Resourcing Girl- and Youth-led Sexual and Reproductive Health Rights Activism: Potential and Challenges

"...there is growing interest in how best to support and expand the capacities of girls' movements within the space of sexual and reproductive rights."

This report, published by Gender and Adolescence: Global Evidence (GAGE), explores the contributions and challenges facing girl- and youth-led organisations working on sexual and reproductive health and rights (SRHR) across a range of contexts in the Global South. The report is based on a rapid desk review of grey and peer-reviewed published literature and in-depth qualitative interviews with girl- and youth-led organisations working on SRHR, girl- and women-focused/feminist intermediary donors, and monitoring, evaluation, accountability, and learning (MEAL) experts.

As explained in the report, "Adolescent girls and young women in low- and middle-income countries face many obstacles to realising and exercising their sexual and reproductive health rights. Girl- and youth-led organisations - because of their proximity to communities and nuanced understanding of the challenges those communities face - are increasingly seen as a vital entry point for reaching adolescent girls and promoting sexual and reproductive health services and rights. However, the exact role that such groups play in advancing these outcomes, and the impact they are able to have on girls' and young women's sexual and reproductive health and well-being, are not yet well understood." This study and report are designed to address this evidence gap.

To illustrate some of the findings, the report includes case studies of girl- and youth-led work on SRHR. Each case study explains how the organisation identified the problem, the approach taken, the lessons learned, and how the organisation perceives its impact. Each case study also offers recommendations about what the organisation would like to see from funding and MEAL strategies. The case studies focus on: 
 

1. SRHR, comprehensive sexuality education (CSE), and active citizenship (Nepal)
2. An app to produce accurate and youth-friendly SRHR information (Benin)
3. Community-wide outreach for changing norms around SRHR (unspecified African country)
4. Financial autonomy to access SRHR (Nigeria)

The research findings around contributions reveal that girls and youth implement SRHR  initiatives through educational, health, or community settings and/or in online spaces, with some larger organisations having projects across many spaces. These activities often complement and extend existing limited programming on SRHR. Some groups conduct dedicated outreach with community health workers on girls' rights to abortion and family planning, but more commonly they work alongside girls and youth within the community. Many groups adopt cascading models, whereby they work with and train youth advisors or "champions" who, in turn, conduct community mobilisation campaigns and advocacy initiatives in their own communities to break taboos around abortion, to facilitate pregnancy prevention (at times including distributing contraception), and to promote positive masculinities. Groups also work to increase knowledge and awareness of gender-based violence (GBV) prevention, response, and risk mitigation and work to document its occurrence. Some do this work solely online by setting up anonymous digital portals for individuals to document cases of GBV, providing users with advice and further avenues for support. Others conduct university-wide campaigns to document instances of violence occurring on campus and have launched campus-wide surveillance networks. Some girl- and youth-led work also seeks to impact networks and decision-makers at international, national, and community/district levels through advocacy on adolescents' and young people's SRHR.

Related to impact, the findings show that girl- and youth-led organisations see their impact in a number of key areas including: community and/or national recognition for the meaningful participation of youth in SRH policy decision-making processes; direct implementation and delivery of SRHR information and CSE; and their service as role models and champions of SRHR. The latter is both empowering for the girls involved in their own lives and also contributes to wider shifts in social norms within their communities. However, they face a number of challenges, which include the fact that girl- and youth-led organisations lack tailored tools and approaches with which to measure their impact, with donor-driven indicators failing to capture processes of meaningful participation in the design, delivery, and evaluation of an intervention. Girl- and youth-led organisations also continue to face challenges in accessing funding for their work, with limited access to long-term flexible funding that could support their organisational growth and reach. Many are forced to work with very limited financial resources (or none at all), at limited scale, and for limited durations. This situation makes initiatives precarious and challenging to sustain; it also excludes girls and youth who are not able to work for free, leading to the underrepresentation of those from economically poorer backgrounds.

The findings point to the following priority actions for donors, practitioners, and policymakers:

For practitioners:
 

• Support linkages between girl- and youth-led organisations and SRHR service providers (such as clinics, safe spaces, and drop-in centres) to address the challenge of translating empowerment and independence into improved access to those services.
• Support connections between girl- and youth-led organisations and other organisations working on SRHR and issues of gender equality to strengthen and empower intergenerational and collective organising around the realisation of SRHR.

For girl-focused and feminist intermediary organisations:
 

• Engage with girl- and youth-led organisations to construct SRHR impact measures that reflect the realities of those organisations' activities and capacities. This process should be collaborative and iterative; priorities for MEAL and the interpretation of both the measures and the resulting data should be mutually agreed. Linked to this, these organisations should advance impact measurements that can monitor impacts of core and flexible funding that is long term.

For donors:
 

• Provide flexible, long-term funding to girl- and youth-led organisations, as well as support for skills development and robust MEAL.
• Invest in efforts to strengthen understanding of the ways in which girl- and youth-led groups impact SRHR outcomes for girls (see below on evidence-informed donor decision-making). 
   

For researchers to support evidence-informed donor decision-making:
 

• Map and evaluate how donors are currently supporting girl- and youth-led groups, including what works in impact measurement and investment packages into girl- and youth-led initiatives, and potential alternative resourcing models, such as intermediary funding.
• Collect disaggregated monitoring data on which organisations are receiving funding and how it is spent, making sure the onus of data collection does not fall on girls.
• Conduct further research into what types of activities are being undertaken by girl- and youth-led organisations more broadly, and how these are connected (directly and indirectly) to the realisation of adolescent SRHR.