Engaging adolescents for sexual and reproductive health and rights and family planning advocacy in Pakistan: a qualitative study protocol.

introductionAdolescents and young people aged 10-24 years comprise 32% of the total population of Pakistan. Adolescents and young people are a heterogeneous group-in different stages of development, living in different circumstances and with differing and changing needs. Neglect of specific adolescents' sexual and reproductive health (SRH) needs can pose serious challenges and affect physical and mental health, future employment, economic well-being and adolescents' ability to reach their full potential. Evidence suggests that adolescents in Pakistan have poor access to SRH services, including access to contraception and limited knowledge of SRH and rights (SRHR), contributing to unplanned pregnancies, very early childbearing, short birth intervals, pregnancy complications, maternal death and disability. Despite recognising adolescence as an important developmental period, research on SRHR needs and access to SRH information among adolescents in Pakistan is scarce. This project will use a participatory action research (PAR) approach based on the principles of public engagement in science and innovation to develop a national SRHR and Family Planning Advocacy Toolkit for adolescents in Pakistan. METHODS AND ANALYSIS: We will use the PAR framework to guide our study. This research project will be conducted in three stages with cyclical recurring activities involving planning, acting, observing and reflecting, as informed by the PAR framework. The three stages are: (1) establishment of youth advisory groups and identification and prioritisation of SRHR concerns, (2) planning and co-designing an appropriate intervention (ie, SRHR and Family Planning Advocacy Toolkit) and (3) implementation and usability testing of advocacy Toolkit. This project leverages strong, well-established partnerships among researchers, clinicians, lady health workers (LHWs) and adolescent communities living in rural parts of Pakistan. ETHICS AND DISSEMINATION: This study has received ethics approval from the University of Alberta Research Ethics Board (Pro00129101_REN1) and the Ethics Review Committee at Aga Khan University (2023-8671-26021). We will actively engage adolescent advisory group members, youth partners and LHWs in the dissemination of the Toolkit to ensure that it will reach end users in the rural community. In collaboration with governmental platforms, community non-governmental organisations and educational campaigns, the Toolkit will be disseminated to ensure SRH knowledge is readily available to young adolescents. We will also publish our study findings for peer-reviewed publications, digital stories and conference presentations.