How do social norms influence the sexual and reproductive health-related attitudes and behaviours of very young adolescents in Sub-Saharan Africa? A scoping review.
Ahmed F, Nyamwanza O, et al. • BMC public health • 2026
Social and gender norms in Sub-Saharan Africa limit very young adolescents' (aged 10-14) SRH knowledge and access, heightening their vulnerabilities, and interventions to shift these norms show mixed results, underscoring the need for tailored, multifaceted, culturally sensitive, gender-responsive/gender-transformative interventions.
Key Findings
Methods
A total of 24 studies were identified examining social and gender norms and SRH outcomes among very young adolescents in Sub-Saharan Africa.
11 studies (46%) were entirely qualitative, 8 (33%) exclusively quantitative, and 3 additional quantitative studies incorporated qualitative components.
Two studies used participatory techniques.
Studies were drawn from nine countries across Sub-Saharan Africa.
Peer-reviewed articles were published between January 1, 2000 and December 31, 2024.
Four databases were searched: MEDLINE, CINAHL, Global Health, and Web of Science.
Results
Social and gender norms identified in the literature included those relating to menstruation, puberty, circumcision, romantic relationships, and gender stereotypes.
These norms were specifically documented in the context of very young adolescents aged 10-14 years in Sub-Saharan Africa.
Norms around menstruation and puberty were among the most commonly identified themes across studies.
Gender stereotypes were identified as a distinct norm category influencing SRH-related attitudes and behaviours.
Norms around circumcision were also identified as relevant to SRH outcomes in this age group.
Results
Social norms led to very young adolescents' limited SRH knowledge and access, and to behaviours and practices that heightened their vulnerabilities and poor SRH outcomes.
Very young adolescents (aged 10-14) were identified as having the worst SRH outcomes of this age group worldwide in Sub-Saharan Africa.
Limited access to SRH information was directly attributed to prevailing social and gender norms.
Norm-driven behaviours were found to increase vulnerability to poor SRH outcomes specifically in the 10-14 age group.
SRH programming in the region often focuses on older adolescents (aged 15-19), overlooking very young adolescents.
Results
Evaluations of interventions designed to shift SRH-related social norms among very young adolescents reported mixed results.
No single intervention approach was found to be consistently effective across contexts.
Findings highlighted the importance of adapting gender-responsive and gender-transformative interventions to the local context.
The mixed results underscore the complexity of norm change in diverse cultural settings across Sub-Saharan Africa.
The review found interventions need to be multifaceted and culturally sensitive to be effective.
Conclusions
The scoping review affirms the importance of intervening during very young adolescence (ages 10-14) to positively influence social and gender norms related to SRH.
Early adolescence (10-14 years) was identified as a critical window for intervention.
The review underscores the need for tailored, multifaceted, culturally sensitive, gender-responsive and gender-transformative interventions.
Findings suggest current programming gaps exist because SRH interventions disproportionately target older adolescents (15-19 years).
The review followed the five-step Arksey and O'Malley scoping review framework.
What This Means
This research reviewed 24 studies from nine Sub-Saharan African countries to understand how social and cultural norms shape the sexual and reproductive health (SRH) knowledge, attitudes, and behaviors of very young adolescents—children aged 10 to 14 years. The researchers found that norms around topics like menstruation, puberty, circumcision, romantic relationships, and gender roles often limit young adolescents' access to accurate SRH information and lead to behaviors that put their health at risk. This age group already has the worst SRH outcomes globally in this region, yet most health programs focus on older teenagers (ages 15-19), leaving the 10-14 age group largely underserved.
The review also looked at programs that tried to change these harmful norms and found that results were inconsistent—some approaches worked in certain settings but not others. This suggests that there is no one-size-fits-all solution, and that interventions need to be carefully adapted to fit the specific cultural and social context in which they are delivered. Programs that are gender-responsive or gender-transformative—meaning they actively address unequal gender norms rather than just working around them—showed particular promise when tailored appropriately.
This research suggests that reaching children during early adolescence, before harmful norms become deeply entrenched, is a critical opportunity to improve long-term health outcomes. It calls for investment in culturally sensitive, multi-component programs that engage not just young adolescents themselves, but also the communities, families, and social structures that shape the norms influencing their health decisions.
Ahmed F, Nyamwanza O, Ladur A, Dambi J, Cowan F, Mavhu W. (2026). How do social norms influence the sexual and reproductive health-related attitudes and behaviours of very young adolescents in Sub-Saharan Africa? A scoping review.. BMC public health. https://doi.org/10.1186/s12889-025-25736-z