Fostering gender equality and reproductive and sexual health among adolescents: results from a quasi-experimental study in Northern Uganda
Outcomes: Gender‑Based Violence, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways The study demonstrates that a resource-light, narrative-based intervention can shift gender norms and behaviors when implemented through a life-stage approach. The most significant changes occurred among older adolescents and newly married/parenting youth, suggesting that adolescence and early adulthood are critical windows for gender norm transformation. The intervention succeeded in transforming inequitable attitudes towards gender roles, SRH, and GBV, and in increasing adult support for adolescent well-being. The discussion emphasizes that social norms are highly embedded and often static but can shift through sustained, context-sensitive, and culturally resonant programming.
Objectives To evaluate the impact of the Gender Roles, Equality and Transformations (GREAT) intervention on promoting gender-equitable attitudes and behaviors, reducing gender-based violence (GBV), and improving sexual and reproductive health (SRH) among adolescents and their communities in postconflict Northern Uganda.
Methods A repeated cross-sectional, quasi-experimental design was used, incorporating propensity score matching and difference-in-difference estimation. Surveys were conducted at baseline (n=2464) and endline (n=2449) across two districts. Participants were grouped by life stage: very young adolescents (10–14), older adolescents (15–19), newly married/parenting adolescents (15–19), and adults (20+). Measures included both attitudinal scales (adapted Gender-Equitable Men scale, household roles, GBV attitudes, SRH attitudes) and behavioral indicators.
Intervention Details The GREAT intervention was a multicomponent, low-resource program implemented from 2012–2014. It included:
A 50-episode radio drama (“Oteka”) tailored to life stages.
A participatory community action cycle involving 382 local leaders.
A toolkit with puberty storybooks, discussion guides, and games delivered through existing youth groups.
Training for village health teams to provide youth-friendly services.
Grounded in gender-transformative and life-course theory, the intervention aimed to shift harmful norms via storytelling, dialogue, and community engagement.
Results
The intervention significantly improved gender-equitable attitudes and behaviors in older adolescents and newly married/parenting youth. These groups showed reductions in inequitable gender norms (e.g., −4.2 and −3.7 points on gender attitude scales), GBV attitudes (−4.7 points), and self-reported GBV perpetration. SRH knowledge and contraceptive use also improved, especially among newly married adolescents (10.4% increase in family planning use). Adults showed increased support for adolescent well-being and decreased gender-inequitable attitudes.
Conclusions GREAT demonstrates that culturally appropriate, low-cost, and life-stage-tailored interventions can catalyze meaningful change in gender norms and health outcomes in postconflict settings. Mass media exposure, particularly through radio, proved an effective channel for norm diffusion. The study supports the scalability of gender-transformative interventions targeting multiple life stages and domains (GBV, SRH, gender equity).
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