Young people, under the age of 30, living in informal settlements in Kenya face complex and challenging socio-cultural and economic environments. These increasingly include forced displacement, migration, unstable families, violence and mental health problems. Inequities, including those linked to poverty and gender, shape all aspects of adolescent health and wellbeing and these have been exacerbated by responses to the COVID-19 pandemic. Young people, as experts in their own lives, are uniquely positioned to provide solutions to their challenges; yet they often remain on the periphery of Kenya’s social, economic and political affairs. They are rarely included in community programming or their role is tokenised, which limits their potential. This chapter contends that a paradigm shift is required, to enable young people to design, implement and evaluate their own programmes. Using the example of a youth organisation in Kenya – Nzumari Africa – the chapter focuses on how youth leadership can create systemic shifts: mobilising young people to challenge the status quo as well as addressing the barriers to their wider participation.