Key Social Norms Take-aways The Nigerian Urban Reproductive Health Initiative (NURHI) explicitly integrates social norms into its behavior change communication strategy, guided by the theory of ideation. The project focuses on transforming beliefs, attitudes, and social expectations—particularly around family size, spousal consent, and acceptability of contraceptive use—by using mass media, community mobilization, and interpersonal communication. Social norms were addressed not only at the community level but also among health providers, who held biases against young, unmarried, or low-parity women. NURHI demonstrated that shifting ideational factors such as peer support, religious leader approval, and perceived community norms can significantly increase contraceptive use. Exposure to multiple communication interventions had a dose-response effect on ideation and contraceptive uptake, indicating that social norms change is both possible and scalable when integrated across system levels. Objectives: To design and evaluate a demand-led, communication-driven family planning program aimed at increasing contraceptive use in four Nigerian cities by addressing ideational barriers, improving service delivery, and influencing social norms. Methods: The program employed a mixed-methods design, including formative research (focus groups, baseline household and facility surveys), and a longitudinal evaluation using baseline (2010–11) and midterm (2012) surveys of women. Propensity score matching was used to estimate the program’s effect on contraceptive prevalence rates. Additional analysis explored the relationship between exposure to NURHI activities, changes in ideational factors, and contraceptive use. Intervention Details: NURHI’s interventions combined demand generation (mass media, entertainment-education, radio programs, social mobilization), service delivery improvements (including provider training, “72-Hour Clinic Makeovers,” and mobile outreach services), and advocacy targeting policymakers and religious leaders. The program used consistent branding and messaging through the “Know. Talk. Go.” campaign and trained non-traditional actors such as barbers and hairdressers as social mobilizers. Results: Modern contraceptive prevalence among married women increased in all cities, with the largest gains in Kaduna (+15.5 percentage points). Among women with high program exposure, contraceptive use was 43.4%, compared to 19.1% among those unexposed. Ideational factors like peer support and positive attitudes toward family planning significantly increased. Outreach services eventually accounted for nearly 50% of clinical service provision at NURHI-supported sites. Propensity score matching estimated a program-attributable increase in contraceptive use of 9.9 percentage points. Conclusions: A demand-led, communication-driven approach can effectively shift social norms, improve ideational factors, and increase contraceptive uptake. Embedding social norms change within both community and health system strategies is essential for sustainable impact.