vouchers or offering subsidized services through social marketing, social franchising and cost-recovery schemes.

6.3.7 Provider capacity: Strengthen the capacities of health service providers and the educational curricula of health personnel training centres (for example, for professional midwives) to be responsive to adolescents and youth. Do this through whole-clinic training, setting quality standards and using World Health Organization recommendations, supportive supervision and values clarification and addressing attitudes that translate into judgmental and disrespectful behaviour or a refusal to offer services altogether. 

6.3.8 Good practices: Promote the generation and regular sharing of evidence and good/best/promising practices as well as high-impact practices on the implementation of adolescent health services.