Youth as Agents of Change: Promoting Equitable and Inclusive Universal Health Coverage in SRHR.



The world is witnessing a profound shift in the landscape of Sexual and Reproductive Health and Rights (SRHR). The voices of young people, once relegated to the sidelines, are now at the forefront of discussions, initiatives, and decision-making processes.
As we delve into the significance of youth partnership in SRHR for Universal Health Coverage (UHC), we draw from the wisdom of our esteemed advisory board members who share their valuable insights.
The Historical Evolution of Youth in SRHR

Not too long ago, young people were seen primarily as beneficiaries rather than active participants in shaping their own destinies. Decision-makers and organisations, while acknowledging the importance of addressing youth SRHR needs, frequently fell short when it came to involving young people in meaningful ways. The common narrative revolved around a perception that young people were not equipped to make significant contributions to SRHR discussions or were considered too inexperienced to be genuine partners.

Young advocates, like Ana Aguilera, have vividly experienced this era when tokenisation was the norm. Ana found herself in situations where her involvement was more symbolic than substantial, leading to a sense of frustration and disillusionment. Her experiences serve as a poignant reminder of the challenges that plagued the SRHR landscape in the past.

“10 years ago, leaders and decision-makers believed it was acceptable to tokenize young people and minimally involve them in matters that affected their health and rights. I know that because I was one of those young people that was tokenized (and unfortunately sometimes put in situations that in retrospect were manipulative).”

Ana Aguilera – Director of Adolescent and Youth SRHR, EngenderHealth

This approach to youth engagement was not only inequitable but also ineffective. It failed to harness the innovative ideas, energy, and passion that young people could bring to the table. It also perpetuated a disconnect between SRHR services and the evolving needs and preferences of young individuals.

However, as time progressed, so did the realisation that meaningful youth involvement was not just an ideal but a necessity. Miranda Van Reeuwijk reflects on how organisations and leaders began to recognise that young people were not just passive recipients of SRHR services but were essential architects of change. Their unique perspectives, experiences, and insights were invaluable assets in shaping SRHR initiatives that were responsive to the diverse needs of youth.

“I’ve seen a shift from young people helping to carry out program activities to more structural engagement in all phases and decision-making levels of programs, research, and advocacy.”

Miranda Van Reeuwijk – Senior Researcher for International Programmes, Rutgers (The Netherlands)

Beyond the individual empowerment of young people, youth-led organisations have also been at the forefront of advocacy efforts, pushing for policies and programmes that prioritise youth-friendly SRHR services, comprehensive sexuality education, and the removal of barriers that hinder young people’s access to information and care. These organisations provide a crucial bridge between young individuals and decision-makers. They create spaces for dialogue, where young advocates can directly engage with policymakers, healthcare providers, and educators. Through these interactions, youth-led organisations facilitate the exchange of ideas and the co-creation of strategies that address the unique needs of young people.

The journey toward meaningful youth involvement in SRHR has been a testament to the power of advocacy, resilience, and a commitment to equity. The shift from tokenisation to genuine partnership marks a pivotal moment in the history of SRHR. It is a journey that continues to evolve, with organisations and advocates working tirelessly to ensure that young people are not only heard but actively engaged in shaping their own sexual and reproductive health and rights.

“Decision-makers are now listening more, and we as an SRHR community are increasingly putting more pressure on these decision-makers to ‘walk the talk’ and put their time and money behind more meaningfully and equitably engaging young people.”

Ana Aguilera
Challenging Assumptions and Changing Perceptions

While significant strides have been made in promoting meaningful youth involvement in SRHR work, contemporary challenges persist. These challenges pose hurdles for young individuals seeking to be recognised and actively contribute to SRHR initiatives.

Age Bias and Stereotyping:

In the present-day SRHR landscape, age bias and stereotyping remain prevalent challenges. Some stakeholders still hold preconceived notions about young people, viewing them as inexperienced or incapable of offering valuable insights. This bias can result in youth being sidelined or tokenised in SRHR discussions.

To address this challenge, it is essential to challenge these stereotypes actively. Emphasising the diverse talents, experiences, and perspectives of young individuals can help dispel age-related biases. Organisations and decision-makers must recognise that youth are not just the future but also the present, with meaningful contributions to offer.

“There is a lot of work for people who are more senior to accompany youth at certain spaces to facilitate that these young people are being heard and taken seriously.”

Miranda Van Reeuwijk

Limited Access to Resources and Opportunities:

Young advocates often encounter barriers related to access to resources and opportunities. Financial constraints, limited access to education, and a lack of platforms for engagement can hinder their ability to participate fully in SRHR work. This limitation can restrict their capacity to develop expertise and gain credibility in the field.

To mitigate this challenge, initiatives that offer scholarships, mentorship programmes, and capacity-building opportunities must be expanded and made accessible to a wider range of young individuals. Creating inclusive spaces and platforms for youth to collaborate, network, and access resources is crucial for levelling the playing field.

Intersectional Barriers:

Modern SRHR work acknowledges the importance of intersectionality—the interconnectedness of various aspects of an individual’s identity, such as race, gender, sexuality, and socioeconomic background. However, young individuals often face intersectional barriers that compound their challenges in SRHR involvement. Discrimination, systemic inequalities, and marginalisation based on these intersecting identities can hinder their ability to be taken seriously. Our first Action Learning Cycle on Gender Equity and Intersectionality focused on strategic ways to overcome these barriers, see case study.

Addressing these intersectional barriers requires a holistic approach to youth empowerment in SRHR. Initiatives and policies must consider the unique challenges faced by youth from marginalised backgrounds and prioritise inclusivity. By recognising the intersectional nature of these challenges, we can create more equitable opportunities for all young advocates.

Youth-Driven Transformation and UHC

“Young people need health services that are accessible and responsive to their needs. Too often they aren’t.”

Miranda Van Reeuwijk

One of the cornerstones of UHC is ensuring that all individuals have access to essential healthcare services, including comprehensive SRHR services. Within this framework, the active engagement of young people is not just desirable but essential for achieving the ambitious goals of UHC.

Young people are uniquely positioned to make SRHR services more accessible and responsive to the diverse needs of their age group. Historically, SRHR services have often fallen short in meeting the specific requirements of young individuals. These services may not adequately address issues such as comprehensive sexuality education, accessible contraception, confidential counselling, or youth-friendly healthcare environments.

“With young people at the helm, SRHR services would become youth-centered wherein they make informed choices about their bodies, they are able to exercise their rights, and policies/programmes address their specific needs (and consider youth in all their diversity).”

Bhavya Durgesh – Adolescent & Youth Constituency Coordinator, PMNCH

Bhavya Durgesh’s perspective adds depth to the discussion. Envisioning a future where youth lead in SRHR decision-making promises transformative changes. Services would become youth-centred, focusing on informed choices, rights, and diverse needs. Comprehensive sexuality education would take priority, reducing stigma and improving accessibility. Furthermore, youth leadership in SRHR can contribute to gender equality and have positive ripple effects across the wider health landscape.

The Path Ahead

As we reflect on the journey of youth engagement in SRHR and its pivotal role in Universal Health Coverage, it is evident that young people are not just the beneficiaries of change but the architects of a healthier, more equitable future. The wisdom of our advisory board members serves as a testament to the progress made and the path ahead.

“By empowering young people to take control of their SRHR, we would see positive ripple effects throughout society, ultimately leading to healthier, more informed, and more equal communities.”

Bhavya Durgesh