When Faith* met Velindah—a youth peer provider, trained to make reproductive health care more accessible—she believed emergency contraception was her only option. She had been relying on it repeatedly, unaware that longer-term methods existed and with no one she trusted enough to ask. Over several conversations, Velindah walked her through the full range of choices until she found a contraceptive method that worked for her. When Faith later decided she was ready to start a family, she paused contraception, gave birth, and eventually returned to Velindah for guidance on postpartum family planning."She came back looking for me because she trusted me, " Velindah says. "She learned which method was right for her, and after having her baby she returned to a health facility for another long-term method."
Faith's story is one of thousands unfolding across Migori County, where Lwala supports more than 420,000 young people. For many, conversations about sexual and reproductive health have long been shaped by stigma and misinformation. Working alongside county government and communities, Lwala has helped create trusted spaces—in homes, schools, health facilities, and communities—where young people can ask questions, access accurate information, and make informed decisions about their health. The result is a profound shift in how communities support young people's futures.
Shifting social norms over time in Migori building trust through dialogue
Paul, another youth peer provider, has watched this transformation happen firsthand. "The biggest change I've seen is people's perception," Paul says. "People are now accepting conversations about sexual and reproductive health, and they’re accepting contraception positively."
That change is the result of Lwala's youth-led health model, which deploys a cadre of 591 youth peer providers to give trusted information to their peers and link them to youth friendly health services through a range of access points.
Supporting this work are community advisory boards— groups of local leaders who guide discussions on adolescent health, family planning, and interpersonal violence, helping shift social norms, influence local policy, and strengthen community support for young people's health and wellbeing.
In the last three years, more than 400,000 people participated in over 1,600 community dialogues and 1,300 male forums, helping communities sustain these shifts and create enabling environments for young people to exercise greater agency over their health.
The ripple effect
For Velindah, the clearest sign of change for her community in Suna East is the trust young people place in one another. "They can call me, they refer their friends, and those conversations continue even when I'm not there,” she says. “Those we couldn't reach directly are now being reached by their peers."
Leah, a community advisory board member from Rongo, has also seen attitudes toward girls shift. "Unlike before, today girls who become pregnant can still go back to school," she says. "We tell them this is not the end of the world."
The impact is becoming visible across Migori. Since this work began in 2017, teen pregnancy across Migori has fallen from 35% to 18%. In Rongo and Awendo, where Lwala has partnered with communities for years, teen pregnancy rates are now below the national average. For Leah, these changes belong to the community itself. "These changes have happened through collective responsibility," she says. "That is what has made the norms change possible."
Beyond the stories: evidence of change
An independent evaluation by Laterite Kenya, with support from the Children’s Investment Fund Foundation, found measurable shifts in social norms. Communities reported greater acceptance of family planning, stronger support for girls' autonomy in making health decisions, and more progressive attitudes toward contraceptive use in areas where Lwala has partnered with communities the longest.
Beyond shifting attitudes, we have seen changes in how young people access and use reproductive health services. Since 2023, young people aged 15-24 in Lwala-supported communities have made 146,000 additional family planning visits, exceeding expectations by 57%. This contributed to 84% more couple-years of protection delivered than expected in Migori since 2023—a measure of how long people are protected from unintended pregnancy through contraceptive use. Across the measures, a clear pattern is taking shape: community-led efforts translate into stronger reproductive health outcomes.
Looking ahead
Our goal is to help make youth-led health care a foundational part of the health system across Kenya, and progress in Migori is showing what that can look like.
This year, the county launched its Adolescent and Youth Peer Provider Engagement Guide, formally recognizing youth peer providers as part of the county health system and establishing their role in providing guidance on youth-friendly services. Additionally, the county's Multisectoral Action Plan for Adolescents and Youth has adopted proven approaches from Lwala's model, including youth-targeted outreaches, group antenatal care for adolescent mothers, and community-based contraceptive services. These milestones are embedding approaches that have improved outcomes for young people into county plans and health systems, helping government sustain what works.
Our ambition is to make youth-led health a core part of Kenya’s primary healthcare system, including integrating youth peer providers into the community health workforce. Lessons from Migori are helping advance that goal nationally. Lwala is contributing to Kenya’s national peer-to-peer curriculum for adolescent and youth engagement—an important step toward embedding youth-led, youth-friendly care in government systems.
Faith once struggled to find someone she trusted enough to ask for help. Today, thousands of young people have someone they can turn to—a peer, a teacher, a parent, a community leader. Those conversations are changing more than individual decisions. They are helping communities build healthier futures for the next generation
