Getting to intent: Are social norms influencing intentions to use modern contraception in the DRC?

Costenbader, Elizabeth; Zissette, Seth; Martínez, Andrés; LeMasters, Katherine; Dagadu, Nana Apenem; Deepan, Prabu; Shaw, B. W.

doi:10.1371/journal.pone.0219617

Cited by 30 publications

(36 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with the literature, the study found that social norms that discourage premarital sex and contraceptive use are associated with lower levels of contraceptive use [ 1 , 24 , 34 – 36 ]. Our findings suggest that the effect of social norms on behavior is associated with ability.…”

Section: Discussionsupporting

confidence: 82%

Understanding how social norms affect modern contraceptive use

et al. 2021

View full text Add to dashboard Cite

Background An aim of this study is to introduce a practitioner-friendly behavior model. Few theories of health behavior explicitly take the effect of social norms on behavior into account. Generally, theories that do take social norms into account assume that the effect of social norms on behavior operates through motivation. We use the Fogg Behavior Model (FBM), a behavior model that is new to public health, to explore whether social norms are associated with modern contraceptive use among Nigerian women, and whether they affect behavior through motivation or through ability. In other words, do social norms that discourage contraception lower women’s motivation to use contraception or do they lower women’s ability to use contraception. Methods This study uses data from a cross-sectional household survey of Nigerian women, ages 14–24. The survey collected data on socio-economic and demographic characteristics of women, whether they were sexually experienced, and whether they used contraception. Modern contraceptive use was the outcome of interest for the study. The survey also collected data on social norms around premarital sex and contraceptive use. Multivariate logistic regression was used for the analysis. Results After adjusting for a range of socio-economic and demographic variables, we found that social norms that discourage contraception had a statistically significant negative association with contraceptive use (aOR = 0.90, p < 0.001). The analysis found that the negative association between social norms and contraceptive use remained statistically significant after controlling for motivation but did not remain statistically significant after controlling for ability. Conclusion These findings suggest that social norms may affect contraceptive use in Nigeria through ability rather than motivation. In terms of programmatic implications, these finding suggest that public health interventions may be able to counter the negative effects of social norms that discourage contraceptive use by increasing women’s ability to practice contraception.

show abstract

Section: Discussionsupporting

confidence: 82%

Understanding how social norms affect modern contraceptive use

et al. 2021

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…Social norms can help explain reproductive health decisions, including the use of modern FP to space children [25][26][27]. According to social norms theory, individuals follow unwritten and unspoken rules that are shared amongst people in their reference group [25,28,29]. These rules are mutual behavioral expectations and are sustained, amongst other things, by anticipation of approval or disapproval for, respectively, complying or not with them [30].…”

Section: Introductionmentioning

confidence: 99%

Reproductive health decision making among nomadic pastoralists in North Eastern Kenya: a qualitative social network analysis

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background To our knowledge, no studies exist on the influence of nomadic pastoralist women’s networks on their reproductive and sexual health (RSH), including uptake of modern family planning (FP). Methods Using name generator questions, we carried out qualitative egocentric social network analysis (SNA) to explore the networks of four women. Networks were analyzed in R, visuals created in Visone and a framework approach used for the qualitative data. Results Women named 10–12 individuals. Husbands were key in RSH decisions and never supported modern FP use. Women were unsure who supported their use of modern FP and we found evidence for a norm against it within their networks. Conclusions Egocentric SNA proves valuable to exploring RSH reference groups, particularly where there exists little prior research. Pastoralist women’s networks likely change as a result of migration and conflict; however, husbands make RSH decisions and mothers and female neighbors provide key support in broader RSH issues. Interventions to increase awareness of modern FP should engage with women’s wider networks.

show abstract

“…A study in India showed that descriptive norms around FP moderated the effects of spousal influence and interpersonal communication on married women's use of modern contraception (MC) (Rimal et al, 2015). Another study from the Democratic Republic of Congo found that injunctive FP norms among married women and descriptive FP norms among married men were associated with future intention to use MC (Costenbader et al, 2019). In Kenya and Ethiopia, a study by Dynes and colleagues highlighted that the alignment or divergence between injunctive norms and personal perceptions about the ideal number of sons influenced women's MC use (Dynes et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Strategic behaviour change communication and interventions that go beyond shifting individual-level attitudes and behaviours have been a relatively recent focus of interventions in sub-Saharan Africa, including Nigeria (Costenbader et al, 2019;Ejembi et al, 2015). From 2009 to 2014, the Bill & Melinda Gates Foundation (BMGF) supported the Nigerian Urban Reproductive Health Initiative (NURHI) with the aim of increasing voluntary use of modern contraceptives among women ages 15-49 years in six large cities: Abuja, Ibadan, Ilorin, Kaduna, Benin and Zaira.…”

Section: Introductionmentioning

confidence: 99%

A vignette-based approach to understanding social norms around family planning in three Nigerian cities

Cannon

Mandal

McGuire

et al. 2021

Global Public Health

View full text Add to dashboard Cite

Understanding the mechanisms through which social norms shape contraceptive use can help prevent unintended pregnancies in lowincome countries. The Nigerian Urban Reproductive Health Initiative (NURHI) aimed to increase contraceptive uptake through advocacy, service delivery, and demand generation. Using data from focus group discussions, we examined whether social norms around family planning (FP), and specifically use of modern contraception (MC), varied among women and girls of reproductive age exposed to varying levels of the programme in three Nigerian cities. Injunctive social norms were generally unfavourable of unmarried adolescent girls' use of MC, though participants often shared exceptions for certain types of adolescents whose use of MC would be acceptable. There was greater acceptability for MC use by women who wanted to space or limit pregnancies. Participants reported that norms around FP and MC use have become more accepting in their communities over time. Normative differences between cities were identified. Participants' perceptions of religious leaders' support for FP use may have contributed to positively influencing social norms.

show abstract

Getting to intent: Are social norms influencing intentions to use modern contraception in the DRC?

Cited by 30 publications

References 29 publications

Understanding how social norms affect modern contraceptive use

Understanding how social norms affect modern contraceptive use

Reproductive health decision making among nomadic pastoralists in North Eastern Kenya: a qualitative social network analysis

A vignette-based approach to understanding social norms around family planning in three Nigerian cities

Contact Info

Product

Resources

About