Key Social Norms Take-aways Social norms are central to whether adolescent girls and young women can safely participate in sexual and reproductive health programs. Community expectations around adolescent sexuality, contraception, fertility, and early childbearing create anticipated social sanctions—including being labeled “spoilt” or sexually active—that can lead girls to self-censor and avoid services. These norms are reinforced by parents, partners, peers, community members, and healthcare providers, demonstrating that stigma and judgment are socially produced rather than simply individual attitudes. The authors argue that interventions must therefore move beyond information provision to engage influential community actors, reduce stigma, address gendered power relations, and create supportive environments in which sexual and reproductive health engagement becomes socially acceptable.

Objectives To explore anticipated barriers and facilitators to implementing a community-based, peer-led sexual and reproductive health education intervention among adolescent girls and young women aged 15–24 in Moroto District, northeastern Uganda.

Methods This qualitative case study included six focus group discussions with 51 adolescent girls and young women, stratified by age, schooling status, and whether they had given birth, and five key informant interviews with district and health-facility stakeholders. Data were collected across seven villages and analyzed thematically using the socioecological model. Social norms were explored qualitatively through questions about cultural beliefs, stigma, family, peer and partner influences, decision-making power, community expectations, and institutional attitudes.
Intervention Details The planned intervention consists of four participatory modules delivered by trained female peer educators from participants’ communities. Sessions address risky sexual behavior; unintended pregnancy, unsafe abortion, and sexually transmitted infections; gender-based violence and communication; and contraception and sexual-health counseling. Activities incorporate culturally contextualized discussions, role-plays, storytelling, peer dialogue, life-skills training, contraceptive demonstrations, and referrals to youth-friendly services.

Results Barriers operated across levels and included anticipated stigma and social judgment, limited decision-making power, parental and partner control, judgmental healthcare providers, confidentiality concerns, contraceptive myths, and restrictive cultural norms favoring high fertility and early childbearing. Facilitators included peer trust, supportive family and friends, youth-friendly services, school clubs, community dialogues, youth forums, community champions, and supportive policies and partnerships.

Conclusions Successful implementation will require addressing interacting barriers across individual, interpersonal, institutional, community, and policy levels. The authors recommend reducing stigma and cultural barriers, improving provider attitudes and confidentiality, strengthening peer and family support, engaging communities to shift norms, addressing gendered power dynamics, and leveraging supportive policies and partnerships.