“This is the first time somebody has asked me …“: How can actors realize the dimensions of contraceptive autonomy for adolescent migrant girls? A case study of Venezuelan migrants in Colombia

This article examines how service providers and policymakers include and consider autonomy in providing contraceptive consultation, methods, and services to young Venezuelan women and adolescent girls 15-19 years old. This research adopts a qualitative approach, using multi-perspective interviews with adolescent migrant girls, policymakers, program designers, and service providers conducted during fieldwork in Bogotá, Colombia, in 2022. Using this data, I examine how the attitudes and implementation of public health and humanitarian aid programs have created an environment in which the participation of Venezuelan migrant girls and young women in decision-making processes is limited. Introducing a new framework that builds on existing literature, I develop contraceptive autonomy as enhanced or constrained along three axes: self-determination, self-governance, and self-authorization. The findings show key informants from non-governmental organizations (NGOs), multilateral agencies, and public health institutions working in migration and sexual and reproductive health and rights (SRHR) utilize focus groups, workshops, and representatives as mechanisms that enhance or constrain the decision-making power of adolescent migrant girls and young women. In many cases, participants could not identify a mechanism of participation or feedback that would enhance autonomy. The discussion demonstrates how a mixture of mechanisms is needed to enhance autonomy along all three axes to realize SRHR and justice. More broadly, enhancing contraceptive autonomy can inform the practices of policymakers, program designers, and service providers, creating environments that support adolescents and young women in making full, free and informed reproductive choices in humanitarian contexts. • Theory and evidence overlook adolescent migrant girls’ contraceptive autonomy. • Here, a new framework develops contraceptive autonomy along three axes. • Interviews are used to identify mechanisms of participation that enhance autonomy. • Venezuelan adolescent girls in Colombia need more opportunities to participate. • A mix of mechanisms is needed to enhance all three axes of contraceptive autonomy. • The above is required to achieve sexual and reproductive health and rights and justice