The impact of norms-shifting interventions on family planning and reproductive health

Evidence from the Passages Project shows that norms-shifting, gender-synchronized interventions can create supportive normative environments for improving family planning (FP) and reproductive health (RH) outcomes. A norms-shifting intervention is an intervention that seeks to achieve its outcomes at least in part by changing the social norms or social expectations that drive behaviors of interest. For more information about norms and related concepts, please visit the Social Norms Lexicon.

Such environments open new avenues to other shifts in attitudes and behaviors, in turn leading to increased use and acceptance of modern FP and RH care and services at the individual, couple, household, and community (or reference group) levels.

Findings from five norms-shifting interventions—Husbands’ Schools; Tékponon Jikuagou/Terikunda Jékulu; Responsible, Engaged, and Loving (REAL) Fathers; Growing Up GREAT!; and Masculinité, Famille et Foi—reveal increased uptake of behaviors related to family planning and reproductive health.

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Top-level findings

  • Women and men were more likely to use FP methods and seek RH services and to communicate with peers about FP and RH.
  • Women and men were more likely to support shared decision-making about FP and RH.
  • Community normative environments were more likely to support FP use and spacing of pregnancies.
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Interventions that improved family planning, reproductive health, and healthy timing and spacing of pregnancies

Which norms mattered?

Working with communities, Passages conducted explorations of social norms to identify and prioritize norms for each of the interventions using the Social Norms Exploration Tool. Across Passages interventions, the following norms emerged as key to FP and RH:

Talking about spacing of pregnancies and using FP methods in public settings is not acceptable.

Men are household decisionmakers, including for FP and RH decisions.

In some communities, certain religious beliefs are seen to prohibit the use of modern FP methods.

Having many children is valued in communities; couples should have a first child before using FP methods.

Discussion of or information-seeking for puberty, sexuality, and other RH topics and services is taboo.

Learn More

For more norms—and behaviors and attitudes—related to FP and RH, please see the Social Norms Learning Collaborative’s Social Norms Atlas.

View Atlas

Common strategies used to shift norms to improve family planning and reproductive health

The Passages interventions’ program strategies are intentionally designed to lead to norms-shifting in communities as part of behavior change through working with men, women, girls and boys. Each of the interventions sought to shift norms as part of a multi-level, multi-component social and behavior change approach that also addressed other factors. Across interventions, the following strategies were integral to shifting social norms:

  • Engaging in gender-synchronized interpersonal dialogue and reflection on beliefs, values, and behaviors.
  • Fostering positive role models within communities, including faith communities.
  • Working with communities to engage in social mobilization to promote shifts in beliefs and norms and new behaviors.
  • Hosting collective celebrations, pledges, and testimonials.
  • Creating linkages to RH care and services.
  • Supporting individual and community training and capacity building.
Learn More

For more information, the Passages Theory of Change lays out how norms-shifting approaches are part of our pathway to change.

View Theory of Change
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Evaluation results from Husbands’ Schools, Tékponon Jikuagou/Terikunda Jékulu, REAL Fathers, Growing Up GREAT!, and Masculinité, Famille et Foi suggest that these programs led to a more supportive normative environment for the use of modern FP methods and RH care and increased use of FP methods.