Promoting sexual and reproductive health in development and governance priorities for youth in Nepal: a qualitative exploration using reproductive justice framework.

This qualitative study explores the perceptions of promoting sexual and reproductive health (SRH) as a priority in development and governance among youth in Nepal. Despite progressive national frameworks supporting gender equality and SRH, the SRH indicators and ground reality suggest a pressing need for improved commitment to ensuring safe and quality SRH services. Using a reproductive justice lens, the study engaged 105 diverse participants including youth leaders, former youth leaders, donors, and local government officials through in-depth interviews, key informant interviews, and focus group discussions conducted across all seven provinces of Nepal. While youth-led initiatives demonstrate promising efforts in policy advocacy, and digital engagement, they often encounter systemic and institutional hurdles like tokenism, policy exclusion, limited funding; and socio-cultural barriers such as deep-seated social stigma, and lack of inclusive programming. These barriers disproportionately impact marginalized groups, including sexual and gender minorities, persons with disabilities, and Dalit and Madheshi communities. To enable real progress in promoting SRH, this study identified a shift away from existing top-down approaches towards localized and decentralized strategies fostering youth agency, co-creation, and co-ownership of programs along with local governments, mainstreaming gender, and decentralizing resources and power for effective SRH promotion strategies.