Promoting sexual and reproductive health in development and governance priorities for youth in Nepal: a qualitative exploration using reproductive justice framework.
Neupane P, Adhikari P, et al. • Health promotion international • 2026
Youth-led SRH initiatives in Nepal face systemic, institutional, and socio-cultural barriers that disproportionately impact marginalized groups, and real progress requires a shift from top-down approaches toward localized, decentralized strategies fostering youth agency and co-ownership.
Key Findings
Results
Youth-led initiatives in Nepal demonstrate promising efforts in SRH policy advocacy and digital engagement but encounter systemic and institutional hurdles.
Hurdles identified include tokenism, policy exclusion, and limited funding
Study engaged 105 diverse participants across all seven provinces of Nepal
Participants included youth leaders, former youth leaders, donors, and local government officials
Data were collected through in-depth interviews, key informant interviews, and focus group discussions
Results
Socio-cultural barriers such as deep-seated social stigma and lack of inclusive programming impede SRH promotion among youth in Nepal.
These barriers were identified alongside systemic and institutional hurdles
Barriers were found to operate at multiple levels simultaneously
Lack of inclusive programming was specifically noted as a barrier
Findings emerged from qualitative analysis using a reproductive justice framework
Results
Systemic and socio-cultural barriers to SRH disproportionately impact marginalized groups in Nepal.
Marginalized groups identified include sexual and gender minorities, persons with disabilities, and Dalit and Madheshi communities
The reproductive justice lens was applied specifically to highlight differential impacts across social groups
Despite progressive national frameworks supporting gender equality and SRH, ground reality suggests a pressing need for improved commitment
National SRH indicators were cited as evidence of inadequate current progress
Results
A shift from top-down approaches to localized and decentralized strategies is identified as necessary for effective SRH promotion.
Recommended strategies include fostering youth agency, co-creation, and co-ownership of programs along with local governments
Mainstreaming gender was identified as a key component of effective SRH promotion
Decentralizing resources and power was identified as essential for effective SRH promotion strategies
These recommendations were derived from participant perceptions across all seven provinces of Nepal
Background
Nepal has progressive national frameworks supporting gender equality and SRH, but a gap exists between policy and ground reality.
National SRH indicators suggest a pressing need for improved commitment to ensuring safe and quality SRH services
The study used a reproductive justice lens to analyze this policy-practice gap
The gap was identified as the motivating context for the study
Qualitative exploration was conducted to understand perceptions of SRH as a development and governance priority
What This Means
This research explores why sexual and reproductive health (SRH) services for young people in Nepal remain inadequate despite the country having national policies that support gender equality and reproductive health. The researchers spoke with 105 people across all seven of Nepal's provinces — including young activists, government officials, and international donors — to understand what is getting in the way of making SRH a real priority in government planning and funding.
The study found that while young people are actively trying to advocate for better SRH services through campaigns and digital platforms, they face significant obstacles at multiple levels. Institutions often engage young people in token ways without giving them real decision-making power, and funding for youth-led SRH programs is scarce. Cultural stigma around sexual health topics further limits open discussion and inclusive programming. These problems hit hardest for already-marginalized communities, including LGBTQ+ youth, people with disabilities, and members of lower-caste (Dalit) and Madheshi communities, who face additional layers of exclusion from existing programs.
This research suggests that meaningful improvement in Nepal's SRH outcomes for youth will require moving away from approaches where decisions are made by central authorities and handed down to communities. Instead, the study points toward models where young people — especially those from marginalized groups — are genuine partners in designing, running, and overseeing health programs, with resources and decision-making power distributed to the local level. The findings highlight that policy progress on paper does not automatically translate to real-world improvements without structural changes in how programs are funded, governed, and made inclusive.
Neupane P, Adhikari P, Luitel B, Tuladhar L, Dhakal P, Timilsina A. (2026). Promoting sexual and reproductive health in development and governance priorities for youth in Nepal: a qualitative exploration using reproductive justice framework.. Health promotion international. https://doi.org/10.1093/heapro/daag070