This project will examine these pressing, and largely unmet, adolescent health demands in Niger, Burkina Faso, and Ghana. Using participatory approaches, the project will co-design activities and interventions with adolescents, communities, and front-line health providers to enable gender-transformative and responsive health systems at the primary care level. This involves exploring the values, norms, power, practices, and perspectives of different groups in planning, delivering, and accessing these services; examining how this influences adolescent girls’ agency; and addressing connections between mental health and sexual and reproductive health for adolescents. Expected results of this project aim to improve the quality of health services for adolescents, enhance relationships, norms, and power dynamics within the community, and influence policy and structural changes for enhanced adolescent sexual, reproductive, and mental health.