Findings of an evaluation of community and school-based reproductive health and HIV prevention programs in Kenya
Outcomes: Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways This study provides strong evidence that addressing perceived social expectations can reduce the acceptability and prevalence of female genital mutilation/cutting (FGM/C). While the intervention did not explicitly state they were measuring injunctive norms, the survey included items on perceived community approval, religious endorsement, and social pressure—core elements of injunctive norms. The intervention targeted beliefs that cutting is required for marriageability, social respect, and morality. The study found significant shifts in perceptions of community and religious leader approval of FGM/C, as well as a reduced intention to cut daughters, particularly where both community and school-based components were implemented. These findings suggest that norm-sensitive, multi-level strategies can catalyze change in entrenched practices like FGM/C.
Objectives To evaluate the effectiveness of a community-based intervention, alone and in combination with a school-based intervention, in reducing support for and practice of FGM/C in rural Kenya.
Methods This quasi-experimental study was conducted in three sites: one received a community intervention, one received both community and school-based interventions, and one served as a control. Pre- and post-intervention surveys were conducted with randomly selected female respondents aged 15–49 (n=1,932 at baseline and n=2,178 at endline). The study compared changes in knowledge, attitudes, and behaviors related to FGM/C across sites, using chi-square tests and logistic regression.
Intervention Details The community intervention included facilitated discussions using the “Community Capacity Enhancement” approach, public dialogues, religious leader engagement, and local media. The school-based component involved life skills education and teacher training. The aim was to create safe spaces for dialogue and to influence normative beliefs around FGM/C.
Results Significant reductions in support for FGM/C were observed in both intervention sites. In the community-only site, support fell from 85.6% to 63.1%; in the combined site, from 88.2% to 59.3%. The proportion of respondents reporting that “most people in the community approve of FGM/C” dropped significantly, and fewer women reported intending to have their daughters cut. The control site showed no significant change. Knowledge about health consequences and legal status also improved more in the intervention sites.
Conclusions Multi-component, community-driven approaches can shift social norms that sustain FGM/C. Although not framed in formal social norms theory, the intervention effectively altered perceived community expectations and intentions. Combining community dialogue with school engagement appears particularly effective in challenging the normative basis of harmful traditional practices.
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