Executive Summary 

Introduction: 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. To address this evidence gap, this report presents findings on the contributions and challenges facing girl- and youth-led organisations working on sexual and reproductive health and rights across a range of contexts in the Global South.

Methods: This report, a companion piece to the study Resourcing girls: the potential and challenges of girl- and youth-led organising (Guglielmi et al, 2024), draws on a rapid desk review of grey and peer-reviewed published literature and in-depth qualitative interviews with: 12 girl- and youth-led organisations working on sexual and reproductive health and rights; eight girl- and women-focused/feminist intermediary donors; and three monitoring, evaluation, accountability and learning (MEAL) experts.

Key findings: 


Girls and youth implement sexual and reproductive health and rights 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 sexual and reproductive health and rights. 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, pregnancy prevention (at times including distributing contraception), and promoting positive masculinities. Groups also work to increase knowledge and awareness of gender-based violence prevention, response and risk mitigation and work to document its occurrence. Some do this solely online through setting up anonymous digital portals for individuals to document cases of gender-based violence, 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 sexual and reproductive health and rights.


Girl- and youth-led organisations frame their impact in various terms: community or national recognition for the meaningful participation of youth; direct implementation and delivery of sexual and reproductive health and rights information and comprehensive sexuality education; and the impact of role-modelling, on themselves and on the prevailing social norms in their communities. However, 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. This means that many are forced to work with very limited financial resources (or none at all), at limited scale and for limited durations. This 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 poorer backgrounds. 2 Resourcing girl- and youth-led sexual and reproductive health rights activism: potential and challenges


This report explores the contributions and challenges facing girl- and youth-led organisations working on sexual and reproductive health and rights in low- and middle-income countries. It highlights that such organisations can play a key role in supporting outreach efforts to diverse groups of girls and young women, especially through online spaces and through community mobilisers, and in serving as role models for empowered access to sexual and reproductive health and rights information and services. Girl-and youth-led initiatives typically rely on small scale funding and have limited organisational experience, which impact the scope and scale of their initiatives. Nevertheless, they provide a value-added complement to larger initiatives in the broader ecosystem of actors catalysing change on sexual reproductive health and rights outcomes for young people. The findings point to the following priority actions for donors, practitioners and policymakers:


For practitioners:

  • Support linkages between girl- and youth-led organisations and sexual and reproductive health and rights 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 sexual and reproductive health and rights and issues of gender equality to strengthen and empower intergenerational and collective organising around the realisation of sexual and reproductive health and rights.

For girl-focused and feminist intermediary organisations:

  • Engage with girl- and youth-led organisations to construct sexual and reproductive health and rights impact measures that reflect the realities of those organisations’ activities and capacities. This should be a collaborative and iterative process in which priorities for MEAL and the interpretation of both the measures and the resulting data are mutually agreed. Linked to this, 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 monitoring, evaluation and learning.
  • Invest in efforts to strengthen understanding of the ways in which girl- and youth-led groups impact sexual and reproductive health and rights 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 that the onus of data collection does not fall on girls. This data should include information about the structure and longevity of organisations, and age of funding recipients, to better understand both where funding is going and how social inequalities may be shaping access to resources for sexual and reproductive health and rights work.
  • 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 sexual and reproductive health and rights. In addition, explore in what ways and to what extent working in restrictive contexts vis-à-vis adolescent and youth sexual and reproductive health and rights impacts girl- and youth-led interventions and resourcing.