Communication, Social Norms, and Contraceptive Use among Adolescent Girls and Young Women in Lilongwe, Malawi
Outcomes: Sexual and Reproductive Health
View SourceKey Social Norms Take-aways The study highlights that AGYW are strongly influenced by their social ties — particularly partners and peers — when deciding whether to use non-barrier contraception. Interventions seeking to increase contraceptive use should go beyond delivering information or focusing on approval and instead strengthen peer-to-peer and partner communication and address perceptions of peer behaviors. Family planning programs must also adapt their approaches based on young women’s relationship and parenting status, recognizing that relevant social influences change across life stages.
Objectives This study aimed to understand how communication and social norms within young women’s social networks — including family members, peers, and intimate partners — influence the use of contraception among adolescent girls and young women (AGYW) in Lilongwe, Malawi.
Methods The study used cross-sectional baseline data from the Girl Power–Malawi quasi-experimental study, including surveys with 942 sexually active AGYW aged 15–24. Researchers analyzed associations between contraceptive use (both non-barrier methods and condoms) and measures of communication and social norms. Communication measures included whether participants had discussed contraception with family, peers, or partners. Social norms were measured both descriptively (perceptions of whether others use contraception) and injunctively (perceptions of others’ approval of contraception). Logistic regression models were used to explore these relationships, adjusting for demographic and social factors.
Intervention Details Although this analysis focused on baseline data, the broader Girl Power–Malawi study tested four service delivery models offering youth-friendly health services across public clinics in Lilongwe to improve sexual and reproductive health outcomes for AGYW.
Results Contraceptive communication with partners, peers, and older women in the family was positively associated with non-barrier contraceptive use, especially among single women without children. Peer descriptive norms (beliefs about peer contraceptive use) were also significantly linked to higher non-barrier contraceptive use, but injunctive norms (peer approval) were not. Notably, none of the social factors examined were significantly associated with condom use.
Conclusions Interpersonal communication and perceptions of what peers are doing play a critical role in shaping AGYW’s use of non-barrier contraceptive methods. Simply focusing on individual factors or approval attitudes is insufficient to drive uptake.
Norms Addressed
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