Key Social Norms Take-aways The IMAGINE program demonstrates that interventions targeting adolescent girls’ agency, gender dynamics, and economic empowerment can result in promising shifts in social norms related to family planning and gender roles. Notably, in Bangladesh, the intervention influenced norms around the timing of marriage and childbearing, and in Niger, it fostered greater contraceptive use and women’s agency. However, achieving substantial changes in deeply entrenched norms like early childbearing or ideal family size requires longer-term, multi-level, and gender-synchronized approaches.
Objectives The IMAGINE (Inspiring Married Adolescent Girls to Imagine New Empowered Futures) program aimed to delay first birth among married adolescent girls in Bangladesh and Niger, improve family planning behaviors, increase reproductive health knowledge and service use, enhance communal and personal efficacy, and foster economic empowerment.
Methods A longitudinal, quasi-experimental before-and-after design with baseline and endline surveys was used, involving matched treatment and control areas. Quantitative data were collected from adolescent girls aged 15–19 with no prior pregnancies. Analysis included survival models for time-to-first birth, logistic regressions, latent change score models, and marginal structural models with inverse probability weights to adjust for time-varying confounding and sampling design.
Intervention Details Implemented between 2019 and 2021, IMAGINE included Girls’ Collectives led by trained female facilitators, providing sexual and reproductive health education, vocational and financial training, and support for agency and gender equity. Additional components included couples’ counseling (Bangladesh), community engagement events, and health worker capacity-building.
Results In Bangladesh, there was no overall impact on delaying first birth, but dose-response analysis revealed a significant delay among girls with higher participation. The intervention improved reproductive health knowledge, perceptions, and psychosocial factors such as social cohesion and self-efficacy. In Niger, while no effect was observed on delay of first birth, there were significant increases in contraceptive use, health service utilization, asset ownership, and income-generating activities among treatment participants. Both countries showed shifts in gender norms, including increased support for delayed childbearing and girls’ economic participation.
Conclusions The IMAGINE intervention positively influenced intermediate outcomes tied to social norms, agency, and reproductive health behaviors, though not uniformly across all primary outcomes. The findings highlight the slow and complex nature of social norms change, the need for longer intervention timelines, and the importance of multi-level and gender-synchronized strategies to effectively shift norms influencing adolescent reproductive choices and empowerment.