**Background**
Access to quality reproductive health care is a fundamental human right, yet many adolescents face barriers such as stigma, lack of information, and weak health systems. In Sub-Saharan Africa, adolescent girls bear a disproportionate burden of HIV infections and pregnancy-related complications. In Kenya, about 24% of adolescent women aged 15–19 have an unmet need for family planning, and approximately 18% of teenage girls are either pregnant or mothers. The Kenyan government has implemented policies like the National Adolescent Sexual and Reproductive Health policy and distributes free male condoms, but implementation gaps remain. This study aimed to understand what adolescent high school girls in Kenya perceive as quality reproductive health care, using qualitative data from the *What Women Want* campaign.
**Methods**
This is a secondary analysis of qualitative data from a sub-sample of adolescent girls in Kenya who participated in the global *What Women Want* campaign (April 2018–March 2019). The campaign used a single open-ended question: "My one request for quality reproductive and maternal health care services is________?" Data were collected via convenience sampling in eight counties across western, central, eastern, and Rift Valley regions of Kenya. The analysis included 4,570 survey responses from high school girls aged 12–19 years, with 61.6% from all-girls boarding schools, 13.8% from mixed-day schools, and 24.6% not disclosing school type. Additionally, interview data from nine key informants (teachers, youth advocates, and mobilizers) were analyzed. Thematic content analysis was conducted using Atlas.ti 8 software, with initial codes from the parent study and iterative refinement by three investigators.
**Key Results**
Four overarching themes emerged:
1. **Improved Menstrual Health and Hygiene**: This was the most common request, including free sanitary towels, pain relief, clean toilets, water availability, proper disposal, extra skirts and underwear, and nutrition during menstruation. Girls from mixed-day schools particularly emphasized the need for extra skirts to avoid embarrassment from staining.
2. **Prevention of Adolescent Pregnancy**: Requests included access to contraception (condoms, pills), abstinence education, addressing female genital mutilation (FGM) and child marriage, and safe abortion care. Some girls condemned contraception as promoting immorality, while others saw it as essential.
3. **Respect and Dignity**: Adolescents wanted kind, non-abusive language from healthcare providers, privacy, and confidentiality. Negative past experiences with nurses made some girls reluctant to seek care.
4. **Addressing Social Determinants of Health**: Requests included improved transportation, roads, school fees, uniforms, food, economic empowerment, safe streets, lighting, and women's empowerment. These were especially prominent in semi-arid counties like Isiolo, Narok, and Elgeyo Marakwet.
**Clinical Implications**
The study demonstrates that adolescent girls' reproductive health needs extend beyond clinical services to include menstrual hygiene, respectful care, and social determinants. Interventions should adopt a multi-sectoral approach involving education, water and sanitation, economic empowerment, and infrastructure. Healthcare providers must be trained to offer respectful, confidential care to improve service utilization. Policymakers should integrate menstrual health into broader reproductive health programs and ensure policies address poverty, FGM, and transportation barriers. The findings support the need for targeted, context-specific interventions rather than one-size-fits-all approaches.