Sexual and reproductive health and rights of very young adolescents in low- and middle-income countries: A narrative review.

BACKGROUND: Very young adolescents (VYAs), aged 10 - 14 years, represent a critical yet frequently neglected demographic in the field of sexual and reproductive health and rights (SRHR) research and programming. This developmental stage is characterised by rapid biological, cognitive, social and emotional changes that shape future sexual and reproductive trajectories. Despite their importance, the SRHR needs of VYAs remain under-represented in policy, research and service provision, particularly in low- and middle-income countries. OBJECTIVES: To synthesise existing evidence on the SRHR needs of VYAs, examine barriers and facilitators to service access, and identify strategies to strengthen age-appropriate SRHR interventions. METHODS: A narrative review of English-language peer-reviewed literature, grey literature and global policy documents published between 2000 and 2024 was conducted using PubMed, Scopus and Google Scholar. Twenty-three relevant sources were included and synthesised thematically. RESULTS: VYAs experience intersecting vulnerabilities related to early pubertal onset, restrictive gender norms, limited access to accurate SRHR information, and health systems that are primarily oriented towards older adolescents and adults. Barriers to SRHR information and services were reported in approximately half of the reviewed sources. Evidence indicates that early, context-specific interventions - particularly comprehensive sexuality education, parental engagement and adolescent-responsive health services - can improve SRHR knowledge and protective behaviours. CONCLUSION: Addressing the SRHR needs of VYAs is essential for advancing public health equity and broader development goals. Integrating tailored, rights-based approaches across health, education and policy frameworks can support healthier transitions through early adolescence.