Toolkit for Improving Family Planning Services in School Settings

Access to high-quality and comprehensive family planning services helps promote adolescent sexual and reproductive health. However, youth—especially those who are historically excluded or who live in resource-limited areas—face challenges in accessing services, including lack of awareness about those services, fears about confidentiality, or lack of adolescent-friendly or culturally sensitive practices in clinics. One promising approach to meeting youth’s needs is to provide family planning services in school-based settings, where youth spend most of their time.  

This toolkit has two sections to support family planning providers and administrators in designing and delivering high-quality family planning care and programming to youth in school-based settings: 

Foundational Approaches for Providing Family Planning to Adolescents:

Describes four approaches that are integral to providing effective family planning care to youth. Each foundational approach includes real-life examples based on interviews with providers, along with useful resources to help readers integrate these approaches into their own work. 

Case Studies on Innovative Family Planning Service Delivery Strategies:

Explores four programs and clinics across the United States that are using innovative approaches to improve family planning service delivery in school-based settings. Each case study describes a program in-depth and includes recommendations and resources for readers interested in implementing a similar approach(es) in their own setting.

Research behind the toolkit

This toolkit was developed by Child Trends in partnership with the School-Based Health Alliance, with funding from the Office of Population Affairs. The project team conducted 48 interviews with family planning providers and administrators across the United States to identify innovative and successful strategies for providing family planning and sexual health services for youth. Based on our findings, we identified four foundational approaches that are critical in providing high-quality and effective care: 1) embedding equity, 2) prioritizing adolescent-friendly care, 3) maximizing outreach and access, and 4) leveraging partnerships. Through a rigorous site selection process, we identified four sites to conduct in-depth process evaluations to learn more about their promising strategies. In total, we conducted interviews with 37 participants across the four sites. For detailed information on the study background, full study sample, and methodology, see the Methods page.

The research team

Jennifer Manlove and Jenita Parekh, co-PIs for this project, advised the team on data collection, analysis, and writing and contributed to conceptualization and writing. Elizabeth Cook, Zabryna Balén, and Anushree Bhatia served as project managers and monitored and coordinated multiple components of the study project. The study team (listed in alphabetical order by last name) conducted data collection and analysis and authored different portions of this toolkit: Zabryna Balén, Samantha Ciaravino, Elizabeth Cook, Isabel Griffith, Lisa Kim, Hannah Lantos, Ria Shelton, and Andrea Vazzano. We also partnered with the School-Based Health Alliance—including Katherine Cushing, Andrea Shore, Donnie Greco, Suzanne Mackey, Emily Baldi, and Erin Sullivan—who provided valuable expertise throughout the course of the project and supported data collection and the presentation of findings.

If you would like to contact the research team, please email Jenita Parekh and Jennifer Manlove.


First and foremost, we are deeply grateful to the family planning providers and administrators who offered their time and critical perspectives to this research. The project team also extends their gratitude to the Office of Population Affairs for supporting this research, with special appreciation for our project officer, Callie Koesters, for her leadership. We also thank the School-Based Health Alliance for their partnership on the project, especially Andrea Shore and Katherine Cushing for their input and review of the toolkit. Additionally, we are grateful to members of our advisory group—Jamie Bardwell, Anna Bernstein, Amy Blackshaw, Melanie Bonjour, Vera Borkowski, Ana Caskin, Ashley Coram, Lindsey Reichlin Cruse, Suzanne Mackey, Kay McLean-Grant, Sabrina Owens, Loral Patchen, Baila Salifou, and Samira Soleimanpour—who provided valuable insights throughout the course of the project. Finally, this toolkit would not have been possible without the assistance of many colleagues at Child Trends: Huda Tauseef, Hannah Barnett, Sydney Briggs, Opiaah Jeffers, Sam Hanft, Elizabeth Wildsmith, Brent Franklin, Catherine Nichols, Lee Woods, Jody Franklin, and Stephen Russ.


This publication is supported by the Office of Population Affairs (OPA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $2,036,999 with 100 percent funded by OPA/OASH/HHS. The contents reflect the views of the authors and do not necessarily represent the official views of, nor an endorsement by, OPA/OASH/HHS, or the U.S. Government. For more information, please visit

Suggested citation

Child Trends. (2022). Toolkit for improving family planning services in school settings.