Key Social Norms Take-aways Social norms deeply influence reproductive behavior in the Fertit community of South Sudan, particularly through expectations around high fertility, male decision-making, and limited female agency. However, these norms are shifting. Emerging beliefs support spacing pregnancies and investing in children’s wellbeing, challenging long-standing norms that emphasize having many children. The post-conflict context has created a window of opportunity to support these evolving norms. Public health programs should engage men and women in dialogue, using culturally relevant messaging that promotes family planning as a shared, responsible decision grounded in care and aspiration.

Objectives This study explored how social norms influence family planning decisions and contraceptive use among the Fertit people in Western Bahr el Ghazal, South Sudan. It aimed to inform culturally appropriate sexual and reproductive health programming in a post-conflict setting.

Methods Researchers conducted a qualitative study using five focus group discussions and 44 semi-structured interviews with purposefully selected community members, health workers, and key informants. Topic guides were informed by the theory of planned behaviour and a broader framework on decision-making in sexual and reproductive health. Data were thematically analyzed and validated through workshops and follow-up interviews.

Results Community attitudes strongly supported childbearing, widely seen as both a divine blessing and a social obligation. A deeply entrenched norm expected women to have many children, and failure to conceive carried stigma and social repercussions. At the same time, there was widespread recognition—among both men and women—of the importance of spacing pregnancies for maternal and child health, and spacing was aligned with traditional beliefs as well. While knowledge of modern contraceptive methods was common, especially among younger women, their use remained sensitive. Male resistance to contraception, often rooted in concerns about cultural change and suspicions about external influences, limited uptake. Nonetheless, some women—particularly younger and urban women—used contraception covertly, challenging gender norms in the process. Emerging norms also associated good parenting with providing education and care, not just having many children. These shifting expectations reveal a dynamic social environment where traditional and evolving norms coexist and compete.

Conclusions In Western Bahr el Ghazal, while norms supporting high fertility persist, they are increasingly challenged by new values centered on child wellbeing and gender equity. Programs should build on these evolving norms to promote shared decision-making and family planning grounded in care, health, and aspiration.