Asia and the Pacific is home to 650 million adolescents, yet essential sexual and reproductive health care remains out of reach for too many. Examining health systems across 30 low- and middle-income countries, this UNFPA review exposes the gap between policy commitments and the services young people can actually access, with lasting consequences for their health, education and futures.

Restrictive laws, high costs, fragmented services and judgmental attitudes prevent adolescents from seeking care. Even where services exist, parental consent requirements and concerns about confidentiality can put contraception, HIV testing and other essential support beyond reach. The review examines how these barriers reinforce inequality and leave young people’s needs overlooked in efforts to expand health coverage.

Moving from evidence to action, it sets out seven priorities for reform, including embedding adolescent health in national coverage packages, securing dedicated financing, removing discriminatory restrictions and expanding digital and school-based care. For policymakers, advocates and health leaders, it offers a practical route towards more accessible, equitable services, grounded in a clear principle: universal health coverage cannot be universal while adolescents are left behind.