Governments are making decisions that will shape the future of women’s health, yet the very people most affected by those decisions are often absent from the room. Across low, middle, and even high income countries, funding gaps and political hesitation are slowing progress on sexual and reproductive health and rights. The cost of that silence is already visible in rising maternal deaths, unmet contraceptive needs, preventable HIV infections, and millions of young girls managing menstruation without dignity or support.
When young people are excluded from policy tables, the consequences are not abstract. They are measured in interrupted schooling, unsafe abortions, untreated infections, early marriages, and lost economic potential. According to the World Health Organization, complications related to pregnancy and childbirth remain among the leading causes of death for adolescent girls globally. The United Nations Population Fund estimates that hundreds of millions of women worldwide still lack access to modern contraception. These are not inevitable tragedies. They are policy choices.
Sexual and reproductive health and rights, often abbreviated as SRHR, encompass access to contraception, maternal care, safe childbirth, menstrual health support, prevention and treatment of HIV and other sexually transmitted infections, and comprehensive sexuality education. When these services are adequately funded and grounded in evidence, entire communities benefit. Girls stay in school longer. Families are healthier. Economies grow stronger. Public health systems become more resilient. Yet despite decades of data demonstrating these returns, political cycles and ideological battles continue to disrupt sustained investment.
In recent years, global financing for reproductive health programs has faced increasing volatility. Shifting donor priorities, economic downturns, and domestic political polarization have left many community clinics under resourced. Youth led organizations that provide peer education, menstrual hygiene support, and HIV awareness often operate on fragile budgets. Meanwhile, misinformation spreads faster than public health campaigns can respond. When evidence based policies are replaced with moral panic or electoral calculations, young people are left navigating their health in the dark.
The irony is that today’s generation is more informed and more willing to engage than any before it. Young advocates are organizing online and offline, demanding accountability, and building community led solutions. They are speaking about period poverty, about the stigma surrounding contraception, about the fear of seeking HIV testing, about the trauma of inadequate maternal care. They are not asking for charity. They are asking to be heard.
Research consistently shows that youth inclusive policymaking improves outcomes. When adolescents are consulted in the design of health programs, services become more accessible and culturally relevant. Clinic hours are adjusted to accommodate school schedules. Confidentiality protections are strengthened. Digital platforms are used to disseminate accurate information. Policies move from being well intentioned documents to lived realities.
Consider contraception. Access to modern contraceptives allows young women to delay pregnancy, complete their education, and participate fully in the workforce. Yet in many settings, legal barriers, provider bias, and stock outs restrict availability. Political reluctance to discuss contraception openly often translates into underfunded supply chains and limited public education. The result is predictable: unintended pregnancies and increased health risks.
HIV prevention tells a similar story. Young people, particularly young women in parts of sub Saharan Africa, remain disproportionately affected. Evidence based strategies, including comprehensive sexuality education, access to condoms, pre exposure prophylaxis, and community outreach, have demonstrated effectiveness. But when funding fluctuates or policies shift away from science driven approaches, infection rates can stall or rise again. Progress is fragile when it depends on short term political will.
Menstrual health is another overlooked dimension. Millions of girls miss school each month because they lack affordable sanitary products or safe sanitation facilities. The stigma surrounding menstruation reinforces silence and shame. When governments prioritize menstrual health through subsidies, education campaigns, and infrastructure investment, school attendance improves and long term educational outcomes strengthen. When they do not, inequality deepens quietly.
Maternal care remains a stark indicator of systemic priorities. Skilled birth attendance, emergency obstetric services, and postnatal care are proven interventions. Yet in under resourced health systems, rural clinics lack trained staff and essential equipment. Young mothers, particularly adolescents, face elevated risks. Ensuring quality maternal care is not simply a medical issue. It reflects whether societies value the lives and futures of young women.
Critics sometimes frame youth engagement in SRHR debates as disruptive or overly idealistic. But exclusion carries greater risk. Policies designed without youth input often fail to address the realities young people face, including digital misinformation, social media pressure, gender based violence, and economic precarity. Sustainable solutions require those with lived experience to contribute to decision making processes.
The economic argument is equally compelling. Investments in reproductive health yield measurable returns. Fewer unintended pregnancies reduce strain on health systems. Healthier mothers contribute to stronger households. Educated girls are more likely to enter the labor force and contribute to national productivity. In this sense, funding SRHR is not a niche social agenda. It is a core development strategy.
Global institutions have long recognized this link. The World Bank has emphasized the role of women’s health and empowerment in driving economic growth. The UNAIDS continues to highlight the centrality of youth engagement in ending the AIDS epidemic. Yet recognition must translate into sustained, predictable financing and inclusive governance.
Political leaders now face a clear choice. They can allow short term ideological battles to erode decades of progress, or they can reaffirm commitments grounded in data and human rights. They can treat young people as passive beneficiaries, or as partners in shaping policy. They can close funding gaps, or watch preventable crises widen.
Listening to youth voices is not a symbolic gesture. It is a practical necessity. Town halls, digital consultations, youth advisory boards, and participatory budgeting mechanisms are not radical innovations. They are democratic tools. When young people articulate their needs regarding contraception, HIV prevention, menstrual health, and maternal care, they are offering governments a roadmap for effective investment.
Silencing those voices carries a tangible price. It is paid in hospital wards, in classrooms with empty desks, in communities burdened by preventable illness. It is paid by young women who must navigate adulthood without the information and services that should be their right.
The future of women’s health will not be determined solely by medical advances or technological breakthroughs. It will be determined by whether policymakers are willing to align budgets with evidence and include young people in decisions that define their bodies and their futures.
If governments truly aim to build stronger communities and resilient economies, the path is clear. Invest in comprehensive sexual and reproductive health services. Protect them from political volatility. Invite youth into the room, not as an afterthought, but as equal stakeholders. Because when politics silences youth voices, women’s health pays the price.
– Inah Boniface Ocholi writes from Ayah – Igalamela/Odolu LGA, Kogi state.
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