Adolescent-Responsive Contraceptive Services: Institutionalizing adolescent-responsive elements to expand access and choice

Group of Muslim girls together on the beach

Adolescence, defined by the World Health Organization (WHO) as ages 10 to 19, is a time of tremendous physical, cognitive, and social change and when many people initiate sexual activity. Adolescents need a range of supports to remain well, to transition safely into adulthood, and to adopt lifelong healthy behaviors; a key support is access to contraceptive information and services. However, many countries continue to invest in interventions that are ineffective at increasing contraceptive use (e.g., youth centers), demonstrate mixed effects (e.g., peer education), or are challenging to sustain and bring to scale (e.g., separate spaces for young people within health facilities). This contributes to poor sexual and reproductive health outcomes. For example, about half of all pregnancies among adolescent females (15 – 19 years) in developing regions being unintended. With 1.25 billion adolescents, increasing to 1.35 billion in 2050, and countries striving to achieve universal health coverage, health systems must go beyond piecemeal approaches to institutionalize service delivery that acknowledges adolescents as distinct from other age groups and addresses the barriers that limit adolescents’ access to and use of contraception.

There is evidence that adolescent-friendly services, when well-designed and well-implemented, can help increase access to and use of contraception. However, traditional models of specialized service delivery for adolescents have proven difficult to sustain and scale. Establishing adolescent-responsive contraceptive services (ARCS) is emerging as a more scalable and sustainable way to meet adolescents’ needs for contraceptive information and services. The term adolescent-responsive contraceptive services (ARCS) signals an evolution from traditional stand-alone models of adolescent-friendly services towards a systems approach to making existing contraceptive services adolescent-responsive by incorporating elements with demonstrated effectiveness for increasing adolescent contraceptive use. A systems approach implies that policies, procedures, and programs across the entire health system are adapted to respond to the diverse needs and preferences of adolescents.

ARCS is an “enhancement to high-impact practices in family planning” as identified by the HIP Technical Advisory Group. An enhancement is a practice that can be implemented in conjunction with HIPs to further intensify their impact. For more information about HIPs, see For examples of how HIPs can be enhanced through the inclusion of adolescent-responsive elements, please see the ARCS Appendix document available on the HIPs website noted above. This brief focuses on service delivery aspects of ARCS and does not discuss other investments that support adolescents’ use of contraception or that reduce adolescent births, such as girls’ education, community engagement, engaging men and boys, or social marketing, which are addressed in other HIP briefs.