Dr Alex Awiti, Vice Provost of the Aga Khan University in Kenya, writes that Africa’s median age is estimated at 19.7 years and is projected to increase modestly to 24.8 years by 2050. Africa’s demographic surge is both a source of hope and despair. Reproductive health choices are unfailing predictors of critical outcomes for children, households, communities and nations. For example, infants born to adolescent mothers are likely to be born premature, face higher risk of dying, and face an inordinate risk of malnutrition. We must address the health service related factors that rob young women of their reproductive rights. These factors include lack of comprehensive sexuality education, misconception of contraception, lack of access to contraception services.