Agency and Access: Why LARCs Are Significant to the Narrative of Family Planning

“Young people represent agents, beneficiaries and victims of major societal changes and are generally confronted by a paradox: to seek to be integrated into an existing order or to serve as a force to transform that order. Young people in all parts of the world, living in countries at different stages of development and in different socio-economic settings, aspire to full participation in the life of society.”

—World Programme of Action for Youth

“Youth” and “youth rights” have become buzzwords of contemporary human rights advocacy. Almost every international forum makes a point of emphasizing young people and the need to include them in the language of policy and decision-making—an idea introduced by the United Nations in 1965. The concept of engaging youth in advocacy and policy development initiatives at the community, local, and national levels is commonly articulated, but too often political will fails to capture or leverage young stakeholders. 

This is largely because the needs of ‘youth’ are often seen as transient or temporary, so tailored responses are rare, and the distinct issue of young people are frequently compressed into larger frameworks which are not capable of resolving the matrix of rights violations they bear on their journey from adolescence to adulthood.

When one considers the many issues youth and adolescents face, sometimes exclusively as well simultaneously—such as the access to education, employment opportunities, quality healthcare, and the freedom to live a life free of any kind of discrimination—the likelihood that these will manifest into a multiplicity of human rights problems, if left unaddressed, is almost inevitable. So it becomes imperative that young people be granted agency and treated as distinct and active partners in global developmental efforts.  

On January 24th and 25th, I will be joining many other young people from around the world participating in a youth preconference preceding the International Conference on Family Planning (ICFP) in Bali, Indonesia. We will gather to talk about the challenges we face concerning access to contraceptive services and  how to further our goal to be effective advocates for sexual and reproductive rights and health services for ourselves, our peers and in our home countries, as well as across the world.

Joining the global call to expand contraceptive choice for adolescents and youth to include long-acting reversible contraception (LARCs) is one step we can all take. It is imperative for me, as a young woman, to be an active supporter of the Global Consensus Statement for Expanding Contraceptive Choice for Adolescents and Youth to Include Long-Acting Reversible Contraception, which will be celebrated at the conference in Bali. This new consensus statement responds to the growing demand from young people, married or unmarried, for more choices, more control, and more affordable options.

There has been mass approval and acceptance of LARC methods, especially as an effective choice for young women. From a youth perspective, LARCs have a few significant advantages:

  • Choice: LARCs are reversible (unlike sterilization), so young women who may consider conceiving at a later date may do so. In the meantime, they provide women the ability to plan their lives and families and make decisions regarding education, employment, welfare, and health.
  • Ease of Use: LARCs are fairly stress free – they do not require the same regular regime that is so often necessary with other method. This supports sexual freedom and agency, ensuring unplanned pregnancies are greatly reduced.
  • Birth Spacing: LARCs allow couples to set and manage their own reproductive goals and make their own decisions about how many children to have and when.
  • Affordability: The long-term costs of condoms and oral contraceptives are extremely high compared to LARCs.

It is critical to recognize we still have a long way to go it comes to access to contraceptives, LARCs included. Sexual hierarchy is a stifling social structure that diminishes the freedom to choose, most particularly for young women. The yoke of this is placed squarely and heavily on young women of marginalized communities. Young women and girls in many parts of the world are dangerously isolated in terms of their health and access to medical services. They rarely have any agency and are limited to seeking permissibility from their partners, spouses, guardians and community gate keepers. In spite of this, even if they are able, by some positive stroke, to seek health care services by themselves, a number of myths, fears and inaccurate bits of information are sometimes embedded deep into their mindscreating apprehension around seeking the contraceptive method that is best for them.  

The Global Consensus Statement For Expanding Contraceptive Choice For Adolescents And Youth To Include Long-Acting Reversible Contraception will hopefully act as a tool of both engagement and advocacy to improve the situation, especially for young people. Check out the website to add your voice—and use this statement when you approach health providers, community representatives, local leaders, guardians, and other gate keepers to talk about the importance of full access to contraceptive choice, including LARCs. 

This year’s ICFP, Youth Pre-Conference, and Consensus Statement are all notable steps toward a world where young people are actively involved in global decision-making. We are here to come together to keep that momentum going—this is objective, this is the vision!

Ramya Jawahar Kudekallu is the Vice Chair for the International Youth Alliance for Family Planning.

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