Theory and practice of social norms interventions: eight common pitfalls

Abstract

BackgroundRecently, Global Health practitioners, scholars, and donors have expressed increased interest in “changing social norms” as a strategy to promote health and well-being in low and mid-income countries (LMIC). Despite this burgeoning interest, the ability of practitioners to use social norm theory to inform health interventions varies widely.Main bodyHere, we identify eight pitfalls that practitioners must avoid as they plan to integrate a social norms perspective in their interventions, as well as eight learnings. These learnings are: 1) Social norms and attitudes are different; 2) Social norms and attitudes can coincide; 3) Protective norms can offer important resources for achieving effective social improvement in people’s health-related practices; 4) Harmful practices are sustained by a matrix of factors that need to be understood in their interactions; 5) The prevalence of a norm is not necessarily a sign of its strength; 6) Social norms can exert both direct and indirect influence; 7) Publicising the prevalence of a harmful practice can make things worse; 8) People-led social norm change is both the right and the smart thing to do.ConclusionsAs the understanding of how norms evolve in LMIC advances, practitioners will develop greater understanding of what works to help people lead change in harmful norms within their contexts. Awareness of these pitfalls has helped several of them increase the effectiveness of their interventions addressing social norms in the field. We are confident that others will benefit from these reflections as well.

Association of collective attitudes and contraceptive practice in nine sub-Saharan African countries

“…Using the TNS as an interpretive framework to explain the correlation between norms of premarital sex and violence against women with family planning practices, we hypothesise that -granted contextual differences -a norm of premarital sex has a strong influence on people' s sexual practices because the practice is a) interdependent, as the action is coordinated with other(s), even though these others (men) are not necessarily under the same normative influence; b) relatively undetectable in principle, as it involves an intimate act, but potentially highly detectable in the case of pregnancy; c) followed by strong sanctions for non-compliers, several of which are detailed in the relevant literature [63]; and d) proximal to the norm, as the two have a direct relationship [28]. We hypothesised that when attitudes and norms are aligned -when people both personally accept premarital sex and believe others find it acceptable as well -transformative change in women' s family planning practices/preferences may result [64], as suggested by previous evidence showing that sexual behavior has been highly regulated but prone to change [65], although we recognize that our attitudinal norms are only an aggregation of individual attitudes and do not necessary may reflect those beliefs.…”

Exploring stigma and social norms in women’s abortion experiences and their expectations of care

“…1 Despite being a common procedure and an essential component of sexual and reproductive health care, many women still face barriers to safe abortion, and their pathway to care is influenced by a number of social, cultural and legal factors. Among these, social normsthe unwritten rules of acceptable behaviour in a group 2 have been found to play a key role. [3][4][5][6] Social norms are generally characterised in the global health literature as people's beliefs about RESEARCH ARTICLE 50 © 2019 The Author(s).…”

“…[3][4][5][6] Social norms are generally characterised in the global health literature as people's beliefs about RESEARCH ARTICLE 50 © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group (1) what others in a group do (descriptive norms) and (2) what others in a group approve or disapprove of (injunctive norms). These norms are often kept in place by the anticipation of positive or negative social sanctions, such as rewards or punishment for engaging in certain behaviours that are considered acceptable or unacceptable.…”

How Cities Erode Gender Inequality: A New Theory and Evidence from Cambodia

“…Within beliefs, we can further distinguish between an individual's internalised stereotypes (their unquestioned assumptions about members of a gender) and their norm perceptions (beliefs about what others think and do). (Though the two are often conflated -as noted by Cislaghi and Heise, 2018). This distinction recognises that someone might privately disavow gender stereotypes, yet comply with widespread practices due to concerns about how they will be perceived and treated by others.…”