“Building a better wheel” based on evidence: Reflections on the Learning Collaborative’s Scale-Up meeting

Marta Pirzadeh, MPH, is Senior Technical Officer in Research Utilization at FHI 360. She has over fifteen years of experience in the public health field with a primary focus on youth, maternal and infant health, HIV prevention, and sexual and reproductive health programming.

The quintessential question “why reinvent the wheel?” can be applied to many global health and development problems. Sometimes the phrase is used when activities are perceived as duplicating something that already exists, when in reality, the activities may possess additional value. Sometimes ideas are re-packaged or enhanced to meet current demands and new evidence. As global health and development professionals, we improve outcomes by scaling up what we know works—not “reinventing the wheel,” but building a better wheel. The better wheel is based on an existing framework, evidence, and lessons learned. Can we say the same for scaling up normative change interventions?

The Problem: A Fragmented Field

The influence of social norms on adolescent and youth sexual and reproductive health (AYSRH) is not an entirely new concept, but we still have much to learn. It is a fragmented field, often creating duplicative efforts and coordination gaps. While there are new initiatives emerging, there is a limited theoretical understanding of normative change mechanisms to support AYSRH and a lack of a documented (and disseminated!) evidence on shifting social norms: what works, why, and costs.

Why a Learning Collaborative?

The Learning Collaborative to Advance Work on Normative Change for Adolescent Sexual and Reproductive Health (“Learning Collaborative”) facilitates collaboration between organizations working on adolescent sexual and reproductive health norm change initiatives, enhancing collective efforts, building knowledge, and developing shared tools to promote and guide effective social norm theory, measurement and practice at scale. To achieve these goals, the Learning Collaborative established three focused Learning Communities: Theory, Measurement, and Scale-up & Costing.

Convening the Scale-Up Learning Community

In late April 2017, The Scale-up & Costing Learning Community hosted Building on the Momentum: Taking Normative Interventions to Scale, a half-day meeting  in Washington, DC to grapple with issues of scale-up and sustainability as they relate to AYSRH social norms interventions. The meeting convened nearly 20 AYSRH experts from around the world, including program advisors and implementers, researchers, donors, and advocates. Meeting participants shared their experiences with AYSRH social norms interventions, discussed critical challenges and successes, and helped to define activities for the Learning Community.

Building on a day and half meeting hosted by Pathfinder International and its Evidence to Action project, entitled Diving in: Exploring Evidence & Learning from a Decade of Reproductive Health Programming for Married Youth & First-Time Parents, the Learning Collaborative meeting was not about answering questions or finding solutions, but rather about sharing experiences and finding ways to work together. We challenged each other with questions like:

• What is a normative change intervention in AYSRH? What is the essence of the program, and what makes it work? Are there key elements that are critical for every social norms intervention to be successful?
• What does scale up mean for normative change interventions in our sector?
• What more do we need to learn for scaling up and sustaining social norms change AYSRH interventions?
• When there is sustained impact, do we need sustained interventions?
• How can we better understand and improve on our approaches to estimate the cost of social norm interventions? How can the use of this information promote sustainability and adaptation in other settings?

These are not questions to be answered in a half-day forum. Yet the meeting was an important step in a series of thought-provoking discussions, and a rare and refreshing opportunity to share honestly about successes and failures without hesitation or judgement. Over the next eighteen months, the Learning Collaborative will continue to wrestle with these types of questions and use our evidence, practice, and experiences to create a set of common considerations for programs to operate effectively at scale.

Missed the meeting?

• Check out the presentation from “Passages Project: Transforming Social Norms for Sexual and Reproductive Health.” 
• Learn more about the Learning Collaborative to Advance Work on Normative Change for Adolescent Sexual and Reproductive Health
• Join the Scale-Up and Costing Learning Community within the Learning Collaborative! Email Monica Giuffrida at mmg273@georgetown.edu.