Introduction: About one-quarter of the world’s population are adolescents, and majority of them reside in low- and middle-income countries. This group, particularly girls, is vulnerable to many adverse health outcomes, including unintended pregnancies occurring in adolescence, especially if unwanted, are associated with increased health risks posing a global public health concern. A considerable attention has been given to the Sexual and Reproductive Health (SRH) of women and girls with majority of the national efforts are center around establishing SRH regulations and services. Therefore, this systematic review assessed the use of family planning in empowering and strengthening the agency and vice versa among adolescents and young women.  

Methods: We ran the searches in seven databases. The methodological quality was assessed, and the meta-analysis was performed using Review Manager 5.  

Results: A total of 39 studies were included. Included studies provided evidence of empowerment interventions on improving the use of family planning; however, a lack of evidence was identified on longer-term outcomes of the use of family planning on empowering and strengthening agency of adolescent and young women. We are uncertain about increasing ever use of contraception (RR 1.15; 95% CI 1.07-1.23; GRADE: very low), adolescent pregnancy [RR 0.77; 95% CI 0.44-1.33; GRADE: Very low), and a probable impact on discussion with partners regarding condom use (RR 1.60; 95% CI 1.28-2.00; GRADE: Moderate). We found no evidence of the use of family planning and its impact on the empowerment of adolescent and young women.

Conclusion: This systematic review suggests that empowerment and agency strengthening of adolescents and young women has a direct positive impact on improving immediate and short-term outcome such as family planning uptake. However, the converse impact of family planning use in empowering adolescent and young women is limited.