Evaluation of a male engagement intervention to transform gender norms and improve family planning and HIV service uptake in Kabale, Uganda
Outcomes: Gender‑Based Violence, Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways This study highlights the difficulty of transforming entrenched gender norms through short-duration, community-based interventions without adequately trained facilitators. Although some improvements were observed in men’s health-seeking behaviors, meaningful changes in gender attitudes were minimal. The findings underscore that deeply held cultural beliefs are resistant to change, especially when interventions are not sufficiently intensive, tailored, or supported. Effective social norms transformation requires well-resourced, longer-term efforts that are grounded in the local context and involve skilled facilitators.
Objectives To evaluate the effectiveness of a male engagement intervention designed to promote equitable gender norms and increase the uptake of family planning (FP) and HIV services among men in Kabale, Uganda.
Methods The study used pre- and post-intervention cross-sectional surveys conducted with men participating in community-based workshops. Surveys included the Gender Equitable Men (GEM) Scale to assess changes in attitudes and behaviors related to gender norms. Exploratory factor analysis (EFA) was used to develop composite scores for inequitable (IGN) and equitable (EGN) gender norms. Health-seeking behaviors were also self-reported and compared across time points.
Intervention Details The intervention engaged 32 male community-nominated “model men” (Emanzis) to serve as peer educators. These men received two weeks of training based on a simplified, localized version of the Men As Partners (MAP) curriculum. They led groups of 20 men through a 10-session workshop covering topics such as FP, HIV prevention, and challenging harmful gender norms. Workshop delivery was entirely oral, designed for low-literacy participants, and supported with periodic mentoring and a modest stipend for facilitators.
Results The intervention showed only modest improvements in GEM scale scores, with very small effect sizes (Cohen’s d = 0.11–0.13). Some positive shifts occurred in attitudes toward shared contraceptive decision-making and women’s condom use. However, many men continued to express support for inequitable norms, such as the belief that a woman’s primary role is domestic. Encouragingly, men reported increased health-seeking behaviors: more sought services for themselves and their partners, HIV testing increased (from 71.5% to 87.6%), and condom use rose (from 13.9% to 32.8%).
Conclusions While the intervention did not substantially shift gender norms, it generated valuable lessons about implementation challenges. These include the need for better facilitator training, longer program duration, and culturally grounded strategies. The study cautions against assuming short-term interventions can achieve transformative change and calls for practical guidance on designing scalable, effective gender-transformative programming.
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