# Describing the roles of civil society organizations in sustaining adolescents’ family planning programs in nine Asian and African countries

## TL;DR

This study examines how civil society organizations help sustain adolescent family planning programs in nine Asian and African countries by engaging communities and adapting to local cultures.

## Contribution

The study systematically documents the unique role of civil society organizations in sustaining adolescent family planning programs across diverse cultural and political contexts.

## Key findings

- Community participation, multi-stakeholder partnerships, and cultural-religious adaptation are key pillars for sustaining adolescent family planning programs.
- CSOs contribute to youth empowerment, local ownership, and culturally sensitive advocacy despite sociocultural and political challenges.
- Collaboration between CSOs and governments leads to inclusive policies and better acceptance of family planning initiatives.

## Abstract

Globally, adolescent pregnancy affects around 21 million girls in low- and middle-income countries (LMICs) annually, leading to 12 million births. Family planning education, sexual abstinence, and contraception utilization, mainly for married adolescent girls, are essential to prevent adolescent pregnancy. Although the role of civil society organizations (CSOs) in advancing family planning has been increasingly recognized within the global health, there was lack of systematic documentation of its unique contribution and limited knowledge on its conceptualization and operation on sustainability. This study critically evaluating CSO members in nine carefully selected Asian and African nations involved in Adolescent and Youth Sexual and Reproductive Health (AYSRH) programs, with an emphasis on community involvement, collaboration, and cultural and religious program adaptation.

This critical review study analyzed sustainability factors for adolescent family planning (AFP) programs across nine Asian (Bangladesh, India, Indonesia, Myanmar) and African countries (Cameroon, Kenya, Madagascar, Malawi, Nigeria) through structured review submissions from CSOs practitioners, based on their perspectives. Using thematic analysis, the study identified three key sustainability pillars: (1) community participation, (2) multi-stakeholder partnerships, and (3) cultural-religious adaptation of programs.

This study highlights the crucial role of CSOs in sustaining AFP programs across nine countries in Asia and Africa. Despite an unsupportive situation in the studied countries, such as sociocultural, political, and resource constraints, CSOs provide benefits. Three theme were reflected from the thematic analysis; community engagement and participation (youth empowerment, local ownership, grassroots mobilization, hybrid digital–community models, culturally sensitive advocacy); partnerships and collaboration (government–CSO alliances, joint implementation, cross-sector engagement, data-driven accountability); and cultural and religious adaptation (integrating local values, engaging gatekeepers, addressing barriers through dialogue and innovation).

According to this multi-country study, community engagement, strategic partnerships, and cultural-religious adaptation are the three main pillars that support the effectiveness of family planning programs. The findings of this study advocate for scaled-up collaboration among governments, CSOs, and global health actors to institutionalize contextually grounded solutions. Strengthening CSOs through targeted investments, inclusive program designs, and institutionalizing these strategies within health systems is essential to ensure lasting acceptance, effectiveness, and community ownership.

Civil society organizations (CSOs) play a crucial role in fostering community trust and overcoming societal challenges in sensitive or conflict-affected areas.

Collaboration between CSOs and governments promotes inclusive, adolescent-friendly policies and programs.

Family planning initiatives that align with local religious and cultural beliefs are more accepted and effective.