Key Social Norms Take-aways The ATWA program demonstrates that comprehensive, school- and community-based life skills education can lead to early shifts in social norms around gender and adolescent sexual and reproductive health and rights. Although short-term changes in community-level norms were modest, significant improvements in adolescents’ knowledge, attitudes, and gender-equitable beliefs suggest that norms around bodily autonomy, contraception, and gender roles are beginning to shift. Importantly, the program showed potential to transform internalized beliefs—especially among girls—about their rights and roles, laying the groundwork for broader normative change.
Objectives The Adolescent Transition in West Africa program aimed to improve the sexual and reproductive health and rights of adolescents in the Liptako Gourma region of West Africa by increasing ASRHR knowledge, fostering gender-equitable attitudes and behaviors, and improving access to adolescent-responsive health services.
Methods The evaluation used a cluster randomized controlled trial design across Burkina Faso, Mali, and Niger. External evaluators from the University of California San Diego and GRADE Africa conducted baseline and endline surveys in intervention and control sites over two years. Data were collected from adolescents aged 10–14 and 15–19 and analyzed to assess changes in ASRHR knowledge, life skills, gender norms, and access to and use of health services.
Intervention Details The four-year ATWA program delivered life skills education in schools and, in Niger and Mali, to out-of-school adolescents through small-group mentorship. Trained teachers and mentors led sessions on ASRHR, gender equality, communication, and decision-making. The program also worked to improve the quality and youth-responsiveness of health services by training providers and equipping health facilities. Menstrual hygiene management was integrated into the school-based intervention, reaching over 200,000 girls.
Results The evaluation found significant gains in ASRHR knowledge, gender-equitable attitudes, and intent to use contraception among adolescents in intervention areas compared to control groups. Improvements were stronger among girls and younger adolescents. There were also reported increases in self-efficacy, peer support, and openness to discussing SRHR topics. However, more substantial shifts in community-level social norms and service utilization were less evident in the short term, highlighting the need for sustained engagement.
Conclusions ATWA successfully advanced knowledge and attitudes related to ASRHR and gender equality among adolescents, showing early movement toward norm change. While structural and community barriers remain, particularly in conservative and resource-constrained areas, the program illustrates the importance of reaching adolescents early and holistically to promote long-term shifts in social norms and health outcomes.