Adolescent sexual and reproductive health in Ethiopia and Rwanda: a qualitative exploration of the role of social norms

Abstract

This article seeks to address the dearth of evidence on early adolescent understandings and experiences of sexual and reproductive health (SRH) in Ethiopia and Rwanda, drawing on a multisite qualitative research study with 10- to 12-year-old and 14- to 15-year-old male and female adolescents and a range of adult participants. The article is informed by a conceptual framework that draws on Amartya Sen’s capability approach, which calls for investments in a broad set of assets that expand individuals’ capacity to “be” and to “do.” Using SRH as a focal lens, the article considers the role played by gendered social norms in adolescents’ experiences of SRH-related understandings and experiences. Three key interrelated gender themes emerge from our thematic analyses of qualitative evidence generated by our multi-methods approach: puberty transitions, sexuality, and victim blaming. In our analyses, we pay attention to diversity (e.g., age, gender, place of residence) among adolescents within and across the two focal countries and consider how discriminatory gendered social norms play a role in hindering the effective uptake of expanding health services. We conclude by emphasising the need for program designers and implementers to address the role of underlying social norms in a more strategic and context-specific way to help young people navigate their sexual and reproductive lives. This article is an output of the Gender and Adolescence: Global Evidence (GAGE) programme