Across Europe, too many children still lack the support they need.
This roadmap is a practical guide for health policymakers working to embed the voices of young people in the design, delivery and evaluation of health policies and services. It applies across all four thematic areas and its principles, stages and tools are transferable to any area of health policy where ministries wish to engage young people meaningfully.
It is addressed primarily to health ministry officials; ministries and dedicated government bodies responsible for youth affairs; officials in regional and sub-national health authorities; EU and international programme officers; and civil society organisations working in partnership with health institutions.
Who should be consulted: Throughout this roadmap, “children and young people” is used inclusively, spanning the UNCRC definition of a child (0–18), the UN definition of youth (15-24) (10–19), and youth as defined in the EU Youth Strategy (up to 30, though most health engagement in practice concentrates on ages up to 24). There is no single correct age range for consultation: who should be engaged, and how, depends on the health topic and decision at hand. Engagement on early childhood development may draw on older siblings, peer role models, and young parents; engagement on adolescent mental health, substance use, or sexual and reproductive health typically centres young people aged 10–19; and sustained advisory, co-design or governance roles may extend to youth up to 24 or beyond, in line with national youth structures, national definitions, legislations and mandates. Ministries should define the appropriate age range explicitly for each engagement process at the outset (see Stage 3.1), and ensure the young people consulted reflect the diversity of ages, genders, backgrounds and lived experiences relevant to the topic, rather than defaulting to the same age group across all forms of engagement.
The roadmap can be used as a step-by-step planning pathway — from securing a mandate and understanding context through to institutionalising engagement and monitoring quality — or consulted at any stage as a reference.
1. Why Engaging Children and Young People on their Health Matters
Children and young people face a distinct set of health challenges — shaped by developmental transitions, social pressures and emerging identities. Policies and services designed without their input often end up harder to access, less relevant, or underused. Involving children and young people changes this — for them, and for the systems meant to serve them.
For children and young people themselves
Meaningful engagement produces direct benefits for children and young people beyond better policy outcomes. Participation builds health literacy, self-confidence and civic competence, it develops communication and leadership skills that carry into adulthood and it creates a sense of belonging and agency that is itself protective for mental health and wellbeing.
For policy makers and health systems
Children and young people bring unique insights, energy and lived experience to the health challenges that affect them most. When they are involved in designing the policies and services meant to serve them, the results are measurable: higher uptake, greater relevance, and more sustained impact. Young people identify barriers to access, service gaps and emerging health risks that are invisible to adult-centred data collection.
Their involvement in co-design produces interventions that are more relevant, acceptable and effective. Health systems that involve young people are more responsive and better positioned to build the long-term trust that effective public health requires.
Health area | Why young people's engagement matters |
|---|---|
Mental health | Services co-designed with young people show higher uptake and sustained impact. |
Healthy Lifestyles | Adolescence is a critical window. Behaviour-change interventions co-designed with young people show significantly higher uptake than those designed without them. |
Immunisation | Vaccine confidence is shaped by a range of factors, including peer networks. Youth engagement is a priority strategy for addressing hesitancy and expanding uptake in adolescent cohorts. |
Early Childhood Development | Young people — as older siblings, peer role models and future parents — can play an influential role in early childhood environments, offering insight into the gaps young families face. |
The EU and international policy case
Engaging young people in health policy is both good practice and a commitment under EU and international frameworks. The table below sets out the key frameworks and what they require — providing both the mandate and the legitimacy for action at national and regional level.
Framework | What it requires for health policy |
|---|---|
UNCRC — Article 12 | Establishes the right of every child to be heard in all matters affecting them — including health policy and service design — as a legal obligation for all state parties. |
EU Youth Strategy 2019–2027 | Sets 'engage' and 'connect' as cross-cutting priorities across all EU policy areas including health, calling on Member States to create meaningful opportunities for youth participation. |
Council of Europe Youth Sector Strategy 2030 | Calls for co-management — genuine shared governance between young people and institutions — as the standard for youth participation in public policy. |
WHO — Global Accelerated Action for Adolescent Health (AA-HA!) | Requires youth participation as a condition of effective health programming and supports governments to develop national adolescent health strategies with young people. |
Our Common Agenda — Policy Brief 3 (UN, 2021) | Calls for institutionalisation of youth engagement in all policymaking processes, with dedicated mechanisms, resources and accountability. |
EU Strategy on the Rights of the Child | Situates child and adolescent participation within the EU's broader child rights framework, linking it to protection, non-discrimination and access to services. |
2. What Meaningful Engagement Looks Like
Article 12 of UNCRC establishes the child's right to be heard — to express their views on matters affecting them and have those views given due weight. Consultation is the natural starting point for putting this into practice in any engagement process: done well, it's a genuine act of governance, the first real opening for children and young people's voices to reach decision-makers.
But consultation is a starting point, not a destination. The goal is to build toward sustained partnership, in which children and young people are active contributors across the full health policy cycle, not only asked for their views at key moments, but involved in design, delivery and accountability.
From → | → To |
|---|---|
Ad-hoc, one-off consultations | Consultations as the start of a sustained partnership |
Developing policies for young people | Developing policies with young people |
Tokenistic engagement | Meaningful co-ownership across the policy cycle |
Engaging a few accessible, articulate voices | Actively reaching diverse and marginalised voices |
Young people as passive recipients | Young people as active partners and change-makers |
Not all participation is meaningful. Without careful design, engagement processes can be tokenistic, extractive or, in health-related contexts, harmful. Two complementary frameworks guide this roadmap: the Lundy Model as a quality test, and the Five Areas of Engagement as a planning menu. Both apply across all six stages, return to them when designing, running and evaluating any engagement process.
The Lundy Model: a quality test for participation
The Lundy Model of Participation, developed by Professor Laura Lundy, identifies four interconnected elements that must all be present for engagement to be genuine rather than tokenistic.
Young people are given safe, inclusive and appropriate opportunities to form and express their views — including those hardest to reach.
Young people express views in their own words, through their chosen media, without being co-opted or spoken for by adults.
Young people's views are heard by someone with the authority to act. Reaching only middle-level administrators — without decision-makers listening — fails this test.
Young people's views are taken seriously and acted upon. Where not possible, they are told why — clearly and promptly. This is the most omitted element.
Use the four elements as a design checklist before any engagement process begins and as an evaluation lens after it concludes. In health-related engagement, Influence is most frequently absent — young people's contributions are received but the feedback l
Five areas of meaningful engagement
The five areas below describe the different contributions children and young people can make to health policy, programmes and services when the conditions for meaningful engagement are in place. They are not a hierarchy: more than one area may be relevant in a single process, depending on the policy objective, health topic and intended outcome.
Together, they provide a practical planning menu, helping policymakers identify what contribution is needed from young people: sharing insights and lived experience; raising awareness and reducing stigma; expanding reach and access; co-creating and implementing solutions; or advocating for systems change. The Lundy Model and the participation standards apply across all five areas, ensuring that every form of engagement provides genuine space, voice, audience and influence.
Stage 4 (link) then helps translate the selected contribution(s) into an appropriate engagement mechanism and level of influence.
implement
change
- Dialogues & consultations
- Surveys & focus groups
- Lived experience evidence
- Peer-led education
- Destigmatisation campaigns
- Health literacy programmes
- Peer support networks
- Health navigators
- Community safe spaces
- Co-design of services
- Participate in delivery
- Youth advisory panels
- Policy advocacy
- Governance representation
- Hold institutions accountable
Share insights
Young people actively bring their lived experience, knowledge and perspectives into the spaces where health decisions are made — through structured dialogues, focus groups, surveys and consultations. They are contributors of evidence that professionals and institutions cannot generate alone. Insights shared here inform every other area of engagement.
Raise awareness and reduce stigma
Young people are uniquely placed to open conversations about health, normalise help-seeking, and reach communities that formal health systems struggle to access. In mental health: destigmatisation campaigns. In SRH: peer-led information on contraception and consent. In nutrition: youth food ambassadors. In immunisation: young vaccine champions countering misinformation.
Expand reach and access
Young people as health navigators, peer support providers, and facilitators of community safe spaces extend the effective reach of health systems into settings and relationships that institutions alone cannot access. In contexts where services are distant, stigmatised or unaffordable, young people's informal networks are often the primary route through which peers are connected to care.
Co-create and implement
Co-creation means young people working as genuine partners in designing, testing and refining health programmes — not being consulted after decisions have been made. Crucially, young people are also valuable in implementation: as peer educators, outreach workers, navigators or co-facilitators, they extend reach and ensure programmes remain responsive to the communities they serve.
Advocate and drive systems change
The most systemic contribution young people can make is driving institutional and policy change — sitting on health authority boards, participating in EU Youth Dialogues, taking co-management roles, and running campaigns that hold systems accountable. This is where young people move from contributing to existing structures to actively reshaping them.
A Ministry developing a mental health strategy may prioritise Share insights and Co-create. One running an immunisation campaign may prioritise Raise awareness and Expand access.
Stage 4 then helps teams decide how young people will be involved in making the intended contribution: whether they will be consulted on defined questions; work as equal partners to co-design solutions; hold formal roles in decision-making and governance; or help deliver interventions as peer educators. It also helps teams determine the appropriate level of influence in each case.
Stage 1
Secure Mandate and Readiness
Meaningful youth engagement in health policy requires an institutional mandate, named leadership, a budget, and a minimum level of staff capacity. This stage puts the foundations in place before engagement begins, so that what follows is durable, not dependent on individual goodwill.
Step 1.1
Establish political and institutional mandate
Why it matters
Youth engagement processes grounded in existing legal and policy obligations are more durable and easier to resource than those driven by individual initiative.
What to do
- Review your country's UNCRC ratification and how Article 12 (the right of children and young people to be heard and to have their views given due weight) plays out in practice for your health ministry.
- Map national youth strategies, health legislation and EU programme commitments that include child and youth participation requirements.
- Document gaps between formal commitments and current practice — this becomes the evidence base for a mandate to act.
- Identify a named champion at ministerial level with authority to require cross-departmental cooperation.
- Formalise this ownership through a mandate letter, strategic plan commitment or equivalent, it should not be dependent on personal initiative.
- Map existing budget lines and advocate for a dedicated line if none exists, using EU and international framework commitments as leverage.
- Designate a specific unit and named officer with day-to-day responsibility for youth engagement across all health portfolios.
- Conduct a rapid mapping of existing youth engagement mechanisms in your health system and in related sectors (education, environment, climate, youth affairs).
- If formal health-specific mechanisms do not yet exist, look to practice in other ministries (youth affairs, education, social affairs, culture/sport, environment).
- Assess what can be built on, adapted or connected to, to avoid duplication and accelerate progress.
Questions to guide your work
Practical tool 1 — Readiness Assessment Checklist (Stage 1)
Use before moving from Stage 1 to Stage 2. For each item, mark: In place / In progress / Not yet started.
Readiness area | Status |
|---|---|
Legal and policy mandate identified | In place / In progress / Not yet started |
Senior champion named and mandate formalised | In place / In progress / Not yet started |
Budget line identified or secured | In place / In progress / Not yet started |
Lead unit and named officer designated | In place / In progress / Not yet started |
Safeguarding lead designated; referral pathways established | In place / In progress / Not yet started |
Staff training needs assessed and training planned | In place / In progress / Not yet started |
Step 1.2
Build minimum staff capacity
Why it matters
Staff who cannot facilitate meaningful participation with young people will default to tokenistic approaches even with good intentions. Building the right skills before engagement begins is an investment that protects the quality of everything that follows and signals to young people that the ministry takes the process seriously.
What to do
- Conduct a brief skills assessment across the team: knowledge of participatory methods, understanding of child and youth rights, experience working with young people in health contexts.
- Identify priority training gaps: participatory facilitation; child and youth rights; inclusive design for hard-to-reach groups; trauma-informed approaches for sensitive health topics.
- Build training into the planning timeline as a prerequisite for Stage 2 not as a parallel track to be completed alongside engagement.
- Before any engagement begins, designate a named adult with safeguarding responsibility, trained in relevant protocols and known to all staff and young participants.
- Establish referral pathways for health-related disclosures before they are needed.
- See the Standards section for the full safeguarding framework and checklist.
Questions to guide your work
Stage 2
Understand the National Context
Good engagement starts with understanding who young people are in your context — their health needs, their diversity, the barriers they face to participation, and what structures already exist to involve them. In many countries, this picture varies significantly between regions: where regional authorities hold strong autonomy over health planning and service delivery, a regional analysis is equally needed alongside the national one. Without this grounding at both levels, engagement risks missing the groups with the greatest needs and the least voice.
Step 2.1
Map children’s and young people's health landscape
Why it matters
Engagement grounded in an understanding of children’s and young people's actual health situation is more relevant, more equitable, and easier to justify to decision-makers. This mapping also defines the priority areas for engagement in subsequent Stages and identifies the data gaps that young people themselves are best placed to fill.
What to do
- Compile available data on health issues most affecting children and young people: mental health and psychosocial wellbeing, SRH, nutrition, immunisation, substance use, digital health, access to care.
- Look at trends over time: is the situation improving or deteriorating, and for whom?
- Disaggregate: by gender, age, socioeconomic status, disability, sexual orientation, migration status and geography to identify which groups carry the greatest burden and face the greatest barriers.
- Identify data gaps: these point to groups whose health needs are invisible to existing surveillance systems, and define priority areas for engagement.
- Map all existing mechanisms through which children and young people are engaged in health policy - advisory panels, youth health councils, national youth councils, peer programmes, and mechanisms in related sectors.
- Pay particular attention to national youth councils and established youth bodies that already play roles in health promotion and prevention, these are potential partners.
- Apply the nine basic requirements (see Standards section) to each existing mechanism to assess quality honestly: where is current practice meaningful and where is it tokenistic?
Questions to guide your work
Step 2.2
Map your stakeholders and partners
Why it matters
Effective youth engagement in health requires strong partnerships. Civil society organisations, youth networks and dedicated youth representation bodies often have the legitimacy, trust and reach to engage young people that health institutions lack, particularly for reaching marginalised groups. Mapping this landscape early prevents coordination failures and identifies the partners without whom meaningful engagement cannot happen.
What to do
- Identify all relevant stakeholders: health ministry units, regional health authorities, ministries and dedicated government bodies responsible for youth affairs, education and social service ministries, youth-serving civil society organisations, young people's own networks and associations.
- Map their roles, mandates, geographic reach and existing relationships with different groups of young people.
- Identify overlaps, gaps and potential conflicts and opportunities for better coordination.
- Map which organisations have the trust and legitimacy to engage the young people that health institutions cannot easily access: migrant and refugee youth organisations, disability networks, organisations working in rural or deprived areas, LGBTIQ+ youth groups.
- Clarify roles before engagement begins: who will lead, who will co-facilitate, who will connect to specific communities of young people.
- Resource partnerships adequately, partners cannot be expected to provide access to their communities without institutional investment.
Questions to guide your work
Stage 3
Co-design Engagement
This is where policymakers and young people begin working together - not to produce outputs immediately, but to co-design the engagement process itself. Young people who help shape the process are more likely to engage meaningfully in it, and less likely to feel used by it. Co-design is also a quality signal: it communicates that the ministry regards young people as genuine partners.
Step 3.1
Define purpose, scope and timeline
Why it matters
Clarity about what is open to young people's influence — and what is not — protects all parties. It ensures young people know what they are contributing to, enables the ministry to choose the right mechanisms and evaluate outcomes, and builds the trust that makes sustained engagement possible.
What to do
- Identify specifically which health policy decisions, programme designs or service improvements the engagement will inform.
- Map the decision-making timeline: when do engagement outputs need to be available to have a genuine chance of influencing the outcome?
- Draft a clear, accessible statement of purpose to share with young participants at the outset — including what is and is not open to change. Young people should never be asked to contribute to decisions that have already been made.
- Agree and communicate the feedback mechanism before engagement begins: how and when will participants be told what happened to their input? This is the Lundy Model's Influence element — the most frequently absent.
- If constraints exist — legal, budgetary or political — name them honestly upfront. Young people respect honesty; they do not respect being managed.
- Set a realistic timeline that allows genuine co-design and participant preparation — not just the extraction of opinions at the last moment.
- Build in preparation time for young participants (briefing materials, preparatory sessions, questions in advance — so they can contribute meaningfully rather than reactively).
- Identify the decision points where engagement outputs will be formally presented, discussed and responded to.
- Communicate the timeline clearly to all participants from the start, including when and how they will receive feedback.
Questions to guide your work
Step 3.2
Co-design with young people
Why it matters
Engagement designed entirely by adults reflects adult assumptions about what young people want to say and how they want to say it. Involving a small group of young people in designing the process is not an extra step - it is what transforms consultation into genuine partnership.
What to do
- Identify a small (6–12), diverse group of young people to help shape the methods, questions, formats, recruitment strategy and feedback mechanism — compensating their time.
- Ensure this group reflects the diversity of the wider participant group — not just the most articulate or easily accessible young people.
- Share the purpose and constraints openly; ask what would make them want to participate, what would put them off, and who is likely to be missing.
- For each target group, identify specific barriers to participation and concrete steps to address them — including adapting formats, language, timing and location.
- Children with disabilities: accessible formats and venues, additional time, trusted support persons. LGBTIQ+ young people: never require disclosure, test safe spaces with the group. Young people from marginalised communities: plan for outreach, accompaniment and follow-up.
- Designate the safeguarding lead from Stage 1 as the responsible person for this process; establish referral pathways before engagement begins.
Note: The co-design group is not the consultation itself. Young people who help design the process are not substitutes for the wider group who will participate in it. Co-designers shape the how; the wider process addresses the what.
Questions to guide your work
Stage 4
Select and Run Engagement Mechanisms
With the groundwork in place, this stage focuses on choosing the right engagement mechanisms and running them well. The goal is participation that is genuinely useful — producing insights that feed into health policy decisions and building relationships with young people that last beyond a single event.
Step 4.1
Choose the right mechanism
Why it matters
There is no single correct mechanism for youth engagement in health policy. The right choice depends on the policy moment, the health topic, the depth of engagement sought and available resources. Use the engagement spectrum below to select the appropriate level.
Use the engagement spectrum to identify the appropriate level:
Young people share views on defined questions. Time-limited. Used when decisions are at an early or review stage and young people's perspectives are needed to inform options.
Young people work as partners in designing programmes, services or policy options over weeks or months. Used when the approach is genuinely open and contributions can shape the design.
Young people hold formal roles in governance structures: advisory bodies, health boards, policy committees. Used when the aim is sustained institutional influence.
Young people participate in delivering health interventions - as peer educators, outreach workers, navigators or co-facilitators - extending reach and ensuring responsiveness.
Section 2 of this roadmap introduced the five areas of meaningful engagement, describing what young people actively do and contribute when the conditions for genuine participation are in place. Stage 4 now asks a different but related question: not just what young people contribute, but how deeply and in what form.
The engagement spectrum describes the depth and institutional form of the engagement process.
The planning matrix below brings both frameworks together. Read it in either direction:
- By row (five areas): 'We want young people to help raise awareness: how deep should we go, and what does that look like at each level?'
- By column (spectrum level): 'We are planning a consultation: across which of the five areas can we generate the most value?'
01
Focus groups, surveys and structured dialogues on defined health questions — producing evidence decision-makers cannot generate alone.
Young people help design the questions, methods and analysis — shaping what evidence is collected and how it is interpreted.
Young people sit on advisory bodies that feed evidence directly into governance decisions, with authority to influence what gets actioned.
Young people gather peer evidence continuously through outreach, community research and lived experience monitoring.
02
Young people consulted on communication campaigns before launch — testing messages, tone and channels for relevance and acceptability.
Young people co-create campaigns — developing the messaging, format, visual identity and distribution strategy alongside professionals.
Young people lead the communications strategy and hold institutions accountable for whether campaigns reach their intended audiences.
Young people deliver peer education, animate communities, run counter-misinformation campaigns and networks.
03
Young people consulted on barriers to service access — identifying where services fail, who is not reached, and why.
Young people co-design low-threshold services, referral pathways and outreach models — building the solutions alongside health professionals.
Young people on service governance bodies shape access policy — influencing decisions on opening hours, location, cost and format.
Young people work as health navigators, peer supporters and community connectors — bringing services to those who would otherwise not reach them.
04
Young people consulted on programme design options — feeding in lived experience before the design is finalised.
Young people work as genuine partners across the full design cycle — from needs assessment through prototyping, testing and iteration.
Young people hold decision-making roles in programme governance — approving designs, reviewing outcomes and redirecting resources.
Young people deliver programmes as peer educators, co-facilitators and outreach workers — extending reach and keeping programmes responsive.
05
Young people consulted on policy proposals — providing perspectives that challenge assumptions and surface blind spots.
Young people co-author policy recommendations — contributing to the analysis, the options and the proposed solutions.
Young people hold formal governance roles: health boards, official delegations, co-management structures, EU Youth Dialogue.
Young people run advocacy campaigns, mobilise communities and hold systems publicly accountable for commitments made.
Questions to guide your work
Step 4.2
Support young people in sustained engagement roles
Why it matters
Advisory panel members, peer educators, youth health advocates and co-governance representatives are ongoing partners — not occasional consultees. They invest time, expertise and often sensitive personal experience in the work. Without adequate support, sustained engagement is extractive: it depletes young people without giving back.
What to do
- Brief young people on the health policy context, how decisions are made, their specific role, and who to contact with questions or concerns. Allow time for questions before the role formally begins.
- Build in regular check-ins and peer support structures; ensure access to professional support where engagement involves sensitive health topics — sustained exposure to accounts of mental health difficulties or trauma can affect young people's own wellbeing.
- Manage workloads realistically — do not let institutional urgency create unsustainable demands on young people's time.
- Young people's time, expertise and lived experience have value. Develop a clear compensation policy - financial, in-kind or formal accreditation - before sustained engagement begins (see Standard section on Recognition and compensation).
- Compensation also signals institutional respect and makes participation accessible to those without the economic privilege to engage for free.
- Apply the policy consistently across all forms of sustained engagement: co-design groups, advisory panels and peer education roles.
Questions to guide your work
Stage 5
Institutionalise, Resource and Build Capacity
Individual consultations and participation events are not enough. Meaningful engagement becomes sustainable only when embedded in laws, budgets, governance structures, workforce skills and young people's own capacity — moving from project to system.
Step 5.1
Embed in legislation, policy and budgets
Why it matters
Mechanisms that depend on individual champions or project funding are fragile. A change of minister, a budget cut, or a shift in institutional priorities can dismantle years of relationship-building overnight. Legal and budgetary entrenchment creates durability: it transforms youth engagement from a discretionary programme into a systemic requirement of health governance.
What to do
- Identify opportunities to include youth participation requirements in national health legislation, health strategy frameworks and programme funding criteria.
- Use EU and international framework commitments — mapped in Stage 1 — as leverage for domestic legislative advocacy.
- Work with legal advisers to identify the most effective instrument for your national context: primary legislation, secondary regulation, ministerial decree or strategy commitment.
- Advocate for dedicated budget lines for youth engagement across health governance portfolios — not just within project funding cycles.
- Ensure budget covers the full cost of meaningful engagement: facilitation, participant compensation, accessible formats, safeguarding, follow-up and evaluation.
- Connect national action to EU-level mechanisms including the EU Youth Dialogue, European Child Guarantee and WHO European regional monitoring.
Questions to guide your work
Step 5.2
Build adult capacity and create sustained platforms
Why it matters
Staff across health, education and social services who lack participatory facilitation skills will produce tokenistic engagement even when processes are well designed on paper. And platforms without genuine governance influence produce engagement that is advisory in name only. Both capacity and platform quality need sustained investment.
What to do
- Map training needs across all staff groups: health ministry officials, frontline practitioners, youth workers, community health leaders and civil society partners.
- Integrate participatory methods and youth rights into pre-service and in-service training for health professionals — building institutional self-sufficiency over time rather than relying on external facilitators.
- Work to shift how health professionals perceive young people — from passive recipients of services to legitimate partners in governance. Leadership modelling by senior officials is the most powerful signal.
- Create or strengthen formal platforms: national youth health advisory bodies, regional youth councils, sub-national consultation mechanisms, digital participation spaces.
- Where national youth councils or youth sector bodies already exist, work with them rather than creating parallel structures - connect, resource and build on what works.
- Ensure platforms report to decision-makers with authority to act. A youth advisory body reporting to communications has no influence.
- Invest in young people's health literacy and advocacy skills, ensuring marginalised groups are included. Resist disbanding platforms with each new policy cycle - institutional knowledge and trust take years to build.
Questions to guide your work
Stage 6
Monitor, Report and Improve
Without monitoring it is impossible to know whether engagement is meaningful, reaching those with the greatest needs, or influencing the policies it is meant to shape. Monitoring is also where the accountability loop with young people is closed — making engagement a genuine dialogue.
Step 6.1
Define what to measure and how
Why it matters
Meaningful monitoring goes beyond counting attendees, it captures the quality and influence of engagement. This allows ministries to demonstrate the value of engagement and continuously strengthen it.
What to do
- Reach: who participated, across which health areas, at which governance levels, from which population groups? Who was not reached?
- Quality: did processes meet the nine basic requirements? Use the post-process checklist (see Standards section) as your quality measurement tool.
- Influence: what specifically changed as a result of engagement? Which policy decisions, programme designs or service improvements were shaped by young people's input?
- Equity: were young people with the greatest health needs and the least institutional voice the ones most actively reached — or did engagement default to the most accessible?
- After each process, assess against the four elements: Did young people have genuine Space? Was their Voice supported? Did it reach an Audience with authority? Did it produce Influence?
- Ask young people to rate each element — their assessment of whether Influence was delivered is the most important data point.
- Track disaggregated data by gender, age, health area, geography and disability status.
Questions to guide your work
Step 6.2
Close the loop and feed learning back
Why it matters
Young people who contribute time and personal experience to a consultation, and then never hear what happened to their input, learn that their participation does not matter. Closing the accountability loop — telling young people specifically what changed — is one of the highest-value actions a ministry can take.
What to do
- Within a defined, communicated timeframe, report back specifically: 'Your recommendation on clinic opening hours was adopted' is feedback. 'Your input was valuable' is not.
- Where contributions could not be incorporated, explain why clearly and honestly. Young people respect honesty.
- Share findings with participants before wider publication where possible, allowing them to verify accuracy and add missing context.
- Publish an annual or bi-annual youth engagement report: what processes ran, who participated, what young people said, what changed as a result. Make it accessible through youth networks.
- Submit the report to relevant EU and international monitoring processes as evidence of implementation.
- Under UNCRC Article 12 General Comment No. 12, informing young people of how their views were considered is part of the right to be heard - build it into every process from the start.
- Schedule a structured learning review at the end of each engagement cycle, involving both staff and young participants.
- Use findings to adjust methods, outreach strategies and platform design — and communicate what changed, and why, to current and past participants.
- Share learning with peer ministries, civil society partners and EU and international bodies. Contribute to the regional evidence base on meaningful youth engagement in health.
Questions to guide your work
Practical Tool - Monitoring and Accountability
Template Complete at the end of each engagement cycle.
Monitoring dimension | Record |
|---|---|
Reach — who participated (disaggregated by gender, age, health area, group) | |
Quality — nine requirements assessment (use Tool 2) | Overall rating + key gaps identified |
Influence — what specifically changed as a result of engagement? | Policy decision / programme change / service improvement |
Equity — which groups were not reached, and why? | Gaps identified + action for next cycle |
Accountability — feedback provided to participants | Date, format, specific content of feedback given |
Standards:
Safe, Inclusive and Quality Participation
The standards in this section apply across every stage and every engagement process — from a single consultation event to a sustained youth advisory panel. They are the quality floor: use them to design processes before they begin and to evaluate quality after they are complete.
The Nine Basic Requirements
UNICEF's Engaged and Heard! guidelines, drawing on UNCRC General Comment No. 12, identify nine basic requirements that every participation process must meet — equally applicable to a one-off consultation, a co-design process or a peer education programme.
1
Transparent & informative
Young people receive full, accessible information about the process, its purpose and how their input will be used — in appropriate formats and languages.
2
Voluntary Participation is never coerced
Young people can withdraw at any stage without consequence, and are told this from the outset.
3
Respectful
Young people's views are treated seriously and with dignity. They have genuine opportunities to initiate ideas, not only to respond to adult agendas.
4
Relevant
Young people engage on issues that genuinely affect their lives and can draw on their real knowledge, skills and experience.
5
Youth-friendly
Adequate time and age-appropriate formats ensure all participants feel confident, prepared and able to contribute effectively.
6
Inclusive
Active steps are taken to reach marginalised young people and avoid reinforcing existing patterns of exclusion — by gender, disability, sexual orientation, socioeconomic status and other factors.
7
Supported by training
Adults facilitating engagement have the skills to listen, share power effectively and work ethically with young people on sensitive health topics.
8
Safe & sensitive to risk
Potential risks — physical, emotional, reputational — are assessed and mitigated before the process begins, especially on health topics involving stigma or possible disclosure.
9
Accountable
Young people receive clear, specific feedback on how their participation influenced decisions. Follow-up mechanisms are built in from the start, not added as an afterthought.
Before any engagement process, use the nine requirements as a planning checklist: has each been designed in? After the process, use them as an evaluation framework — asking both participants and facilitators to rate each one. In health-related engagement, requirements 3 (Respectful), 5 (Youth-friendly), 8 (Safe and sensitive to risk) and 9 (Accountable) deserve particular attention.
Practical Tool — Nine Requirements Planning & Evaluation Grid
Use before each engagement process (planning) and after (evaluation). Rate each requirement: Met / Partially met / Not met.
Requirement | Planning: is this designed in? | Evaluation: was this delivered? |
|---|---|---|
1. Transparent & informative | ||
2. Voluntary | ||
3. Respectful | ||
4. Relevant | ||
5. Youth-friendly | ||
6. Inclusive | ||
7. Supported by training | ||
8. Safe & sensitive to risk | ||
9. Accountable |
Safeguarding
Good safeguarding practice creates the conditions in which young people can participate safely, confidently and honestly - especially in health contexts where consultations on topics such as mental health, SRH, substance use or experiences of marginalisation may prompt disclosures, trigger distress or create risks of stigma.
Core safeguarding principles
Begin every process with an explicit risk assessment covering physical, psychological, social and reputational risks to participants — not only institutional risks. Adjust the design accordingly.
Participants must understand what they are agreeing to, including how their data and contributions will be used, stored and shared. For under-18s, parental or guardian consent is required alongside the young person's own assent.
No young person should feel pressured to participate, disclose personal information, or continue in a process that makes them uncomfortable. Opt-out must be genuinely available and clearly communicated from the start.
Every process must have a named, trained adult known to all participants, with clear referral pathways to professional support established before engagement begins.
Young people's personal information must be handled in accordance with applicable data protection law and never shared without explicit consent.
After an event or consultation
Safeguarding does not end when the event concludes. Debrief with facilitators and, where appropriate, with participants. Ensure that any disclosures or concerns identified during the process are followed up through the relevant referral pathway. Evaluate the process specifically for safeguarding quality and document lessons for future events.
Practical Tool — Safeguarding Checklist
Complete before every engagement process. All items should be in place before the process begins.
Safeguarding requirement | In place? |
|---|---|
Risk assessment completed (physical, psychological, social, reputational) | Yes / No / N/A |
Informed consent process designed and tested | Yes / No / N/A |
Voluntary participation clearly communicated to all participants | Yes / No / N/A |
Named safeguarding lead designated and known to participants | Yes / No / N/A |
Referral pathways for health-related disclosures established | Yes / No / N/A |
Data protection plan in place | Yes / No / N/A |
Wellbeing of Young Participants
Participation in health policy work can be demanding and, without adequate support, harmful, especially when young people draw on sensitive personal experience. Actively supporting wellbeing is what makes sustained, high-quality engagement possible over time.
Wellbeing as an enabling condition
- Assess the emotional and psychological demands of the process before it begins and adjust the design accordingly.
- Provide briefing materials in advance, including whether potentially sensitive or distressing content will be discussed.
- Build in breaks, debrief time and access to support within events and consultation processes.
- Ensure young people in ongoing roles have access to regular check-ins, peer support and professional supervision where needed.
- Take a trauma-informed approach in all health-related engagement, recognising that for some participants the topic itself may be a source of ongoing distress.
Young activists and sustained advocacy roles
Young people engaged in sustained advocacy on health issues — particularly mental health, SRH and nutrition — are at heightened risk of burnout, vicarious trauma and targeted harassment. Organisations have a responsibility to invest in their resilience and recovery, not only their effectiveness: realistic workloads, peer support structures, access to professional support, and explicit recognition that young people's wellbeing comes first.
Recognition and compensation
Young people's time, expertise and lived experience have value. A clear, consistent compensation policy — financial, in-kind or through formal accreditation — should be in place before any sustained engagement begins. Inadequate compensation replicates social inequities and excludes those without economic privilege to participate for free.
Practical Tool — Wellbeing and Compensation Guide
Use when onboarding young people into sustained engagement roles. Review at regular check-ins.
Area | Questions to assess |
|---|---|
Emotional demands | Have we assessed the emotional weight of this role? Are there topics that may cause personal distress? |
Support structures | Does this person have access to peer support, regular check-ins and professional supervision if needed? |
Workload | Is the time commitment realistic? Have we protected against scope creep driven by institutional urgency? |
Compensation | Is there a clear, agreed compensation arrangement — financial, in-kind or formal accreditation? |
Exit pathway | Does this person know how to step back or leave the role without pressure or consequence? |