Key Social Norms Take-aways The Healthy Transitions project demonstrates the potential of community-based, gender-transformative interventions to shift social norms around male roles in reproductive, maternal, and neonatal health in Nepal. By engaging men through relatable media, dialogue, and reflection, the intervention addressed traditional gender norms—such as male detachment from maternal health and harmful menstrual practices—while fostering supportive behaviors among husbands. The project revealed both the potential for transforming gender norms and the cultural and logistical challenges that still inhibit full male participation.
Objectives The study aimed to explore the perceptions and experiences of adolescent girls and young women, their husbands and in-laws, and community stakeholders regarding the Healthy Transitions male engagement intervention and its effect on male participation in reproductive, maternal, and neonatal health in Karnali Province, Nepal.
Methods This qualitative study used semi-structured in-depth interviews and key informant interviews with 64 individuals, including adolescent girls and young women, husbands, in-laws, health workers, government officials, and program staff. Data were collected across four districts and analyzed thematically using a deductive coding framework and narrative synthesis to capture program outcomes and implementation challenges.
Intervention Details Healthy Transitions was implemented from 2018 to 2021 using a multi-level, gender-transformative model targeting newly married adolescents and their families. Activities included home visits using tablet-based videos on six key topics (e.g., spousal roles in maternal care, decision-making, and gender equality), community dialogues facilitated by trained social mobilizers, and social events with games and performances. These tools were designed to improve spousal communication, challenge harmful social norms, and build support for reproductive and maternal health care.
Results Participants reported improved spousal communication, increased male involvement in antenatal care and family planning, and more gender-equitable household practices. Men showed greater awareness of menstruation, maternal health, and child care. Harmful practices like Chhaupadi were reportedly reduced. Barriers included men’s migration for work, discomfort discussing reproductive health, and social stigma around male involvement. However, when men were reached, the intervention often led to substantial behavior change and norm shifts within households.
Conclusions Healthy Transitions effectively engaged men to support adolescent girls and young women’s reproductive and maternal health through targeted, culturally relevant interventions. Despite implementation challenges, the program shifted attitudes and behaviors, suggesting that embedding male engagement in health systems and scaling such interventions can contribute to long-term norm change and improved health outcomes.