The Flower for Sustained Health: An integrated socio-ecological framework for normative influence and change

The impact of harmful social norms, such as expectations related to male use of power to control women, girl’s education, early marriage, and early parenthood, is receiving increasing attention from policy makers, program implementers, and researchers around the globe. As programs seek to foster norms that support healthy behaviors over the life course, there is an opportunity to advance understanding of social norms: what they are, how to measure them, how they influence behavior, and how to scale up norms-shifting interventions that show promise. The Learning Collaborative to Advance Normative Change seeks to advance knowledge and practice related to shifting the social norms that influence the ability of adolescents to reach their full potential. With funding from the Bill and Melinda Gates Foundation, this network facilitates coordination and collaboration between donors, organizations, and projects working on norms-shifting interventions aimed at improving adolescent sexual and reproductive health (SRH) outcomes, ultimately enhancing collective efforts to build and share evidence to promote effective practice at scale. It is a platform for coordinated identification of norms-shifting interventions and evidence, and sharing and discussion of emerging evidence, promising practices, and lessons learned. The Learning Collaborative is organized according to three focused Learning Communities: Measurement, Theory, and Scale-Up. Members of the Learning Collaborative envision a world where the powerful influence of social norms in shaping adolescents’ lives is widely understood, and where projects and programs improve adolescent SRH by applying normative science at scale. Made up of a network of experts committed to facilitating collaboration between organizations and individuals working on adolescent SRH norms-shifting interventions, the Learning Collaborative is working to enhance collective efforts, build knowledge, and develop shared tools to promote and guide effective social norm theory, measurement, and practice at scale. A conceptual framework can add clarity to the design, monitoring, and evaluation of norms-shifting interventions, and facilitate learning by providing a common language and set of concepts to use when comparing and contrasting program experiences and results. This document represents the key task for the first year of the Theory Community of the Learning Collaborative, built on work by members and others to propose a conceptual framework of the influence of social norms on adolescent SRH behavior. Based on this understanding, the Theory Community is now beginning to reach out to practitioners on the ground to develop theories of change for norms-shifting interventions. The proposed conceptual framework of the influence of social norms on adolescent SRH behavior is designed to provide a common language and set of concepts to use when comparing and contrasting program experiences and results. This framework is built on work by members and others to propose a conceptual framework of the influence of social norms on adolescent SRH behavior. Based on this understanding, the Theory Community is now beginning to reach out to practitioners on the ground to develop theories of change for norms-shifting interventions. The conceptual framework proposes that social norms influence adolescent SRH behavior through several mechanisms, including socialization, internalization, and automaticity. Social norms can also be enforced through punishments and rewards, and can be influenced by social identity and the need to solve social dilemmas. Recent advancements in the “norms as belief” approach suggest that social norms are not just descriptive, but also prescriptive, and that they can shape behavior through the creation of social identity and the need to conform to group norms. The Learning Collaborative is working to advance knowledge and practice related to