Most women around the world begin sexual relationships between the ages of 15 and 19 and face significant challenges in obtaining services and information to protect themselves from unwanted pregnancy and sexually transmitted infections, including HIV (Bankole and Singh, 2003; UNFPA, 2014; Wellings et al., 2006). As the world’s population of 15- to 19-year-olds continues to grow beyond 600 million, countries will need to meet increasing demand for contraceptive services and information that address their specific needs (UNDP, 2015).

To inform the next generation of programs, experts in adolescent sexual and reproductive health were asked to propose a streamlined approach, based on learning to date, that would be both scalable and sustainable. Mainstreamed Adolescent Friendly Contraceptive Services (AFCS) incorporate within existing contraceptive services those adolescent-friendly elements that have demonstrated effectiveness in stand-alone or separate-space models. These elements can be incorporated into a range of service delivery channels (i.e., facilities, mobile outreach, community-based distribution, pharmacies, or drug shops). Drawing from a variety of literature reviews, a number of common program elements were identified that can increase contraceptive use among adolescents (Bankole and Malarcher, 2010; Senderowitz, 1999).

This brief focuses on the elements of AFCS that are typically implemented within a service delivery setting. It describes how mainstreaming AFCS can address key challenges for contraceptive programs, discusses the existing evidence of adolescent-friendly elements, outlines key issues for planning and implementation, and identifies knowledge gaps. This brief does not fully cover elements that contribute to the enabling environment for adolescent programming, which are addressed more completely in other High-Impact Practice (HIP) briefs, such as the briefs on health communication and policy.