What does it actually mean to meaningfully engage young people in the decisions that affect their health and their lives?
We use the word “engage” until it loses meaning. We encourage people to be informed, vote, volunteer, speak up. But what are we really asking them to participate in?
A meeting? A consultation? A survey? These are ways of taking part, but not the same as being
meaningfully engaged in the place where you live. Knowing what is happening around you, understanding how decisions are made and recognising that the direction of your country is not simply someone else’s concern, that is something deeper.
But that possibility has never been equally available to everyone.
For us in the Caribbean, that question carries a particular history. For generations, decisions about Caribbean societies were made by people who did not consider those living here equal participants in determining their own affairs. Colonialism was not only about political authority. It was about whose knowledge was considered legitimate, whose voices were respected, who was expected to follow rather than decide.
Independence changed the formal structure of authority. It could not, by itself, teach people what it meant to become responsible for their own affairs. Questions about whose voices are heard, whose knowledge counts and who gets to participate in shaping decisions remain relevant today, including in health.
Within this context, the Healthy Caribbean Coalition (HCC), with support from the Commonwealth Foundation, undertook Caribbean Youth Voices, Healthy Caribbean Futures, an initiative to strengthen meaningful engagement of young people, including those living with non-communicable diseases (NCDs), in health decision-making across CARICOM.
The project responded to a regional reality: opportunities for youth participation in health decision-making remain limited. Unequal access to information, unfamiliarity with policymaking processes and few entry points can further constrain participation.
So the project began by listening. HCC undertook stakeholder interviews, youth consultations and a literature review to understand what meaningful engagement looks like in practice, the barriers that prevent it and what young people and those they engage with need to participate effectively. Young people, advocates, people living with NCDs, civil society and policymakers from 12 countries across the Caribbean took part.
Those perspectives became the foundation for the Guidance on Meaningful Engagement of Youth, Including Young People Living with NCDs in Health Decision-Making across CARICOM, launched in July 2026. It offers a shared understanding of meaningful engagement, examines the barriers to it and the conditions that enable it, and provides practical tools to help decision-makers assess their readiness and the different ways young people can participate, from consultation through to leadership.
But a shared understanding is only one part of meaningful engagement. If young people are expected to participate in decision-making spaces, they also need opportunities to understand how those spaces work, develop relevant skills and build the confidence to advocate for the issues that matter to them.
This became the focus of the Caribbean Youth Voices Handbook and training activities. Created with young people, the Handbook helps them navigate decision-making spaces with greater clarity. In April, workshops were held in Barbados and Saint Lucia, followed by a regional virtual training in May. Participants strengthened skills in advocacy, leadership, storytelling, communications and health-policy engagement while building regional connections.
The next question was what would happen when those young people entered actual decision-making spaces. Trained youth engaged with NCD commissions, health, youth and education ministries, bringing their experiences and perspectives into conversations with those involved in decision-making. The project also created opportunities for young people, youth allies and regional partners to build a shared understanding of what meaningful engagement requires through intergenerational dialogue and sensitisation.
Young people took on active roles in regional conversations, in social media advocacy and through the Caribbean Youth Voices: Art for Action competition, sharing their perspectives on youth leadership and meaningful participation. The competition’s theme, “Nothing For Us Without Us,” captured the wider principle: young people should not simply be included in decisions affecting their health and wellbeing, but help shape them.
Taken together, these experiences revealed that meaningful engagement cannot be reduced to a single consultation, training session or youth representative at a table. It is a process that demands listening, preparation, opportunity, relationships and accountability.
Young people can build their confidence, knowledge and advocacy skills. But that preparation only matters if the spaces they enter are willing to meet them halfway. Those they engage with have a role in sharing information, being clear about what is open to influence, recognising different forms of knowledge and showing what happened as a result.
The question, then, is not whether young people have a voice. They do. The question is whether the spaces where decisions are made are prepared to recognise the knowledge they bring, take their participation seriously and allow it to shape what happens next.
That is what Caribbean Youth Voices set out to explore: not simply how to invite young people into the room, but what it takes for their presence there to be meaningful.
About the author
Jenée Farrell is a public health consultant and Advocacy Officer at the Healthy Caribbean Coalition (HCC). As a project consultant on HCC’s Caribbean Youth Voices project, she was the primary author of the Guidance on Meaningful Engagement of Youth in Health Decision-Making across CARICOM and led the development of its companion Caribbean Youth Voices Handbook.
