Key Social Norms Take-aways This study shows that changing gender norms requires different strategies depending on the outcome of interest. Household visits increased contraceptive use, likely by addressing misinformation and providing private support, while small group sessions were more effective in reducing intimate partner violence by creating space for critical reflection on shared gender norms. The most impactful approach combined both methods, suggesting that meaningful change in social norms and behavior occurs when individual knowledge and collective expectations are addressed together.
Objectives The study aimed to evaluate the effectiveness of the Reaching Married Adolescents program in improving modern contraceptive use and reducing intimate partner violence among married adolescent girls and their husbands in Niger, where early marriage and gender inequity are widespread.
Methods A four-arm cluster randomized controlled trial was conducted in 48 villages in the Dosso region, including 1,099 married adolescent girls and their husbands. The study measured current use of modern contraception and past-year experiences of intimate partner violence using survey data collected at baseline and 24-month follow-up. Data were analyzed using multilevel mixed-effects Poisson regression models.
Intervention Details The Reaching Married Adolescents program was a gender-synchronized, community-based intervention delivered by trained community health workers. It included three components: gender-matched household visits to provide counseling on family planning; single-sex small group discussions for adolescent girls and husbands focused on health, gender norms, and communication; and monthly community dialogues involving religious and community leaders. Intervention arms tested each component individually and in combination.
Results The combination arm (household visits and group sessions) significantly increased contraceptive use and decreased intimate partner violence. Household visits alone increased contraceptive use but had no impact on violence, while group sessions alone significantly reduced intimate partner violence but did not increase contraceptive use. Contraceptive use increased most among women with one child, while nulliparous women showed no significant gains, likely due to stigma and prevailing norms discouraging contraception before first birth.
Conclusions The most effective strategy for improving both contraceptive use and reducing violence involved combining individual and group-based approaches. Addressing gender norms in peer settings supports shifts in collective expectations, while private counseling helps overcome knowledge gaps and stigma. Programs aiming to improve adolescent girls’ reproductive autonomy should use multi-level approaches to simultaneously address individual behaviors and the social norms that constrain them.