As with many of the determinants of adolescent pregnancy, long-term solutions must be multidimensional and address underlying problems, such as gender inequality, negative attitudes of boys and men towards girls, norms that perpetuate violence and impunity, poverty that compels girls to engage in sex as a survival strategy, and inadequate protection of human rights. Narrowly focused interventions are not enough, and efforts centred on changing a girl’s behaviour fail to reflect the multidimensional nature of the challenge. Keeping girls on healthy, safe and affirming life trajectories requires comprehensive, strategic, and targeted investments in adolescents that address the multiple sources of their vulnerabilities, which vary by age, income group, place of residence and many other factors.