Meeting the reproductive health needs of women in post-conflict settings is a global health priority. In the Democratic Republic of the Congo, social norms perpetuate gender-based violence and contribute to low contraceptive use and high fertility. The Masculinité, Famille, et Foi (MFF) intervention is working with communities in Kinshasa to create normative environments supportive of modern contraception access and use. Our analysis uses survey data collected from 900 men and women in 17 community groups prior to the MFF intervention. We aimed to measure the extent to which social norms influence intentions to use modern contraception. Using multiple items to assess social norms and reference groups related to family planning and gender equity, we identified four distinct social norms constructs through factor analysis. Through structural equation modeling, we found that social norms influence intentions to use modern contraception overall, but that normative influence varies by gender.

ObjectiveTo assess the impact of the Gender Roles, Equality and Transformations (GREAT) intervention: a narrative-based, resource-light, life-stage tailored intervention package designed to promote gender-equitable attitudes and behaviours, and improve sexual and reproductive health (SRH) and gender-based violence (GBV) outcomes among adolescents and their communities.DesignRepeated cross-sectional evaluation study, using propensity score matching combined with difference-in-difference estimation.SettingTwo postconflict communities in Lira and Amuru districts in Northern Uganda.ParticipantsMale and female unmarried adolescents (10–14 years, 15–19 years), married adolescents (15–19 years) and adults (over the age of 19 years) were selected using a stratified, two-stage cluster sample of primary and secondary schools and households (baseline: n=2464, endline: n=2449).Primary outcome measuresInequitable gender attitudes and behaviours; GBV; and SRH knowledge and behaviours.ResultsStatistically significant intervention effects were seen across all three outcomes—gender equity, GBV and SRH—among older and newly married adolescents and adults. Among older adolescents, intervention effects include shifts on: inequitable gender attitudes scale score: −4.2 points ((95% CI −7.1 to –1.4), p<0.05); Inequitable household roles scale score: −11.8 ((95% CI −15.6to –7.9), p<0.05); Inequitable attitudes towards GBV scale: −1.9 ((95% CI −5.0 to –0.2), p<0.05); per cent of boys who sexually assaulted a girl in past 3 months: −7.7 ((95% CI −13.1 to –2.3), p<0.05); inequitable SRH attitudes scale: −10.1 ((95% CI −12.9 to –7.3), p<0.05). Among married adolescents, intervention effects include shifts on: Inequitable household roles scale score: −6.5 ((95% CI −10.8 to –2.2), p<0.05); inequitable attitudes towards GBV scale: −4.7 ((95% CI −9.8 to –0.3), p<0.05); per cent who reacted violently to their partner: −15.7 ((95% CI −27.1 to –4.4), p<0.05); inequitable SRH attitudes scale: −12.9 ((95% CI −17.3 to –8.5), p<0.05).ConclusionThe GREAT intervention model demonstrates the promise of a resource-light, life-stage tailored programme that employs culturally appropriate, participatory and narrative-based techniques to advance gender equity and adolescent health. This type of programming contributes towards reductions in GBV and improved adolescent SRH outcomes.

Adolescent girls and young women have recently gained a central position in gender equality and development. However, little research investigates female experiences of the complex dynamics of both change and resistance to change in gender norms and structures. Drawing on the work of Bourdieu, Connell and Schippers to analyse longitudinal in-depth interviews, this paper explores how girls in northern Uganda learn, challenge and (re)produce patriarchal structures throughout the life-course and across social fields. It highlights the costs, consequences and benefits at stake in expressing hegemonic femininity and expands understanding of how adolescent girls and young women actively strategise to protect their wellbeing and create space for contestation. Findings call for greater attention to the coexistence of resistance to, and reproduction of, gender orders, and offer opportunities for additional research for theory building and programme implementation.

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