Transforming social norms to improve girl-child health and well-being: A Realist Evaluation of the Girls’ Holistic Development program in rural Senegal

This article was published in the December 2021 issue of Reproductive Health.

This article shares findings from a Realist Evaluation of the Girls’ Holistic Development approach – implemented by the Grandmother Project – Change Through culture in the Vélingara department of Senegal – using a mixed-method, quasi-experimental design with a comparison population. The authors examined differences in intergenerational communication, decision-making and descriptive and injunctive norms related to early marriage, pregnancy and schooling. Findings demonstrated shifts in social norms, particularly for VYA girls, in intervention villages favoring delaying girls’ marriage, preventing early pregnancy and keeping girls in school along with increased support for and action by grandmothers to support girls and their well-being related to these same outcomes. This research helps explain the linkage between social norms and girls’ reproductive health and education outcomes and demonstrates that normative shifts can lead to behavior change via collective community action mechanisms.