A social ecological approach to promote changes in community health norms and increase social capital: A case study from Senegal on teen pregnancy, early marriage and FGM

A social-ecological approach was used in southern Senegal to promote changes in socio-cultural norms related to the health and well-being of adolescent girls, and to increase communities' social and cultural capital. In the “Girls' Holistic Development Project” an innovative community strategy was developed by Grandmother Project and implemented in collaboration with World Vision between 2008 and 2011. Key elements in the culturally-grounded community strategy were: inclusion of elders and particularly grandmothers; promotion of intergenerational communication; and the use of communication methods based on dialogue and consensus-building between community leaders of different ages and both sexes. After three years, qualitative and quantitative evaluation data reveal; 1) very positive changes in community attitudes and practices related to several key issues concerning adolescent girls (teen pregnancy, early marriage and FGM); and 2) increased social and cultural capital and community-wide commitment to address issues related both to girls' well-being and other priority community problems. Based on analysis of project results an over-arching conclusion is that the changes observed in target norms/practices were the product of and the strengthened social infrastructure and increased social capital within communities.