Civil society organisations’ engagement in advancing adolescent sexual and reproductive health rights in Kenya: a case of Siaya county

Abstract

This study examines the extent to which civil society organisations (CSOs) contribute to adolescent girls’ reproductive justice in Kenya, focusing on Siaya County. Despite a robust constitutional and policy framework supporting adolescent sexual and reproductive health rights, significant implementation gaps persist, limiting girls’ reproductive autonomy and access to comprehensive services. Grounded in reproductive justice theory, the study adopts a qualitative descriptive design. Seventeen purposively selected CSOs implementing adolescent sexual and reproductive health programmes were engaged through in-depth interviews. Data were analysed thematically to explore programming strategies, perceived barriers to reproductive justice, and factors shaping policy implementation. Findings reveal that while CSOs employ diverse interventions—such as menstrual health management, gender-based violence prevention, community outreach, and policy advocacy—these largely reflect neoliberal approaches focused on individual behaviour change rather than structural transformation. Key barriers include entrenched sociocultural norms, religious resistance to comprehensive sexuality education, gendered power relations limiting adolescent agency, and restricted access to contraceptives and youth-friendly services. Policy implementation is further undermined by weak political commitment, poor coordination across governance levels, and inadequate funding at county level. Operational constraints, including donor dependency and short-term funding cycles, further limit CSO impact. From a reproductive justice perspective, current interventions insufficiently address the rights to have children, not have children, and parent in safe environments. The study highlights how intersecting inequalities compound marginalisation and calls for a shift toward rights-based, structurally oriented approaches to adolescent reproductive health.