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Power to Decide

Two adolescent girls on a bike in Malawi

Power to Decide

Accelerating Progress on Adolescent Girls' Sexual and Reproductive Health and Rights

Every day, adolescent girls are making decisions about their lives and futures. These decisions are shaped by a wide range of complex and interlinked factors, and impact everything from where they go, who they talk to, and what goals they set for themselves to whether they have sex, when, and with whom.

Despite advancements in many areas of girls' lives, progress on adolescent sexual and reproductive health and rights (SRHR) remains too slow and is leaving too many behind. Using a feminist approach, where girls' agency and decision making is at the centre of our analysis, we examine what changes are needed in systems and structures – the supportive enabling environment – to enable girls to claim their rights.

We are calling for urgent and focused attention to address the layers of social and gender norms that still surround adolescent girls’ sexual and reproductive rights in each country and community, preventing them from putting their knowledge of these rights into practice.

20 million girls

have an unmet need for modern contraception, resulting in half of adolescent pregnancies being unintended

3.9 million girls

have unsafe abortions each year due to restrictions and stigma in accessing safe services

Complications from pregnancy and childbirth

are the leading cause of death of 15-19 year old girls globally

Power to Decide

Accelerating adolescent girls' access to sexual and reproductive health and rights

Our global report conducts analyses of best practice and emerging trends that are enabling girls to access SRHR. Developed through an agency lens and global literature review, the report is complemented by two country case studies, exploring first-hand experiences of adolescent girls. The country case studies use a youth-led research approach and focus on peri-urban and rural Zimbabwe, rural communities affected by long term climate insecurity, and short-term disaster response to Cyclone Idai in southern Malawi.

Adolescent girl in Malawi
"The most important lesson of all is knowing that I have the right to decide for myself how many children I want and with whom." Gertrude, 16, Malawi

Our feminist approach

By centring our analysis in questions of girls’ agency and decision-making, we are defining an explicitly feminist approach to understanding their needs when it comes to SRHR information and services, that:

  • tackles discrimination and inequality at the root level
  • takes an intersectional view
  • centres agency and human rights
  • prioritises meaningful collaboration and participation. 
Young woman holding her six month old son
“I have learnt that a girl, no matter what and despite having children, can have a future, can make a plan and take better decisions." Jeanette, 20, with her youngest child

The importance of power and agency in a universal health coverage agenda for adolescent girls

Drawing on findings from Power to Decide, in a commentary for Sexual and Reproductive Health Matters Journal, we highlight the need to fully understand and unpack the power structures that regulate girls’ mobility, sexuality, and educational and economic opportunities, and in particular the use of violence to maintain systems of gender inequalities, in order to transform health systems to reach them.

Read the Report

Power to Decide: Accelerating Adolescent Girls' Access to SRHR