Aligning human rights and social norms for adolescent sexual and reproductive health and rights

Figures & data

Panel 1: Definition of SRHR

The 2018 Guttmacher-Lancet report, “Accelerate progress – SRHR for all: Report of the Guttmacher-Lancet Commission”, provides an integrated definition of SRHR highlighting aspects fundamental to all people’s – including adolescents’ – rights to: freely define their own sexuality, including sexual orientation and gender identity and expression; decide whether and when to be sexually active; choose their sexual partners; have safe and pleasurable sexual experiences; decide whether, when, and whom to marry; decide whether, when, and by what means to have a child or children, and how many children to have.

Source: Starrs et al³

Panel 2: Promising practices for developing and evaluating interventions to align social norms and ASRHR

Design
Use an ecological framework to analyse and address different intersecting factors affecting norms and rights for ASRHR.	Develop a theory of change incorporating evolving capacities, norms, gender and rights, and map intervention components to theory of change stages.
Conduct gender and age-analytical formative research to understand local norms and practices concerning gender, human rights and ‘adolescence’ that affect ASRHR.	Design components for the evolving capacities of the intervention age group, rather than adapt material previously for adults.
Incorporate formative research into the design and implementation of multi-level, multi-component interventions and evaluation.	Budget for and develop child protection protocols for implementation and evaluation, including for external evaluation teams.
Implementation
Consider engaging adolescents aged 10-14 years, capitalising on early adolescence for intervening on beliefs about gender roles, responsibilities and norms before they intensify later.	Work with men and boys, and with teachers, parents and community leaders to transform gender norms underpinning poor ASRHR decision-making and outcomes.
Use an empowerment approach with adolescents, taking into account rights to participation, self-expression, information and ASRHR decision-making.	Tap into local media and technology for diffusion of new positive ASRHR norms.
Incorporate participatory activities for community deliberation, mobilisation and collective action that unpack gender, norms, power, human and child rights affecting ASRHR and create new norms for ASRHR.	Monitor ethics and child protection protocols to prevent, monitor and respond to the potential retaliation for resisting strong norms and promoting new ones.
Evaluation
Develop quantitative and qualitative evaluation methods and instruments to diagnose and measure change in ASRHR-relevant norms at community level, and understand pathways where norms affect ASRHR.	Ensure that evaluation of interventions assesses shifts in power dynamics, gender roles and responsibilities, and social norms.
Explore vignettes in focus group discussions and surveys to identify and measure harmful and helpful norms that affect ASRHR.	Select and train evaluation data collection teams on ethical protocols on responding to child protection disclosures.

Sources: Adapted in part from^9,21,33–36

Starrs AM, Ezeh AC, Barker G, et al. Accelerate progress – sexual and reproductive health and rights for all: report of the Guttmacher– Lancet Commission. The Lancet. 2018;391:2642–2692. doi: 10.1016/S0140-6736(18)30293-9

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