Creating inclusive sexual and reproductive health services

Programme: Make Way 
Period:  2021-2025
Partners: Akina Mama wa Afrika, The Circle of Concerned African Women Theologians, Kenya, Forum for African Women Educationalists, Liliane Foundation, VSO Netherlands and Wemos.

What is the issue?

Many young people struggle to get comprehensive sexual and reproductive health (SRH) information and related care. Those who experience multiple forms of marginalization, for example due to gender, age, ability, economic status or a combination thereof, face even more difficulties. Health systems that fail to prioritize inclusion and human rights not only limit access but also compromise the quality-of-care young people receive. As a result, they face higher rates of unintended pregnancies, sexually transmitted infections, and unsafe abortions—putting their health and futures at risk.

What is our solution?

To break systemic barriers, marginalized young people must have a real say in shaping the services designed for them. This means creating structured opportunities for them to engage directly with healthcare providers and policymakers to improve SRH services. Meaningful dialogues and partnerships ensure that services truly reflect youth needs and realities. By closing this gap, we can build a health system that leaves no one behind.

How did we advocate for this?

The Make Way programme tackles barriers to sexual and reproductive health and rights (SRHR) through an intersectional approach. This lens reveals power dynamics and systemic barriers that prevent marginalized people, especially youth, from accessing SRHR. To bridge the gap between marginalized youth’s needs and health service provision, the programme developed the Intersectional Community Scorecard. This tool helps young people to document their needs, assess services and work closely with health professionals to drive improvements.

What was our impact?

By using the Intersectional Community Scorecard across multiple countries, the Make Way programme has achieved significant improvements, ensuring that health services are more inclusive, responsive, and aligned with the realities of marginalized youth. For example:

• Ethiopia implemented an anonymous feedback system allowing vulnerable youth to report discrimination.
• Kenya established dedicated youth corners in health centers.
• In Rwanda, the governement committed to reintegrating teen mothers into schools.
• Uganda created sustainable joint monitoring committees for ongoing service improvement.
• Zambia institutionalized adolescent-specific SRH service days, reaching over 18,000 young people.

The success of the Intersectional Community Scorecard demonstrates its potential for scaling up into national frameworks for SRH service accountability. By integrating this model into public health systems and strengthening partnerships between healthcare facilities, youth organizations, and community leaders, governments can take meaningful steps toward universal health coverage—ensuring that no young person is left behind.