Changing social norms: the importance of "organized diffusion" for scaling up community health promotion and women empowerment interventions

Some harmful practices are sustained by social norms—collective beliefs about what people expect from each other. Practitioners and researchers alike have been investigating the potential of social norms theory to inform the design of effective interventions addressing these practices in low- and middle-income countries. One approach commonly used to facilitate social norms change is community-based dialogs and trainings. This approach has often been criticized for not being cost-effective, as it usually includes a relatively small number of direct participants and does not allow for scaling-up strategies. In spite of some evidence (as for instance, the SASA! Program) that community dialogs can achieve social norms change, little exists in the literature about how exactly participants in community dialogs engage others in their networks to achieve change. In this paper, we look at the potential of organized diffusion^as a cost-effective strategy to expand the positive effects of community-based interventions to participants’ networks, achieving sustainable normative shifts. We provide quantitative evidence from three case studies—Community Empowerment Program in Mali, Change Starts at Home in Nepal, and Voices for Change in Nigeria—showing that participants in community-based interventions can be effectively empowered to share their new knowledge and understandings systematically with others in their networks, eventually facilitating social norms change. Future community-based interventions intending to achieve social norms change would benefit from integrating ways to help participants engage others in their network in transformative conversations. Doing so has the potential to generate additional impact with little additional investment.