The Passages Project: Final Report

"Norms-shifting interventions (NSIs), an emerging field within SBC [social and behaviour change], engage community and social systems, seek to redistribute power and social influence, and thus shift social norms to support the health and wellbeing of community members."

The Passages Project (2015-2022) is an implementation research project that aimed to address a broad range of social norms, at scale, to achieve sustained improvements in violence prevention, gender equality, family planning, and reproductive health. Working in five countries, Passages' implementing partners designed, tested, and/or scaled up a suite of six norms-shifting interventions (NSIs) in several African countries that promoted collective norms shifts and enabling environments for new norms and behaviours, with a focus on individuals in life course transitions. This final report for the project presents the legacy contributions of the endeavour to map the why, what, and how of NSIs as a pathway to improved adolescent and youth sexual and reproductive health (AYSRH).

The report begins with an overview of the Passages Project. Georgetown University's Institute for Reproductive Health (IRH) led the project, whose major funder was the United Stated Agency for International Development (USAID). Alongside IRH, six organisations formed the Passages consortium: FHI 360, Johns Hopkins University's Global Early Adolescent Study team, Save the Children, Tearfund, Population Services International, and the Population Reference Bureau. The report briefly describes the six NSIs (which are also summarised on The CI platform): Masculinité, Famille et Foi in Democratic Republic of the Congo (DRC) with scale-up in Rwanda; Girls' Holistic Development in Senegal; Growing up GREAT! in Uganda; Terikundu Jékulu in Benin with scale-up in Mali; Husbands' Schools in Niger; and Responsible, Engaged, and Loving (REAL) Fathers in Uganda.

Part 1 of the report presents the four legacy areas of the Passages Project - Advancing Understanding, Improving Implementation, Enhancing Evaluation, and Strengthening Scale-Up - and the milestones and conceptual breakthroughs the project made over time. Using Passages' "legacy map", the report outlines the body of evidence, tools, and resources along the four areas ("learning tracks"), which highlight and codify the NSI projects' major conceptual and practical breakthroughs, which Passages believes advanced the field. In many instances, a legacy product makes advances along more than a single learning track: In such cases, a junction is indicated on the map on page 22 of the report. (Search The CI site for the titles included in Part 1.)

To cite only one example of a product described in Part 1: In the project's 2018 working paper "Identifying and Describing Approaches and Attributes of Norms-Shifting Interventions" (at Related Summaries, below) and the accompanying brief, "Community-Based, Norms-Shifting Interventions: Definitions and Attributes", the Social Norms Learning Collaborative - which was created in 2016 to leverage the opportunity created by the Passages Project to advance understanding of social norms - offers nine attributes that distinguish an NSI from other community-based projects: It seeks community-level change, engages people at multiple levels, corrects misperceptions around harmful behaviours, confronts power imbalances, creates safe spaces for critical reflection, roots the issue in the community's own value systems, accurately assesses norms, uses organised diffusion, and/or creates positive new norms.

Part 2 is a distillation of key lessons from the Passages Project, identified and defined by the Passages staff during the final year of the project. In brief, the lessons are organised around the following themes:

1. Advancing understanding of social norms and theory-based practice, operational concepts, and how NSIs contribute to SBC.
   • To define a norm, a reference group must be present, as must rules governing typical and appropriate behaviour, with attention to rewards for compliance and sanctions for non-compliance with a norm or expected behaviour.
   • Participatory theory-building with staff, stakeholders, and researchers/evaluators creates a common understanding of how norms-change mechanisms operate and the relationship between norms, behaviours, and other factors.
   • Passages clarified the operational definition of NSIs, which recognise community and social systems as an essential focus of change to redistribute power and social influence to support the health and wellbeing of community members.
   • Norms-shifting in community-based projects tends to be localised (for example, a community expectation that women give birth with a trained provider) rather than society-wide, at least within the studies under the Passage Project.
2. Improving implementation with practical approaches to identify and include social norms in programming and social change monitoring, applying ethical thinking throughout.
   • Taking time to investigate with primary intervention groups which norms influence behaviors is good practice: Don't assume you know.
   • Monitoring social change effects that emerge from NSI implementation requires only minor adjustments in project monitoring (e.g., build into regular team meetings pause-and-reflect sessions).
   • Look for three signs of norm shifting by asking if the norm is: (i) no longer commonly accepted? (ii) no longer approved? and/or (iii) contested due to a lack of consensus about the norm?
   • Projects are time-bound, but more time may be needed to facilitate norms shifting, or to see evidence of behaviour change - even when intervention strategies are effective.
   • Because NSIs aim to influence communities' determinations about acceptable behaviour, their design and implementation should be rooted in ethical thinking and practice.
3. Enhancing evaluation with field-tested measures and an expanded range of participatory, theory-based, and mixed-methods approaches.
   • Participatory research methods that engage primary groups as partners in defining local issues and priorities can lead to new understandings of norms constructs.
   • Passages fostered creation of globally accepted standards for social norms measures. According to these criteria, social norms measures should: gauge the descriptive norm or the injunctive norm, and ideally both; refer to one specific behaviour; refer to a clearly defined reference group(s); refer to a primary group for the programme; and determine what rewards people anticipate for complying with the norm and what penalties they expect for noncompliance.
   • Valid and reliable quantitative measures of norms change can be developed and used in evaluation; a stepwise process to define each measure involves formative research, testing, and factor analysis.
   • The Passages Project's Realist Synthesis of NSIs, which analysed evaluation and other study findings with theories of change across projects, led to a middle-range theory about how NSIs foster norms shifts.
4. Strengthening scale-up or employing core scale-up principles with attention to norms-shifting adaptations, mitigating pushback, and building confidence and skills of new NSI users.
   • Development organisations and ministries that are inexperienced in norms change but are interested in scaling norms-responsive programming may choose to adapt already-tested NSIs to address social and gender norms. In such cases, stakeholder inputs on adaptations are crucial to increase the likelihood that an NSI is successfully integrated and scaled.
   • When designed with scalability in mind, community-based NSIs can be scaled regionally and across borders to achieve population-level impact. NSIs should respect core scale-up principles, such as partnerships built on trust and collaboration.

Part 3 of the report provides an overview of the how the Passages staff developed the Social Norms Research Agenda, which aims to collectively prioritise evidence gaps related to social norms-shifting for AYSRH for future research and investment. (See Related Summaries below for access to this document.)

The annex of this report contains the complete bibliography of work produced under the Passages Project - many of which are summarised on The CI website. The first table in the annex shares Passages legacy products - those that are cross-cutting between interventions or represent higher-level research and analysis. These products are grouped by their primary learning track, with junctions to other learning tracks indicated. The second table shares Passages products that are specific to one of the six NSIs under the Passages umbrella.