Social Norms Related to Reproductive Health for Adolescent Girls and Young Women in Burundi

17 July, 2021

Forwarded from the CORE Group:

'The Passages Project is happy to share new resources from a qualitative study in Burundi that explored social norms related to reproductive health behaviors among unmarried adolescent girls and young women (15-19 years). The study simultaneously aimed to identify relevant individuals and groups who influence and uphold these social norms (key influencers). Focus group discussions with adolescent girls and young women and key influencers focused on four domains of inquiry: 1) menstruation and menstrual hygiene management, 2) sexual risk behaviors, 3) sexual violence, and 4) fertility and voluntary family planning use. The study report is now available in English and French and a webinar recording and presentation are available in French.'

Below are Selected extracts from the publication and a comment from me:

Using our analytic criteria, eight social norms emerged as having the greatest influence on adolescent girls and young women’s reproductive health behaviors and outcomes:

1. Sexuality and reproductive health are not discussed openly in households or the community and it is not considered socially acceptable to do so;

2. It is not socially acceptable to show any evidence of menstruation;

3. Girls are expected to behave differently after they begin menstruating;

4. Sexual activity among unmarried adolescent girls and young women appears common but not socially approved of;

5. Having sex in exchange for gifts or money appears common;

6. Instances of coerced sex appear common and girls who experience sexual violence are typically socially shamed;

7. It is becoming less socially acceptable to have more children than one can care for; and

8. Adolescent girls and young women do not typically use contraception and it is not considered appropriate for them to use contraception...

We advance the following five specific ideas for potential entry points and accompanying strategies for future interventions to shift the norms and engage the key influence groups identified in this study:

1. Create positive new norms for more open discussion of sexuality, menstruation and reproductive health with family members;

2. Create safe spaces & improved access for adolescent girls and young women to become informed about sexuality and reproductive health;

3. Confront gender and power imbalances contributing to sexual risk;

4. Engage religious leaders as champions for family planning; and

5. Explore underlying drivers of health workers’ bias.

Comments (NPW):

1. Do the above findings resonate with your experience in your country?

2. The authors expand on their five ideas in the publication. In addition to these ideas would it be helpful to consider a 6th: sexual and reproductive health education for adolescent (and pre-adolescent) children in school? This of course has its own social norm barrier ("Children shouldn't learn these things at school") but if such education can be introduced progressively in ways that are acceptable to parents, this will have subsequent positive effects on other social norms in the future.

Best wishes, Neil

Joint Coordinator, HIFA Project on Family Planning

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health movement (Healthcare Information For All - ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: