Passages is a research-to-practice project that seeks to address the core challenges to improving sexual and reproductive health such as gender-based violence, child marriage, and unintended pregnancy by transforming social norms. Researchers on the Passages Project will develop and test scalable approaches to promote social norms that support healthy behaviours. They will also study interventions that promote collective change through media, advocacy, community campaigns/mobilisation, and discussions within social networks and among community leaders. Results from the research will be used to build an evidence base and contribute to the capacity of organisations working to strengthen normative environments that support reproductive health. The project focuses particularly on very young adolescents, newly married youth, and first-time parents in the developing world.
This United States Agency for International Development (USAID)-funded project runs from 2015-2020 and is being managed by Georgetown University Medical Center’s Institute for Reproductive Health (IRH).
Social norms - unspoken rules that govern behaviour - shape the sexual and reproductive journeys of young people. They are enforced by peers, families and communities who influence the way young people behave and think about sex, marriage, and intimate partner violence. "In many settings, sustained improvements in FP [family planning] and reproductive health will only be obtained by addressing norms that inhibit FP access and use. Passages will focus on interventions that aim to reduce stigma and myths related to FP use, increase male engagement in FP, reduce gender-based violence, and improve gender equity attitudes and behaviors." The project will focus on formative life course transitions - children entering puberty, women and men entering marriage, and new parents - and focus on the processes that create and reinforce social norms during these transitions.
The overall aim of Passages is to create an evidence base for effective policy and to develop and test scalable approaches to inform practice. The project will achieve this by: 1) replicating and scaling up social norm interventions and applying implementation science principles to explain what makes interventions effective and sustainable at scale in real-world contexts; 2) strengthening in-country capacity to plan, implement, monitor, and evaluate the scale-up of effective pilot initiatives to address normative change; and 3) distilling and sharing evidence and sparking dialogue on integration, measurement, and evaluation of normative interventions.
Passages will work with USAID missions and other partners to improve and build organisational capacity to support programming and research through the following activities:
- "Provide technical assistance to health and other sector programs interested in including social norm interventions leading to increased FP uptake and healthy timing and spacing of pregnancies. For example, assistance could be provided to programs wanting to include normative interventions to empower women, prevent gender-based violence, and delay marriage.
- Provide technical assistance to FP programs to integrate approaches for fostering supportive social norms and ensure they are designed and implemented with scale-up in mind.
- Raise awareness and strengthen the capacity of national and organizational stakeholders to understand and address at scale the social norms that affect FP uptake.
- Support assessments and systems-based planning to expand and scale up pilots and other evidence-based approaches to establish social norms which support FP use.
- Conduct ‘realist’ evaluations of existing social norm interventions to inform expansion, using an evaluation approach designed to answer the questions: 'What works, for whom, in what respects, to what extent, in what contexts, and how?'
- Design and conduct research to measure the effect of normative interventions and assess their expansion. Apply new approaches to measure gender norms, conduct research with early adolescents, and monitor and evaluate scale up."
Rationale for the project:
"Early pregnancy and child marriage are a reality for millions of young women worldwide, curtailing educational and vocational opportunities, leading to poor sexual and reproductive health and contributing to the intergenerational cycle of poverty. A focus on individual change is important but insufficient to meet this challenge. Young people’s ability to forge healthy sexual relationships is influenced by social norms enforced by their peers, families and communities.
Social norms shape behaviors related to sexual debut, intimate partner and sexual violence and early marriage, as well as access to education and the services and information they need to protect their health. Research has shown that investing in social norm change at the community (rather than individual) level, while ensuring supportive policies and access to good quality services, can bring about significant improvements in sexual and reproductive health."
Georgetown University Medical Center’s Institute for Reproductive Health (IRH), FHI 360, Johns Hopkins Global Early Adolescent Study (GEAS), Population Services International (PSI), Save the Children, and Tearfund