If you don’t measure it, how do you know if it changed?!

Social norms are a hot topic in development. While it seems intuitive that social norms can play a key role in influencing people’s behavior (in both negative and positive ways), the jury is still out on the best way for programs to address norms. We do know that in order to provide evidence on the power of norms change to improve behavior, we need effective ways to measure and monitor norms.

In 2017, as part of the USAID-funded Passages Project, we set out to systematically assess what empirical evidence exists around the relationship between social norms and use of modern family planning methods. The results are detailed in, “Measurement of Social Norms Affecting Modern Contraceptive Use: A Literature Review,” a new report published in Studies in Family Planning.

We started our review by using key word searches in POPLINE to look for original research focusing on family planning and norms, and used additional lexical searches, title screening, and abstract screening to identify studies that met the following criteria:

• they measured use of a modern family planning method as a primary study outcome
• they measured either a behavioral or an attitudinal norm using a specified reference group
• they purposefully included social norms as part of a theoretical framework for the study

­­Of 174 articles reviewed in full, only 17 studies met our minimum criteria. Across these studies, no single measure of social norms was used in more than one study and there also was a lot of inconsistency in the terminology used to describe how the measures were created. Of the 17 studies reviewed in full, almost all of the studies focused on condom use as a behavioral outcome and most were conducted in Sub-Saharan Africa.

While we were hoping to find best practices for designing surveys that measure both social norms and family planning use, our review revealed a general lack of standardization and a need for more studies that systematically measure social norms. More work is still needed to fully understand the relationship between social norms and family planning use, but we do have some recommendations to bring greater consistency and comparability to social norm measures. After all, if you don’t measure it, how do you know if it changed?!

Here are our top recommendations from the report:

1. Additional research is needed to bolster the evidence base around social norms and family planning use, particularly looking at methods other than condoms. There is also a need for data collection on social norms that uses robust study designs, including studies that randomize selection and are conducted longitudinally.
2. Researchers should allow respondents to identify the type of people or the specific people in their lives who influence their behavior (e.g. rather than assuming “friends” are the most relevant influencers or “reference group”). Studies and programs can also distinguish between reference groups for who’s doing the behavior and those who approve of the behavior.
3. Authors should clearly specify the type of norms they are seeking to measure and the theoretical framework they are using to conceptualize their measure to help reduce conflation around terms like social norms, gender norms, normative beliefs, etc. In turn, journal editors and reviewers should require this type of clarity in submitted manuscripts and should advocate increased use of standardized or commonly used terms and measurement approaches.
4. We encourage researchers and practitioners to consider measuring social norms at a more collective level. In other words, as opposed to relying solely on individual, self-reported data – like we collect in most surveys and program evaluations – instead think about looking for data that evidences changes at more macro program or policy-levels. With these data, there may be fewer concerns with biases and reference groups and thus they may be more easily obtained and a more accurate representation of norms.

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Passages, led by the Institute for Reproductive Health at Georgetown University in partnership with FHI 360, JHU’s Global Early Adolescent Study, PSI, Save the Children and Tearfund, aims to address a broad range of social norms, at scale, to achieve sustained improvements in family planning and sexual and reproductive health. This research project is building the evidence base and contributing to the capacity of the global community to strengthen normative environments that support positive family planning and sexual and reproductive health, especially among very young adolescents, newly married couples, and first-time parents. In DRC, Passages’ Transforming Masculinitites/Masculinite, Famille, et Foi study promotes positive masculinity and gender equality through congregations and religious leaders.