Lessons learned from the PEPFAR Male Norms Initiative evaluation in Ethiopia

Background

Certain male gender norms are associated with HIV risk and related behaviors such as gender-based violence. PEPFAR launched the evidence-based Male Norms Initiative to implement and evaluate interventions that encourage men to transform harmful attitudes and behaviors. In Ethiopia, the intervention was led by Hiwot Ethiopia with technical assistance from EngenderHealth, comprising group education (GE) and community engagement (CE) activities. It also included capacity-strengthening for NGOs and PMTCT service providers to promote meaningful male engagement.

Methods

PATH led the evaluation in collaboration with Miz-Hasab Research Center. The quasi-experimental study compared its impact among groups of men exposed to different combinations of activities and followed longitudinally via baseline and endline surveys. In-depth interviews with a sub-sample were used to explore the process of change and reactions to the intervention. A “process evaluation” comprising key informant interviews with organizations receiving technical assistance (n=17) highlighted successes and challenges with implementing the MNI and offered insight into the process.

Results

Men participating in GE and CE (not CE only) activities showed greater support for equitable norms and significant changes in attitudes not seen in the control. Staff receiving technical assistance perceived benefits in their capacity to address gender related issues, noting the need for sustained capacity-strengthening for organizations taking on this work.

Lessons

Multiple strategies are more effective than one in influencing deep-seated norms. It is important to build on local knowledge and successes, identifying target groups that are excited about participating and partners experienced with similar efforts.