The question of how to embed young people meaningfully into the health and policy decisions that shape their daily lives is one that has long been discussed in vague terms. The word ‘engagement’ has been overused to the point of becoming hollow—applied to everything from town hall meetings to online surveys, without stopping to ask whether these structures actually give young people agency over the outcomes that affect them. True engagement runs deeper than token participation: it requires young people to understand local decision-making processes, be aware of ongoing developments in their communities, and recognize that the future of their nations is not a responsibility reserved exclusively for older political leaders. But across many regions, and particularly in the Caribbean, this transformative form of engagement has never been equally accessible to all young people.
For Caribbean communities, the struggle for meaningful youth participation is rooted in a colonial history that shaped power dynamics still felt today. For centuries, decisions about Caribbean societies were made by outside colonial powers that did not view local populations as equal partners in governing their own affairs. Colonialism did not only seize political control—it also dictated whose knowledge was deemed valid, whose voices deserved to be heard, and who was expected to follow orders rather than lead. While formal independence dismantled the overt structures of colonial authority, it could not erase these deep-seated cultural and institutional norms on its own. Even today, the question of which voices get to shape public policy—including critical health policy—remains an unresolved challenge.
Against this historical backdrop, the Healthy Caribbean Coalition (HCC), with funding and support from the Commonwealth Foundation, launched a groundbreaking regional initiative: Caribbean Youth Voices, Healthy Caribbean Futures. The project was designed to expand meaningful youth engagement in health decision-making across all CARICOM nations, with a specific focus on including young people living with non-communicable diseases (NCDs), who are often sidelined from policy conversations that directly impact their care and quality of life.
The initiative grew out of a well-documented regional reality: opportunities for youth to contribute to health policy remain extremely limited. Systemic barriers including unequal access to public health information, widespread unfamiliarity with how policymaking processes actually work, and a lack of accessible entry points for young people all combine to suppress participation. To address this, the project started not with pre-written guidelines, but with intentional listening. HCC teams conducted in-depth stakeholder interviews, regional youth consultations, and a comprehensive review of existing literature to map what meaningful engagement actually looks like in Caribbean contexts, identify the most persistent barriers, and understand what support young people and policymakers need to make participation work. Over 12 Caribbean nations, participants included young people, public health advocates, people living with NCDs, civil society representatives, and sitting policymakers.
The insights gathered through this listening process formed the foundation of the *Guidance on Meaningful Engagement of Youth, Including Young People Living with NCDs in Health Decision-Making across CARICOM*, which was officially launched in July 2026. The document establishes a shared regional definition of meaningful engagement, analyzes the structural and cultural barriers that prevent it, outlines the institutional conditions needed to enable inclusive participation, and provides practical, actionable tools for policymakers to assess their readiness for youth engagement and implement diverse participation models—from initial public consultation all the way to youth-led leadership of policy initiatives.
A shared framework for engagement is only the first step, however. For young people to contribute effectively to decision-making, they need targeted support to understand how policy spaces operate, build relevant professional and advocacy skills, and develop the confidence to speak up about the health issues that matter most to their communities. This need led to the development of the Caribbean Youth Voices Handbook and a series of regional training programs. Co-created with young people, the handbook serves as a clear, accessible guide to help young participants navigate often complex policy and decision-making spaces. In-person workshops were held in Barbados and Saint Lucia in April 2026, followed by a regional virtual training open to participants across CARICOM in May. Trainees built core skills in advocacy, leadership, storytelling, strategic communications, and health policy engagement, while also building cross-regional professional networks that will support collaboration long into the future.
With training completed, the initiative moved to the next critical phase: supporting young people to enter actual decision-making spaces and contribute to live policy conversations. Trained youth participants engaged directly with national NCD commissions, ministries of health, education, and youth affairs, bringing their lived experiences and on-the-ground perspectives to policy discussions. The project also facilitated intergenerational dialogue and sensitization workshops to help established policymakers and senior stakeholders build a shared understanding of what meaningful youth engagement requires, breaking down intergenerational barriers to collaboration.
Young participants took on active public roles across multiple platforms, from regional policy summits to social media advocacy campaigns. The initiative also hosted the Caribbean Youth Voices: Art for Action competition, which invited young creators to share their perspectives on youth leadership and meaningful participation through art. The competition’s core theme—*Nothing For Us Without Us*—encapsulates the central principle driving the entire project: young people should not be treated as afterthoughts in decisions that impact their health and wellbeing; they should be equal partners in shaping those decisions from start to finish.
The multi-year initiative has yielded key lessons that extend far beyond the Caribbean region. The project’s outcomes make clear that meaningful youth engagement cannot be reduced to a single token consultation, one-off training, or a single youth seat at a policy table. It is an ongoing, iterative process that requires consistent listening, targeted preparation, accessible opportunities, intentional relationship-building, and formal accountability mechanisms to ensure participation translates to actual impact.
Young people are more than capable of building the confidence, knowledge, and advocacy skills needed to contribute effectively—but their preparation means nothing if existing decision-making structures are unwilling to meet them halfway. Policymakers and institutional leaders have a core responsibility to proactively share information, be transparent about which policy areas are open to public input, center diverse forms of knowledge rooted in lived experience, and provide clear feedback on how youth participation has shaped final outcomes.
Looking ahead, the core question facing regional governments and public health institutions is not whether young people have valuable perspectives to share. They do. The real question is whether existing decision-making spaces are ready to recognize the unique expertise young people bring, take their participation seriously, and allow their input to shape future policy direction. That is the core question the Caribbean Youth Voices initiative set out to explore: it is not just about how to invite young people into the room, but about what it takes to make their presence in that room meaningful.
This article was written by Jenée Farrell, a public health consultant and Advocacy Officer at the Healthy Caribbean Coalition. As a project consultant for the Caribbean Youth Voices initiative, Farrell served as the primary author of the regional youth engagement guidance and led development of the companion Caribbean Youth Voices Handbook.