Effectiveness of the Communities Care Programme on Change in Social Norms Associated with Gender-Based Violence (GBV) with Residents in Intervention Compared with Control Districts in Mogadishu, Somalia

"[C]arefully designed, community engaged, multipronged interventions that target social norms underpinning GBV and catalyse community-led mobilisation efforts may over time change harmful norms and foster norms that promote gender equality"

Women and girls are vulnerable to violence across their lifespan, especially during conflict and other humanitarian emergencies. Often, they do not disclose gender-based violence (GBV) to healthcare and other service providers because of social norms that blame the woman or girl for the assault, norms that prioritise protecting family honour over safety of the survivor and community, and institutional acceptance of GBV as a normal and expected part of displacement and conflict. These harmful beliefs and social norms may also serve to cause secondary traumatisation to survivors. Thus, the United Nations Children's Fund (UNICEF) used a social norms approach to develop the Communities Care Program: Transforming Lives and Preventing Violence. Communities Care (hereafter, CCP) is based on the understanding that, even within challenging humanitarian settings, there is an opportunity for positive change in social norms to support gender equality and the adoption of behaviours and actions that can prevent GBV. This paper presents findings from the evaluation of the initial implementation of CCP in Mogadishu, Somalia, which has experienced decades of conflict and ongoing emergencies including drought, famine, and a large number of internally displaced people (IDPs).

As outlined here, the feminist-informed CCP is theory driven, drawing on the ecological framework. This framework acknowledges the need to comprehensively address the multiple and interacting levels (i.e., individual, family, community, and social) of factors that cause and maintain GBV. Social norms operate within this framework and include: (i) individuals' beliefs about what others typically do in a given situation (descriptive norms) and (ii) their beliefs about what others expect them to do in a given situation (injunctive norms). Social norms theory suggests that for harmful behaviours to be replaced in a community, there must be a shift in collective social expectations or norms that underpin those behaviours within the community.

CCP's pathway of change starts with actions (e.g., coordination, capacity building, resourcing and mentorship) to strengthen the community-based response to survivors of GBV across relevant sectors (e.g., health, psychosocial, law enforcement, and education). The next step is to engage diverse and influential community members in structured, peer-facilitated dialogues (20 participants per group) examine social norms that cause and maintain GBV, with the goal of empowering participants to work together to discover and affirm shared positive values that promote dignity, respect, and equality. Those who choose to commit to changing particular behaviours in the community then publicly share their intention to take specific actions to that end. The declaration and actions act as the tipping point, the "seeing is believing" component of norm change theory. The final stages involve affirming and reinforcing change by communicating positive norms with others through interpersonal communication and social and mass media. CCP also helps to build an enabling environment by identifying and advocating for laws, policies, protocols, and other mechanisms - e.g., that further strengthen the capacity of institutions and services to provide competent and compassionate care for GBV survivors.

The team collaborated with Somalia governmental ministries, local authorities and community groups to obtain approval to identify key stakeholders (e.g., religious leaders, traditional and administrative authorities, teachers, healthcare providers, GBV and human rights advocates, women's group leaders, and business leaders) that have influence on beliefs, behaviours and actions in the districts selected for the evaluation. These key stakeholders participated in focus groups and individual interviews to diagnose social norms that sustain GBV and advise on programme implementation.

The formative research findings supported the development of the design, implementation, and outcome measures for the study, which used a longitudinal community-based evaluation design. In the intervention district, 192 community members (50% women) completed baseline surveys, with 163 (84.9%) retained at endline. In the control district, 195 community members (50% women) completed baseline surveys with 167 (85.6%) retained at endline. The main outcome is change in social norms related to GBV. Secondary outcomes include: change in personal beliefs about GBV and increase in confidence in services for GBV survivors across diverse sectors.

To measure changes in social norms, a person must be asked about a norm from multiple perspectives. Developed specifically for this study, the Social Norms and Beliefs about GBV Scale is comprised of 3 subscales: response to sexual violence (5 items); protecting family honour (6 items); and husband's right to use violence (4 items). The same 15 items of the injunctive norms were used to assess personal beliefs. Participants were also asked 17 items on a 4-point Likert scale (ie, strongly disagree to strongly agree) as the extent to which they have confidence in the provision of GBV services across the multisector response.

Over the implementation of CCP in the intervention districts, the team recorded discussions and public declarations that reached, for example, 17,071 people through house-to-house visits in the IDP camps and host community, 2,282 teachers and students, 34 religious leaders, 128 youth group members, 154 midwives and nurses, and 10,000 community members through radio messages.

Men and women participants in the intervention district had significantly greater improvement in change in harmful social norms for all three of the subscales as compared to the control group. The greatest change was seen in the norm of protecting family honour". The harmful norm response to sexual violence remained the same in the intervention district over time but increased in the control district. Residents in intervention district had a significantly greater increase in confidence in provision of GBV services across diverse sectors than the control district. There were no significant differences between residents in intervention and control districts on change in personal beliefs on the norms.

In conclusion: "Promising primary prevention interventions build knowledge and awareness about GBV and create opportunities for public and private reflection, discussion and dialogue about harmful social norms that sustain inequality, discrimination and violence and mobilise community leaders and members to take action to prevent and respond to GBV....Longitudinal research is needed to examine the effectiveness of interventions and programming in conflict-affected areas. These contexts pose ethical and logistical challenges to conducting such research, particularly when examining a sensitive topic such as GBV; however, this evaluation serves as an example of the ability to conduct longitudinal evaluations in challenging settings."