Evidence for women's sexual and reproductive health and rights

In Northern Nigeria, where early marriage and restrictive gender norms shape young women's reproductive choices, continued contraceptive use is rarely documented, let alone understood through the lens of communication, trust, and agency. This longitudinal cohort study followed 1,101 married girls aged 15–19 over 14 months across 30 youth-focused facilities in Kaduna and Nasarawa states to uncover the social and behavioral determinants of sustained use.
Findings reveal a striking truth: continuation is not simply a metric of uptake but is a mirror of connection. Ninety-three percent of participants remained on a method after 14 months, with 98.5 % intending to continue. The strongest predictors of sustained use were not method type or education level, but the quality of communication-respectful, empathetic, and youth-responsive counselling that positioned contraception as part of girls' life aspirations.
Despite social constraints and reproductive coercion, 59 % reported autonomous decision-making. Girls described contraception as a tool to pursue education, health, and financial stability, demonstrating that agency can thrive even in constrained contexts when connection and trust exist.
This study challenges what "evidence" means in SBCC: data rooted in lived experience reveals that when systems listen, young women lead. Sustained use becomes an act of communication, where information, empathy, and empowerment converge.

Contraceptive choice has often been framed around provider counseling, with less attention to peer and community influences. However, causal inference modeling across Côte d'Ivoire, Kano and Kaduna in Northern Nigeria, and Sindh in Pakistan shows that among women of reproductive age, peer communication exerts a stronger influence on contraceptive preferences than provider counseling. Peer sharing of method experiences, both positive and negative, emerged as the strongest driver of preferences. This finding challenges long-standing assumptions in family planning program design that privilege provider guidance as the key determinant of preference development. Instead, it positions the community as the arena where method perceptions are constructed and reinforced. The magnitude of peer influence varies by context, ranging from 20 percentage points in Northern Nigeria to 42 in Sindh, Pakistan. Peer narratives also interact with perceptions of which methods are common, shaping how women evaluate options and form positive or negative associations. These dynamics can encourage effective method uptake but also lead to less effective choices when negative experiences dominate or when provision and availability of methods are misaligned. The evidence calls for a shift in strategy: amplifying positive peer narratives, countering harmful ones, and leveraging trusted community voices through interpersonal and media channels. Partnering with BBC Media Action, these insights are being operationalized into a multi-channel campaign to seed and scale constructive peer conversations, representing a paradigm shift in family planning interventions that emphasizes the decisive role of women's networks in shaping contraceptive journeys.

This qualitative study examined how women of reproductive age (WRA) in the Western Cape, South Africa navigated access to contraceptive services during and after the COVID-19 pandemic. Using the Levesque Framework for Access, the study analyzed focus group discussions (n=24) with WRA alongside key informant interviews with healthcare providers and policy makers. It found that pandemic-related disruptions, clinic closures, stockouts, transport limitations, and financial instability, intensified pre-existing barriers to contraceptive access.
Despite these challenges, the research identified several innovative and adaptive models of contraceptive provision. These included pharmacy-based access, community-based distribution via trusted intermediaries, longer refill durations, mobile health applications, and telemedicine-supported counseling. These models improved privacy, reduced travel and waiting times, and in some cases enhanced method choice and agency. However, gaps remained, especially in affordability and digital access.
The study concludes that resilient, user-centered contraceptive delivery models must be institutionalized to protect and extend access during health system disruptions. For SBCC professionals, these findings offer insights into designing communication strategies that support trust, normalize alternative access channels, and reinforce contraceptive continuity in crisis-affected settings.

Safe abortion access is constrained by stigma, misinformation, and deeply ingrained social and gender norms. Social and Behavior Change (SBC) interventions, such as interpersonal communication, community mobilization, digital technology, capacity strengthening, and values clarification, demonstrate improving access to and quality of care, yet their impact on abortion is scattered. This review aims to map SBC interventions that are evident to improve access to and quality of abortion care. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology, we systematically searched four databases (PubMed, Embase, CINAHL, and PsycInfo) for studies published between 2000 and 2024. Screening and full-text reviews resulted in 22 studies that met the inclusion criteria. Data were charted into a structured form and synthesized narratively. The review found a diverse set of SBC interventions that highlight promising results in improving access to and quality of abortion care. While community-based interventions demonstrated effectiveness in improving knowledge and agency, reducing stigma, and shifting community norms, values clarification and capacity strengthening activities showed positive attitudes and improved service delivery. Digital technology-based interventions expanded reach and are effective in engaging youth. Despite these promising findings, there are gaps in the rigorous and comparative evaluations, which limit the generalizability of the outcomes. While the review will guide program designers in integrating these evidence-based interventions to advance safe abortion access and quality, it also encourages them to design rigorous evaluations and contextual diversity during the design and implementation of programs.