This piece summarizes a recent study by the USAID-funded Passages Project exploring social norms impacting the reproductive health of adolescent girls and young women in Burundi. We explore how the research findings can be applied in the design of reproductive health programs to identify and involve key influence groups that affect social norms.
“…The dialogue between parents and children regarding sexual and reproductive health…does not exist! Why? Because of social norms, parents think that by talking about this with their children, they will be saying bad things. That’s why menstruation comes as a surprise to 13- or 14-year-olds.”
Social norms are particularly relevant among young people. Compared to adults, young people have less power in society to make or break social rules. Additionally, peer relationships become more influential during adolescence. In many low- and middle-income countries, such as Burundi, social norms are not well documented, but likely have a large influence on adolescent girls and young women’s ability to access reproductive health information and care.
The Passages Project—funded by the United States Agency for International Development (USAID)— recently completed a qualitative study researching social norms affecting the reproductive health of adolescent girls and young women in four provinces in Burundi. Focus group discussions and a problem tree exercise adapted from the Social Norms Exploration Tool (SNET) explored social norms around the following:
The study also examined the groups of people that influence norms for each of these behaviors, and in what ways.
Targeting adolescents alone will not achieve social norms change: The study identified eight different reproductive health social norms that adolescent girls were expected to follow, such as managing their menstrual hygiene discreetly and not getting pregnant before marriage. Yet, they did not have sufficient support, power, agency, or information to make informed, independent choices about their reproductive health. Rather, the social norms that adolescents are pressured to comply with are enforced and upheld by many others in the broader social community.
Figure 2. Illustration of range of parental influence on adolescents’ reproductive health norms compliance.
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The fact that multiple influence groups exist, many of which both enforce and provide support for opposing harmful norms, has important implications for program design and implementation.