Peer-reviewed article
Innovative methods to analyse the impact of gender norms on adolescent health using global health survey data
Beniamino Cislaghi, Ann M. Weber, Holly Baker Shakya, Safa I.A. Abdalla, Amiya Bhatia et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This peer-reviewed study developed methodological approaches to measure gender norms using existing global health survey data from six countries, without collecting new norm-specific questions. Researchers created proxy measures for gender norms by combining data on attitudes, beliefs, and behaviours, and applied these to examine links between gender norms and adolescent health outcomes. The study found that gender norms were associated with intimate partner violence, unhealthy weight control behaviours, HIV status, health mobility, and childbirth. The research shows that existing health datasets can be analysed to understand how gender norms affect health, informing programme and policy design.
Key points
- Proxy measures for gender norms can be derived from existing survey data on attitudes, beliefs, behaviours, and discrepancies between them
- Gender norms were found to affect intimate partner violence in Nigeria, unhealthy weight control in Brazil and South Africa, HIV status in Zambia, health mobility in the US, and childbirth in Honduras
- Diverse analytical methods and data types (cross-sectional, longitudinal, census, social network-based) were used across the five case studies
- Direct measures of gender norms would improve understanding, but proxy measures can be designed for specific health outcomes and normative contexts
- The approach enables evaluation of gender norm influences on health and identification of reference groups and sanctions relevant to programme design
Limitations
The document is a methodological paper demonstrating analytical approaches rather than a single intervention evaluation; it does not provide detailed quantitative results or effect sizes for the associations found, and the use of proxy measures rather than direct norm measurement may not fully capture the complexity of gender norms.
Abstract
BACKGROUND: Understanding how gender norms affect health is an important entry point into designing programs and policies to change norms and improve gender equality and health. However, it is rare for global health datasets to include questions on gender norms, especially questions that go beyond measuring gender-related attitudes, thus limiting gender analysis. METHODS: We developed five case studies using health survey data from six countries to demonstrate approaches to defining and operationalising proxy measures and analytic approaches to investigating how gender norms can affect health. Key findings, strengths and limitations of our norms proxies and methodological choices are summarised. FINDINGS: Case studies revealed links between gender norms and multiple adolescent health outcomes. Proxys for norms were derived from data on attitudes, beliefs, and behaviours, as well as differences between attitudes and behaviours. Data were cross-sectional, longitudinal, census- and social network-based. Analytic methods were diverse. We found that gender norms affect: 1) Intimate partner violence in Nigeria; 2) Unhealthy weight control behaviours in Brazil and South Africa; 3) HIV status in Zambia; 4) Health and social mobility in the US; and 5) Childbirth in Honduras. INTERPRETATION: Researchers can use existing global health survey data to examine pathways through which gender norms affect health by generating proxies for gender norms. While direct measures of gender norms can greatly improve the understanding of how gender affects health, proxy measures for norms can be designed for the specific health-related outcome and normative context, for instance by either aggregating behaviours or attitudes or quantifying the difference (dissonance) between them. These norm proxies enable evaluations of the influence of gender norms on health and insights into possible reference groups and sanctions for non-compliers, thus informing programmes and policies to shape norms and improve health.