This article seeks to address the dearth of evidence on early adolescent understandings and experiences of sexual and reproductive health (SRH) in Ethiopia and Rwanda, drawing on a multisite qualitative research study with 10-to 12-year-old and 14-to 15-year-old male and female adolescents and a range of adult participants. The article is informed by a conceptual framework that draws on Amartya Sen's capability approach, which calls for investments in a broad set of assets that expand individuals' capacity to "be" and to "do." Using SRH as a focal lens, the article considers the role played by gendered social norms in adolescents' experiences of SRH-related understandings and experiences. Three key interrelated gender themes emerge from our thematic analyses of qualitative evidence generated by our multimethods approach: puberty transitions, sexuality, and victim blaming. In our analyses, we pay attention to diversity (e.g., age, gender, place of residence) among adolescents within and across the two focal countries and consider how discriminatory gendered social norms play a role in hindering the effective uptake of expanding health services. We conclude by emphasizing the need for program designers and implementers to address the role of underlying social norms in a more strategic and context-specific way to help young people navigate their sexual and reproductive lives.
Background: Until recently, global public health initiatives have tended to overlook the ways that social factors shape adolescent health, and particularly how these dynamics affect the specific needs of adolescents in relation to information about puberty, menstruation and sexual health. This article draws on mixed methods data from rural and urban areas of Ethiopia to explore how access to health information and resources-and subsequently health outcomes-for adolescents are mediated by gender and age norms, living in different geographical locations, poverty, disability and migration. Methods: Data was collected in 2017-2018 for the Gender and Adolescence: Global Evidence (GAGE) mixedmethods longitudinal research baseline in three regions of Ethiopia (Afar, Amhara and Oromia). Quantitative data was collected from over 6800 adolescents and their caregivers, with qualitative data obtained from a sub-sample of 220 adolescents, their families and communities. Adolescent participants shared their experiences of health, illness and nutrition over the previous year; their knowledge and sources of information about sexual and reproductive health and puberty; and their attitudes toward sexual and reproductive health. Regression analysis was used to explore differences by gender, age, rural/urban residence, and disability status, across a set of adolescents' health knowledge and other outcomes in the quantitative data. Intersectional analysis was used in analysing the qualitative data. Results: Analysis suggested that gender inequality intersects with age, disability and rural/urban differences to shape young people's access to information about puberty, with knowledge about this topic particularly lacking amongst younger adolescents in rural areas. Drought and lack of access to clean water exacerbates health challenges for adolescents in rural areas, where a lack of information and absence of access to preventive healthcare services can lead to permanent disability. The research also found that gaps in both school-based and alternative sources of education about puberty and menstruation reinforce stigma and misinformation, especially in rural areas where adolescents have higher school attrition rates. Gendered cultural norms that place high value on marriage and motherhood generate barriers to contraceptive use, particularly in certain rural communities. Conclusions: As they progress through adolescence, young people's overall health and access to information about their changing bodies is heavily shaped by intersecting social identities. Structural disadvantages such as poverty, distress migration and differential access to healthcare intersect with gender norms to generate further inequalities in adolescent girls' and boys' health outcomes.
Adolescence is a time of particular risk for violence perpetrated by parents, teachers, peers and intimate partners. Social norms that condone violent discipline, promote masculinities focused on violence, and support gender inequality play an important role in perpetuating violence. However, little is known about the relationship between inequitable gender norms and children's experiences of violence from parents or other adults in the household. Utilising data from the Gender and Adolescence: Global Evidence (GAGE) study, this paper explores how adolescent and household attitudes and community-level gender norms influence experiences of violence among young adolescents (aged 10-12) in Ethiopia. Our results show that community norms, rather than adolescent and household attitudes, are significantly associated with experiences of household violence. This result holds for boys and girls, and in rural areas. In urban areas, however, adolescent attitudes were more influential than community norms, perhaps indicating less cohesive communities. Overall, these findings suggest that violence prevention programming should prioritise shifting community norms, particularly in rural areas, in order to promote adolescent girls' and boys' right to bodily integrity.
Our article explores how intersecting crises, sociocultural norms around gender, age, household and community and broader political and economic shifts are affecting youth transitions. We draw on qualitative virtual research with 138 young people in Ethiopia and Jordan undertaken between April and August 2020. COVID-19 is exacerbating ongoing crises and gender inequalities in Ethiopia and Jordan and foreclosing opportunities for youth transitions. In Ethiopia, the pandemic has compounded the precarity of young people who have migrated from rural to urban areas, often to locations where they are socially marginalised. In Jordan, the confinement of young people affected by forced displacement to their households with extended family during pandemic-related service closures augments existing perceptions of an extended ‘waithood’—both psychosocially and economically. In both contexts, conservative gender norms further entrench the restrictions on adolescent girls’ mobility with consequences for their opportunities and wellbeing. This article makes an important contribution to the literature on gender, migrant youth and the ongoing effects of the COVID-19 pandemic by showing how multiple crises have sharpened the social and political (im)mobilities that already shaped young men and women’s lives in Ethiopia and Jordan and the consequences for their trajectories to adulthood.
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