Youth collective action for accountability towards sexual and reproductive health (SRH) rights: a systematic scoping review

In the field of sexual and reproductive health and rights (SRHR), there is a growing consensus that participation is critical to ensuring that the voices of youth are heard and their agency is exercised in a way that enables them to practice active citizenship. This includes collective action to hold duty bearers and power holders to account for their rights. Youth are increasingly being seen as important constituents; however, despite the growth in practice, the evidence on what strategies are adopted, how these initiatives work and why is limited. To explore interventions implemented within the ambit of accountability for SRHR rights, and to understand how these interventions generate or strengthen collective action to ultimately lead to the improvement of sexual and reproductive health and rights. We conducted a scoping review following the 5-step methodology developed by Arksey and O’Malley. Systematic searches were conducted on PubMed and Web of Science databases, identifying articles from Jan 2008 to Dec 2022, about interventions with youth that involve collective action for accountability pertaining to SRH rights. Data were charted, synthesized and reported. A total of 25 articles describing 18 interventions were included and represent a range of interventions categorised as collective action. The interventions can be divided into three categories: first, articles analysing the impact of community-based interventions by NGOs or external agencies (15); second, articles describing the evolution and impact of advocacy networks and broader social movements (4); and articles examining (national or global) policy advocacy processes that seek to engage youth (6). The strategies are analysed across three broad categories/themes, identifying what factors influenced the success of each: (1) Building youth empowerment and solidarity – seeding youth collectives as critical mass, ensuring diversity in the collectives, and the extent of critical consciousness and analysis engaged in by them (2). Building pressure and allyship – casting a wide net of allies across different interest groups, allying with adults in a manner that fosters equitable collaboration, building strategically relevant evidence and framing issues in a manner that speaks to change-makers and people at large; and (3) Negotiation with power holders – going beyond the state and negotiating with other power holders, building on existing favourable legislation, utilizing invited spaces and leveraging of political opportunities. As the interest in youth leadership in SRH deepens, this review underscores that even in contexts where youth engagement is recognised, the readiness of the system to respond to and grant legitimacy to youth voices is necessary for effective implementation. The evidence suggests that collective action interventions must be multi-level, strategic, and consider local social hierarchies, histories of civic organising, and policymaking. Power holders, not just at the state but also at the community level, must be held accountable for the sexual and reproductive rights of youth and their leadership to be realised.