changing social norms associated with fgm · changing norms associated with fgm validating a macro...

C H A N G I N G N O R M S A S S O C I AT E D

W I T H F G M

VALIDATING A MACROVALIDATING A MACROLEVEL M&E FRAMEWORK

P R E - B I D M E E T I N G P R E S E N TAT I O N

2 6 T H N OV E M B E R 2 0 1 8

C H A N G I N G S O C I A LN O R M S A S S O C I AT E D

W I T H F G M

VALIDATING A MACRO-VALIDATING A MACRO-LEVEL M&E FRAMEWORK

B I D M E E T I N G P R E S E N TAT I O N

N OV E M B E R 2 0 1 8

B A C K G R O U N D

THE JOINT PROGRAMME

• Since 2008, UNICEF and UNFPA have implemented a Joint

to accelerate the abandonment of FGM through addressing the social

norms holding the practice in place.

– Financial and technical support with a human rights

approachapproach

This framework will be used to evaluate the effectiveness of communication interventions aimed at altering social norms around FGM

Since 2008, UNICEF and UNFPA have implemented a Joint Programme

to accelerate the abandonment of FGM through addressing the social

norms holding the practice in place.

Financial and technical support with a human rights-based, culturally sensitive

framework will be used to evaluate the effectiveness of communication

aimed at altering social

THE ROAD SO FAR

20

16

Drexel commissioned

to conduct desk

review and draft

framework

201

7

Presentation at a

meeting of the Joint

Programme in

Kampala, Uganda

01

7

Validation of draft at

a 2-day meeting with

experts from several

different universities

Webinars with

UNICEF and UNFPA

colleagues from

ESARO, WCARO, and

MENARO

20

18

An expanded and aligned

version of the framework

presented at a one day

UNFPA social norms

meeting

20

19

2 validation countries

selected based on

consultation with

UNICEF and UNFPA

Guinea (French);

Ethiopia (English)

19

with

UNICEF and UNFPA

colleagues from

ESARO, WCARO, and

MENARO

Roadmap (research

design, methods,

sampling and tools

outlining the entire

validation process

finalized

TORs developed for

both countries to hire

LRA to conduct

validation field work

OVERVIEW OF SOCIAL NORMS

Social norms are the

unwritten rules that guide

human behaviour. In other

words: words:

what we do,

what we believe others do,

what we believe others

think we should do.Source: (WHO, 2010)

OVERVIEW OF SOCIAL NORMS

Beliefsunwritten rules that guide

other

BehavioursExpectancies

we believe others do,

we believe others

SOCIAL NORMS AND FGM

FGM facilitates entry into social networks and the associated social support, social capitol, and power.

• A critical mass of people must abandon FGM as well as the social conventions, such as marriage, that are dependent on FGM status.

Social and economic benefits families attribute FGM provide incentives to continue the practice, high costs to abandoning FGM, and social welfare Social and economic benefits families attribute FGM provide incentives to continue the practice, high costs to abandoning FGM, and social welfare benefits.

• Norms change requires addressing the costs and highlighting the benefits of FGM abandonment.

The practice of FGM exists in a web of contradictory and complementary moral, religious, social, gender, and legal norms.

• Harmony must be struck among different types of norms to facilitate change.

SOCIAL NORMS AND FGM

FGM facilitates entry into social networks and the associated social support,

A critical mass of people must abandon FGM as well as the social conventions, such as marriage,

Social and economic benefits families attribute FGM provide incentives to continue the practice, high costs to abandoning FGM, and social welfare Social and economic benefits families attribute FGM provide incentives to continue the practice, high costs to abandoning FGM, and social welfare

Norms change requires addressing the costs and highlighting the benefits of FGM abandonment.

The practice of FGM exists in a web of contradictory and complementary moral, religious, social, gender, and legal norms.

Harmony must be struck among different types of norms to facilitate change.

CONCEPTUAL MODEL

T H E A C T F R A M E W O R KT H E A C T F R A M E W O R K

• Assess what people know, feel and do• Ascertain “normative” factors: descriptive and injunctive

norms and outcome expectanciesA

ACT FRAMEWORK

• Consider context, especially gender and power• Collect information on social networks and social

supportC

• Track individual and social change• Triangulate all data and analysisT

Assess what people know, feel and doAscertain “normative” factors: descriptive and injunctive norms and outcome expectancies

Consider context, especially gender and powerCollect information on social networks and social

Track individual and social changeTriangulate all data and analysis

COMPONENTS OF THE ACT FRAMEWORK

ConstructsIIndicators

The ACT Framework is a macrolevel model for measuring social norms change relative to FGM

COMPONENTS OF THE ACT

Methods

Tools

IndicatorsMethods

The ACT Framework is a macrolevel model for measuring social norms change relative to FGM.

1 . A S S E S S W H A T P E O P L E A 1 . A S S E S S W H A T P E O P L E K N O W , F E E L , A N D D OA 1 . A S S E S S W H A T P E O P L E 1 . A S S E S S W H A T P E O P L E K N O W , F E E L , A N D D O

A ASSESS WHAT PEOPLE KNOW

POTENTIAL INDICATORS

• Types of FGM/C • Risks of FGM/C• Harmonization of

legal, religious, and moral norms.

ASSESS WHAT PEOPLE KNOW

POTENTIAL METHODS

• Questionnaire• Body maps• Draw and Describe

AASSESS WHAT PEOPLE KNOW:

Body Map to Assess Risks of FGM/C

When a girl undergoes

FGM/C, what does her mind

think?

When a girl undergoes FGM/C,

what does her heart feel?

ASSESS WHAT PEOPLE KNOW:EXAMPLE

Body Map to Assess

When a girl undergoes FGM/C,

what does her heart feel?

A ASSESS WHAT PEOPLE FEEL

• Reasons why FGM/C exists


• Reasons why FGM/C exists• Positive beliefs about FGM/C• Support for the continuation of

FGM/C• Intention to cut daughter• Self-efficacy to abandon

FGM/C

ASSESS WHAT PEOPLE FEEL

POTENTIAL METHODS

• Questionnaire• Self-efficacy scale• Belief scale

• Free-listing• Empathy Mapping• Complete the Story• Confidence Snails

Support for the continuation of

A ASSESS WHAT PEOPLE DO


• Prevalence of FGM/C • Type of FGM/C• Age when cut

ASSESS WHAT PEOPLE DO

• Questionnaire

POTENTIAL METHODS

• Questionnaire• Gynaecological Exams• Review of health records• Cultural markers

(e.g., henna feet)

AASSESS WHAT PEOPLE DO:

Cultural Markers -prevalence of FGMC

Photographs of the feet of all girls entering primary school

A girl is considered cut if there foot or if she responded yes to having been purified.

ASSESS WHAT PEOPLE DO:EXAMPLE

“henna” on feet to examine prevalence of FGMC

Photographs of the feet of all Have you been purified?

A girl is considered cut if there was residual henna on her foot or if she responded yes to having been purified.

A 2 . A S C E R T A I N N O R M A T I V E F A C T O R SA N O R M A T I V E F A C T O R S2 . A S C E R T A I N N O R M A T I V E F A C T O R SN O R M A T I V E F A C T O R S

A ASCERTAIN NORMATIVE FACTORS


• Descriptive norms• Injunctive norms• Outcome Expectancies

• Benefits• Sanctions

ASCERTAIN NORMATIVE FACTORS

POTENTIAL METHODS

• Questionnaire• Free-listing• 2x2 tables for social norms

AASCERTAIN NORMATIVE FACTORS:

2x2 Tables to Measure Descriptive Norms, Injunctive Norms, Benefits,

APPROVAL SELF

NO YES

AP

PR

OV

AL

CO

MM

UN

ITY

MEM

BER

S

NO

NO, NO

REASONS:REWARDS:PUNISHMENTS:

YES, NO


YES

NO, YES

REASONSREWARDS:PUNISHMENTS:

YES, YES


ASCERTAIN NORMATIVE FACTORS: EXAMPLE

2x2 Tables to Measure Descriptive Norms, Injunctive Norms, Benefits, and Sanctions

BEHAVIOUR SELF

NO YES

BEH

AV

IOU

RC

OM

MU

NIT

Y M

EMB

ERS

NO

NO, NO


YES, NO


YES

NO, YES

REASONSREWARDS:PUNISHMENTS:

YES, YES


1 . C O N S I D E R C O N T E X T , E S P E C I A L L Y C C O N T E X T , E S P E C I A L L Y G E N D E R A N D P O W E RC1 . C O N S I D E R C O N T E X T , E S P E C I A L L Y C O N T E X T , E S P E C I A L L Y G E N D E R A N D P O W E R

C CONSIDER CONTEXT ESPECIALLYGENDER & POWER


• Agency• Decision-making• Gender roles• Progressive Beliefs• Egalitarian beliefs

CONSIDER CONTEXT ESPECIALLYGENDER & POWER

POTENTIAL METHODS

• Questionnaire

• Empowerment scales

• Empowerment Scorecard

• Mobility Map• I am• Gender Jumble

CCONSIDER CONTEXT, ESPECIALLY

GENDER & POWER: EXAMPLE

Gender Jumble to Measure Gender Roles

What can girls and boys do? What should

girls and boys do?

CONSIDER CONTEXT, ESPECIALLY GENDER & POWER: EXAMPLE

Gender Jumble to Measure Gender Roles

What should girls and boys

do?

2 . C O L L E C T I N F O R M A T I O N O N S O C I A L N E T W O R K S A N D C O N S O C I A L N E T W O R K S A N D S U P P O R T

C 2 . C O L L E C T I N F O R M A T I O N O N S O C I A L N E T W O R K S A N D O N S O C I A L N E T W O R K S A N D

C COLLECT INFORMATION ON SOCIAL NETWORKS AND SUPPORT


• Discussion • Dialogue• Spousal communication• Social support

COLLECT INFORMATION ON SOCIAL NETWORKS AND SUPPORT

• Questionnaire

POTENTIAL METHODS

• Questionnaire • Network questions• Social support scale

• Participatory Social Network Maps

CCOLLECT INFORMATION ON SOCIAL

NETWORKS & SOCIAL SUPPORT:

Social Network Maps to Measure Discussion,

Dialogue, and Social SupportDialogue, and Social Support

o Who do you talk to about FGM/C?o What specifically do you talk about?o Who started the conversation?o How often do you discuss FGM/C?o Do you trust their information? o Who do you turn to for help?o Who do you turn to for advice?

COLLECT INFORMATION ON SOCIAL NETWORKS & SOCIAL SUPPORT: EXAMPLE

Social Network Maps to Measure Discussion,

Dialogue, and Social SupportDialogue, and Social Support

Who do you talk to about FGM/C?What specifically do you talk about?Who started the conversation?How often do you discuss FGM/C?Do you trust their information? Who do you turn to for help?Who do you turn to for advice?

1 . T R A C K I N G A N D S O C I A L C H A N G E T A N D S O C I A L C H A N G E O V E R T I M ET1 . T R A C K I N G I N D I V I D U A L A N D S O C I A L C H A N G E A N D S O C I A L C H A N G E

T I M E

T Tracking Outputs, Outcomes, Exposure

• Communication outputs


• Participation• Advocacy • Communicative Action• Readiness to change• Exposure• Dose• Recall

•

Tracking Outputs, Outcomes, Exposure

• Content Analysis• Fidelity Monitoring

POTENTIAL METHODS

• Fidelity Monitoring• Questionnaire• Photovoice• Most Significant Change• Community mapping• Community-level case

studies• Rapid Assessment Survey

2 . T R I A N G U L A T E A L L D A T A A N D A N A L Y S I ST D A T A A N D A N A L Y S I ST 2 . T R I A N G U L A T E A L L D A T A A N D A N A L Y S I SD A T A A N D A N A L Y S I S

R O A DR O A DR O A D - M A PR O A D - M A P

Sele

cti

ng

sam

ple

Primary Sampling Unit

Map

pin

g

Co

mm

un

itie

s

Household Listing

Sele

cti

ng

sam

ple

Map

pin

g

Co

mm

un

itie

s

Household Listing

Co

ncu

rren

t D

ata

C

ollect

ion

Secondary

Primary

Co

ncu

rren

t D

ata

C

ollect

ion

1 Sample Selection

Adolescent girls

• Rural and urban• 10-14 and 15-19• 10-14 and 15-19

Based on girl and caregiver mapping:

social network contact sample.

Sample Selection

One caregiver per adolescent girl

• Rural and urban• Rural and urban• 10-14 and 15-19

Based on girl and caregiver mapping:

local community influentials sample

2 COMMUNITY MAPPING

Informed Consent

Classify household along the readiness to change continuum

Household Listing

COMMUNITY MAPPING

Cultural Markers of FGM/C PracticePractice

Identify social networks and social support

Household Listing

SECONDARY

Program Structured

3 CONCURRENT DATA COLLECTION

Program Records

Health Records

Structured Interviews

Household level

PRIMARY

Structured Focus Group

In-depth

CONCURRENT DATA COLLECTION

Structured Interviews

Rapid Assessment

Group Discussions

In-depth Interviews

• Types of FGM/C• Risks of FGM/C• Harmonization

of legal, religious, and moral norms

• Positive beliefs about FGM/C

• Support for continuation of FGM/C

• Intention to cut• Self-efficacy to

abandon FGM/C• Prevalence of

• Injunctive norms• Outcome

expectanciesFGM/C

• Descriptive norms

expectancies• Agency• Decision• Beliefs about

gender roles

Questionnaire

Injunctive normsOutcome expectanciesexpectanciesAgencyDecision-makingBeliefs about gender roles

• Discussion • Dialogue• Spousal

Communication• Actual social

support• Advocacy

• Public activities

• Public declarations/ pledges

• Exposure• Dose• Recall

Measures

Method Focus Group Discussions

Body Maps OR Draw

and Describe

PurposeUnderstand

risks associated

with FGM/C

Focus Group Discussions

Free Listing 2X2 Tables Gender Jumble

Identify why FGM/C

exists, legal, moral, religious or gender norms, benefi

ts and sanctions (outcome

expectancies)

Extent to which

FGM/C behaviours

are governed by descriptive or injunctive social norms

Examine gender role

attitudes that drive gender norms and in turn uphold

FGM/C

Measures

Method

Complete the Story

Purpose

Examine support for, intentions to cut and outcome

expectancies

In-depth Interviews

Confidence Snails OR I am

OR Empowerment Score Cards

Empathy Mapping

Examine support for, intentions to cut and outcome

Score Cards

To measure self-efficacy and

agency

To understand beleifs about

FGM/C

SAMPLE AND TOOLSIndividual Structured Interviews:

• Adolescent Girls• Caregivers (Female and Male)• Network Contacts• Community Influentials

Indepth Interviews:

• Adolescent Girls• Caregivers (Female and Male)• Community Influentials

Focus Group Discussions (FGD):

• Adolescent Girls• Caregivers (Female and Male)

Additional Tools/Checklists for Pilot Testing:

• Community Mapping• Validation (Quality Control)

PILOT TESTING SAMPLE SIZES

• 30 participants will be selected for each stakeholder

group for the structured interviews, for a total of 960 to

1,320 interviews.

• 3 FGDs and 3 IDIs will be conducted per stakeholder • 3 FGDs and 3 IDIs will be conducted per stakeholder

group for a total of:

–36 FGDs with 288-432 participants

–72 IDIs with 72 participants

PILOT TESTING SAMPLE SIZES

30 participants will be selected for each stakeholder

group for the structured interviews, for a total of 960 to

3 FGDs and 3 IDIs will be conducted per stakeholder 3 FGDs and 3 IDIs will be conducted per stakeholder

432 participants

72 IDIs with 72 participants1,824 total participants

THE ROAD AHEAD

01Field Staff Selection and Training

03Pre-testing

05Community Mapping

07Pilot Testing (Data Collection)

02Debrief Meeting

04Data Entry and CleaningCleaning

06Data Analysis

08Reports – Results and Validation

LRA REQUIREMENTSEnglish fluency and

fluency in Amharic, Afar, and one language from SNNP

as needed.

A team leader with at least 10 years of

experience

LRA core and field team represent

diverse perspectives (gender, cultural and ethnic background)

The organization should have proven

experience of leading an evaluation in the

last 3 years.ethnic background) last 3 years.

Experience conducting FGDs and IDIs, especially with

participatory methods.

Experience conducting research with adolescents.

Experience with Computer Assisted Personal Interviews

(CAPI).

LRA REQUIREMENTSExperience in mixed

methods research, with children, parents/caregivers,, C4D and social

norms.

Appropriate and adequate teams to

complete data collection in no more

than 30 days.

Access to quantitative software (CS

Pro, EpiInfo, SPSS or STATA) for data entry

and analysis.

Demonstrated track record of data from HH surveys with an effective system for quality assurance.and analysis. quality assurance.

Diverse set of team member in specialist

roles

Adequate data transfer and storage capabilities.

Preferably have experience of working

with UN partners

L R A R O L E S A N D L R A R O L E S A N D R E S P O N S I B I L I T I E S

R O L E S A N D R O L E S A N D R E S P O N S I B I L I T I E S

PLANNING

LRA ROLES AND RESPONSIBILITIES

FIELD WORKPOST-

CONTRACTFINALIZATION

LRA ROLES AND RESPONSIBILITIES

FIELD WORK

POST FIELD WORK

Review and finalize documents from Drexel and UNICEF on existing policy framework.

Provide adaptations and feedback to the M&E Framework, specifying any additions and deletions to the global framework

Finalize the Inception Report

Participate in an expert’s consultation regarding the ACT Framework, FGM, and social norms, as well as other key meetings of the national alliance.


Translate and back translate all tools and consent and assent forms to be used in the pre- and pilot testing.

Pretest all forms and tools and produce a report on findings and recommendations.

Secure local IRB approval.

Review and finalize documents from Drexel and UNICEF on existing policy framework.

Provide adaptations and feedback to the M&E Framework, specifying any additions and deletions to the global framework

Finalize the Inception Report



Translate and back translate all tools and consent and assent forms to be used in and pilot testing.

Pretest all forms and tools and produce a report on findings and recommendations.

Secure local IRB approval.

Create a training schedule for training of supervisors, field enumerators and moderators.

Aid Drexel in organizing and facilitating the training of supervisors, the field enumerator and moderators Produce a training report.

Finalize a quality control plan and detailed field movement plan.

Recruit all research participants.Recruit all research participants.

Cover all costs for data collection materials and field work teams.

The LRA will conduct analysis of all data collected during the validation, with Drexel providing assistance as needed.

Provide weekly field updates and progress reports during field work.

Create a training schedule for training of supervisors, field enumerators and moderators.

Aid Drexel in organizing and facilitating the training of supervisors, the field enumerator and moderators Produce a training report.

Finalize a quality control plan and detailed field movement plan.

Recruit all research participants.Recruit all research participants.

Cover all costs for data collection materials and field work teams.

The LRA will conduct analysis of all data collected during the validation, with Drexel providing assistance as needed.

Provide weekly field updates and progress reports during field work.

Finalize a detailed field implementation report specifying positives as well as the challenges in the field, consultations, corrections and quality control measures.

Finalize a data entry and cleaning plan.

Conduct analysis of all data collected during the validation, with Drexel providing assistance as needed

Draft a detailed template of the final report and presentation with dummy tables and graphs showcasing the analyses that will be done.


Share de-identified, clean and labelled final datasets with codebooks with variable names and data cleaning notes for the quantitative data. Original audio tapes, local

language and English language transcripts from the FGDs and IDIs.

Conduct preliminary analysis for the presentation and report.

With Drexel, write the final reports and create the final presentation.

Finalize a detailed field implementation report specifying positives as well as the challenges in the field, consultations, corrections and quality control measures.

Finalize a data entry and cleaning plan.

Conduct analysis of all data collected during the validation, with Drexel providing assistance as needed



identified, clean and labelled final datasets with codebooks with variable names and data cleaning notes for the quantitative data. Original audio tapes, local

language and English language transcripts from the FGDs and IDIs.

Conduct preliminary analysis for the presentation and report.

With Drexel, write the final reports and create the final presentation.

THANK YOU

THANK YOU

S u r u c h i S

D o r n s i f e S c h o o l o f P u b l i c H e a l t h , D r e x e l U n i v e r s i t y

s s 3 7 2 4 @ d r e x e l . e d u

THANK YOU

THANK YOU

S o o d , P h . D

c h o o l o f P u b l i c H e a l t h , D r e x e l U n i v e r s i t y

s s 3 7 2 4 @ d r e x e l . e d u

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