Report: Effects of Social Norms on Health and Livelihood Outcomes for Adolescent Girls and Young Women in Low- and Middle-Income Countries

Over the past decade, there has been growing recognition of the role social and gender norms play in shaping health and development outcomes, particularly for adolescents and young people. With those aged 10–24 representing about a quarter of the world’s population, understanding how social norms influence their behaviors and life trajectories is critical. Within global health programming, norm-shifting interventions—ranging from community-based initiatives to mass media and edutainment approaches—seek to transform harmful norms or reinforce positive ones. However, both empirical evidence on their effectiveness and mechanisms of change, as well as practical implementation guidance on the “how-to”, remains limited.

This report presents findings from a set of scoping reviews conducted in 2024 by the Center on Gender Equity and Health at the University of California San Diego to support the Gates Foundation’s Adolescent and Youth Learning Agenda. The scoping reviews examined the relationship between social norms and the health and livelihood outcomes of adolescent girls and young women in sub-Saharan Africa and South Asia. As such, the report synthesizes existing evidence on how norms shape behaviors, the key drivers of normative change, and the effectiveness of interventions designed to shift norms across these contexts.

To support accessibility and relevance for different audiences, the report is structured in a modular format, with each module organized to align with the learning questions. Module 1 serves as an introduction, providing a detailed overview of the project and methodology, as well as an assessment of the strength and limitations of the evidence included in the review. Each subsequent module begins with a brief introduction before delving into specific analytical approaches relevant to its focus. As you read the report modules, we recommend you refer to Module 1 for expanded details on the methodological approach. Module 2 summarizes empirical evidence on the broader influence of social norms, including the drivers of and pathways leading to behavior change. Module 3 and Module 4 offer a deeper examination of programmatic and evaluation components related to entertainment media and faith and cultural champion interventions, as well as recommendations for best practice to inform future research and programmatic efforts.