Key Social Norms Take-aways The SASA! study demonstrates that community mobilization can meaningfully shift social norms related to intimate partner violence and gender equality, leading to reductions in both the social acceptance and actual experience of violence against women, and influencing HIV risk behaviors. It highlights the importance of engaging entire communities in dialogue about power and gender norms and the value of measuring outcomes at the community—not just individual—level.
Objectives The study aimed to assess the community-level impact of SASA!, a community mobilization intervention designed to prevent violence against women and reduce HIV risk behaviors in Kampala, Uganda.
Methods The research employed a cluster randomized controlled trial over a four-year period, with cross-sectional surveys conducted at baseline and follow-up in eight communities (four intervention and four control). The study used multistage stratified random sampling to select respondents aged 18 to 49 and conducted adjusted cluster-level intention-to-treat analyses on six predefined primary outcomes.
Intervention Details SASA! is a community mobilization approach developed to address violence against women and HIV risk by shifting social norms around power and gender. Implemented over 2.8 years in four Ugandan communities, SASA! engaged community activists to lead informal activities, share materials, conduct street dramas, and hold conversations about power, relationships, and gender equity. The intervention included four phases—Start, Awareness, Support, and Action—designed to build momentum and reinforce norm change across different layers of the community.
Results The intervention significantly reduced the social acceptance of intimate partner violence among women and men, increased support for a woman’s right to refuse sex, and halved women’s past-year experiences of physical violence. Although reductions in sexual violence were not statistically significant, they were in the hypothesized direction. Communities exposed to SASA! also showed improved responses to women experiencing violence and significantly lower levels of male sexual concurrency.
Conclusions The SASA! study is the first in sub-Saharan Africa to demonstrate that community mobilization can lead to meaningful shifts in both social norms and behaviors related to violence and HIV. Results show consistent positive effects across all primary outcomes. These findings affirm the value of structural, community-driven approaches to gender equality and public health.