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In 2005, the African Union (AU) developed a regional policy on sexual reproductive health (SRH) and rights aimed at improving member states' SRH delivery, the Maputo Plan of Action (MPoA). It initially ran from 2006 to 2015 and was then extended to 2016 to 2030. However, the MPoA's implementation has been slow and largely ineffective. This thesis explores the factors behind this ineffectiveness despite the apparent commitment to improving SRH delivery on the part of the AU member states as demonstrated by their collective development and adoption of the policy. The thesis addresses reproductive health policy from a social policy perspective and begins its investigation by exploring existing regionalism literature that provides insights into why regionally integrated social policies oftentimes fail. The thesis finds that existing literature highlights specific institutional structures and path dependencies as factors that undermine regionalism's efforts in social policy. In this thesis, I argue that these explanations, while relevant, offer only part of the story, because they do not consider the gendered character of regional organisations and the impact of this on policy formulation and implementation processes. I address this gap by exploring the role of gendered institutions in the design and delivery of regional social policies using the MPoA as a case study. To develop this analysis, I use Feminist Institutionalism (FI) to study the gendered factors behind the ineffectiveness of the MPoA. Overall, I argue that the design, development and implementation processes of the MPoA are shaped by the gendered institutions of its host organisation, the AU, which undermine its priority setting, strategy development and resource allocation processes by undervaluing and trivialising the needs of women and girls, contributing to weak delivery. These gendered institutions are indicated by the exclusion of women in the AU structure, gendered sharing of roles and responsibilities and unequal opportunities to participate and influence AU processes. The thesis therefore concludes that the MPoA fails to deliver on SRH for women and girls due to the underlying gendered institutions of the AU that shaped the policy and drives in implementation in gendered ways. More broadly, the thesis concludes that regionally integrated social policies oftentimes fail because of the gendered character of regional organisations, which undermines policy formulation and implementation processes.