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Scope, Range and Effectiveness of Interventions to Address Social Norms to Prevent and Delay Child Marriage and Empower Adolescent Girls: A Systematic Review

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Affiliation

GreeneWorks (Greene); Avenir Health (Edmeades); The Demographic and Health Surveys Program (Edmeades); University of Washington School of Public Health (Siddiqi)

Date
Summary

"While momentum has built around better conceptualisation and measurement of norms in preventing child marriage over the past 10 years, greater consensus is needed on prioritised norms and pathways of change."



A large body of research has established the importance of social norms in shaping child marriage, particularly those related to gender and power, sexuality, and life aspirations. Discriminatory norms perpetuate the view of marriage as the only viable alternative for girls, so working to transform inequitable gender norms and provide education and employment opportunities for girls can improve child marriage outcomes. This systematic review examines the scope, range, and effectiveness of interventions to change social norms and delay child marriage.



The researchers conducted a search of electronic databases and grey literature to look for experimental or quasi-experimental evaluations involving interventions that sought to change norms related to child marriage, collected data on age at marriage and norms/attitudes, and were published in English from January 2000 to September 2021. In keeping with the broader literature on what works to delay marriage, the researchers focused not only on interventions intended only to delay marriage but also included those that would drive change in how girls might be viewed or would transform the life choices open to them and measured the impact on the timing of marriage.



The 12 included studies were concentrated in India, Bangladesh, and Malawi, with the remaining studies distributed across other countries. Although all of the included interventions indicated their intention to address norms in their programmatic activities, they diverged in several ways.

  1. The norms and attitudes they aimed to address were quite disparate, describing efforts to shift norms and attitudes related to decision-making, gender roles (girls' and caregivers' attitudes), schooling, the right to refuse an arranged marriage, ideal age at marriage for girls and boys, appropriate age at first birth, aspirations for daughters to study beyond secondary school and levels of empowerment.
  2. The approaches and activities in which interventions were engaged were highly variable. Safe spaces where girls could meet and talk with peers was an approach used by several interventions, though the link of these activities to broader community or social norms was often poorly described. Other programmes were explicit in their engagement with family and community members, including health workers, seeking to change their attitudes toward adolescent pregnancy and early marriage and build their understanding of girls' needs and desires.
  3. The normative outcomes on which the programmes focused were also diverse. Only 5 of the 12 studies measured attitudes or norms held by individuals other than the participant girls themselves, including caregivers and other family members. Five studies measured gender attitudes, predominantly among girls who participated in the programme themselves, while a further 2 studies measured overall empowerment. Four studies specifically measured attitudes or knowledge around age at marriage, either among participant girls/ Two of the studies did not report any quantitative normative outcomes related to child marriage, although the programme descriptions emphasised norm change to a significant extent.

Variability in the normative outcomes, programmatic activities and measurement of impact makes it challenging to compare the norm-change programmes. However, Table 3 in the paper summarises the key findings by extent of norm change programming. In brief:

  • Overall impact on norms related to child marriage: 2 out of 12 programmes had positive and statistically significant effects; 2 had mixed effects; 6 had no statistically significant effect; and 2 did not report effects on norms.
  • On child marriage or delaying marriage: 4 out of 12 programmes had positive and statistically significant effects; 3 had mixed effects; and 5 had no statistically significant effect.

The researchers identified common elements across the studies that showed mixed or positive impact in changing child marriage norms. Several included an economic component as a key activity of their intervention - e.g., providing girls with entrepreneurship training and engaging girls in village saving and loans schemes. While this result could be read as evidence that norms are not important and that child marriage is just a practical choice, girls are much more likely to be married as children, and when under the same pressures, families do not marry the boys. Relieving economic pressure may reduce child marriage risk for girls if families are primed to make that decision and see the girl as worth investing in.



Notably, there appears to be insufficient acknowledgement that girls themselves are not always the primary decision-makers for their own marriages. Most of the attitude/norm outcomes in the selected studies focused on the girls' attitudes, which unfortunately may not have a direct connection to their ages at marriage.



Relatedly, even when programmes worked at multiple levels, such as through engaging influential gatekeepers in the community, parents or siblings, programme activities aimed at groups other than girls themselves were often superficial, did not focus on influential reference groups, and were not explicitly linked to norms that had clearly been identified as important for child marriage. In other words, norm change in some cases appeared to almost be an afterthought rather than a key focus of the programme. What the researchers found, therefore, "was not that norms programming will not work, but rather that almost no one is doing it well."



According to the researchers, the varied ways the studies approach social norm change reflects a lack of a clear consensus about what "social norms" are, how they can be defined and measured, and what approaches to use in attempting to shift them.



On the whole, the results suggest an inconsistent relationship between interventions that purport to shift norms and child marriage outcomes. Just over half (7 of 12) of the studies showed any indication of having influenced child marriage outcomes and, among those, there was no clear relationship between the observed changes in child marriage and shifts in measured norms. These findings echo prior research showing that norm change programming has had more success in shifting individual attitudes than in shifting broader norms and related behaviours.



Per the researchers:

  • The field would do well to explore the impact of efforts to shift norms through structural interventions that go beyond social and behavioural communication programming.
  • Research and programming on norm change would benefit from shared definitions and consistent terminology for the different types of norms and theories of change that precisely link activities to the specific norms they seek to address.
  • In order to evaluate the range of interventions working to shift norms related to child marriage, the child marriage field needs validated instruments for quantitatively and qualitatively measuring change in social norms.
  • Data must be collected from the correct people in girls' lives and should go beyond attitudes to collect data on norms and behaviours - for example, asking about the perceived benefits of delaying child marriage.

The potential sustainability of norm change programming to address child marriage, as witnessed by work in related areas such as female genital mutilation and education, leads the researchers to call on the field to hold itself accountable to greater conceptual clarity, consistent implementation, and more complete and rigorous measurement of norms-change work.

Source

BMJ Open 2024;14:e071275. doi:10.1136/bmjopen-2022-071275. Image credit: Jonathan Torgovnik/Getty Images/Images of Empowerment (CC BY-NC 4.0)