Social Norms: A Missing Ingredient of Programs Seeking to Foster Women's Agency in Nutrition

Francine E Wood; Katherine L Dickin; Lisa Sherburne; Mariam Diakite; Abdoulkader Boubacar; Meghan Pollak; Rebecka Lundgren

doi:10.1016/j.cdnut.2024.104440

Social Norms: A Missing Ingredient of Programs Seeking to Foster Women's Agency in Nutrition

Curr Dev Nutr. 2024 Aug 14;8(9):104440. doi: 10.1016/j.cdnut.2024.104440. eCollection 2024 Sep.

Authors

Francine E Wood¹, Katherine L Dickin^{2

3}, Lisa Sherburne³, Mariam Diakite⁴, Abdoulkader Boubacar⁵, Meghan Pollak⁶, Rebecka Lundgren¹

Affiliations

¹ Center on Gender Equity and Health, University of California San Diego, La Jolla, CA, United States.
² Department of Public & Ecosystem Health, Cornell University, Ithaca, NY, United States.
³ USAID Advancing Nutrition/The Manoff Group, Arlington, VA, United States.
⁴ Center on Gender Equity and Health, University of California San Diego, Bamako, Mali.
⁵ Save the Children, Maradi, Niger.
⁶ Save the Children, Fairfield, CT, United States.

Abstract

Social expectations play a crucial role in shaping dietary practices among women and children. However, despite significant attention to promoting social and behavioral change in nutrition-focused programs and research, the influence of social norms on women's agency in enhancing nutrition practices is often overlooked. In this perspective, we advocate for a paradigm shift by incorporating a "norms aware" approach. This underscores the importance of recognizing, measuring, and addressing the societal constraints and barriers that women and children encounter in their journey to improved nutrition. Drawing on insights from the United States Agency for International Development-funded Kulawa project in Niger, we highlight the implications of using social norms diagnosis tools to understand the contextual dynamics within child-feeding practices, informing intervention design, and targeted populations. Integrating a norms perspective into nutrition programming and research does not require an overhaul, but rather a nuanced application of understanding of contextual drivers, such as social norms and agency, that have been underemphasized. We delve into the role of the socio-ecologic system, underscore the importance of addressing power imbalances related to gender and social hierarchy, and emphasize that programs targeting norms should aim for community rather than individual-level change. We provide guidance for programs and research integrating a norms perspective, as well as examples of how tools, such as the Social Norms Exploration Tool and Social Norms Analysis Plot framework, can be applied to identify and prioritize social norms, facilitating the design of "norms aware" programs. Additionally, we highlight the critical role of community engagement and discuss the value of using qualitative and quantitative approaches to document the process and outcomes of social norms research, program design, and implementation. When we recognize the role of social norms in nutrition as a missing ingredient in nutrition research, programming, and social and behavior change strategies, we create opportunities for more effective and contextually relevant research and interventions that address the complexities of enhancing nutrition practices among women and children.

Keywords: agency; community engagement; infant and child nutrition; maternal nutrition; nutrition programming and research; social and behavior change; social context; social norms.