Faith, norms and community: exploring pathways to better health.

Somalia faces one of the world's highest maternal mortality rates, 563 per 100,000 live births, with a lifetime maternal death risk of 1 in 22. Persistently high fertility (6.2–6.9 children per woman), low modern contraceptive use (1%), and strong cultural and religious norms exacerbate poor reproductive health outcomes. Against this backdrop, the Johns Hopkins Center for Communication Programs (JHCCP), under the Women's Integrated Sexual Health (WISH) 2 program, implemented faith-aligned Social and Behavior Change (SBC) interventions to increase acceptance and uptake of family planning (FP) services in Somalia. Using Human-Centered Design (HCD), JHCCP conducted a needs assessment through qualitative inquiry to explore social and gender norms influencing FP behaviors. Findings identified religious leaders as trusted influencers, prompting a co-design process that reframed "family planning" into the culturally acceptable concept of "birth spacing." Through sermons, radio programs, and community dialogues, leaders helped normalize FP discussions, while engaging men as allies. Concurrently, healthcare providers received Empathways training to build trust, strengthen counseling skills, and engage youth. Results revealed significant increases in youth visits to Benadir health facilities, a rise in male condom uptake from zero to 470 within three months, and greater male participation in FP conversations. Providers reported improved confidence and capacity to counsel young clients, while communities expressed enhanced openness toward FP and SRH discussions. This experience underscores that reframing FP within faith-aligned narratives and co-creating with religious leaders can effectively shift norms, build trust, and enhance service uptake, even in fragile, religiously conservative communities.  

Somalia faces severe sexual and reproductive health (SRH) challenges due to entrenched cultural, religious, and gender norms that limit access to services and open dialogue. To address these barriers, the International Rescue Committee (IRC), with the Federal Ministry of Health (FMoH), launched a Social and Behavior Change Communication (SBCC) initiative to transform norms through faith and community networks. A National Islamic Advisory Group was formed, and 34 religious scholars were trained to promote SRH using culturally and theologically grounded messaging aligned with Islamic principles. The intervention mobilized faith leaders and community networks to challenge restrictive gender norms and foster acceptance of SRH services, including family planning.
Based on the IRC baseline and midline evaluation results in 2025, across six districts in Mudug, Galgaduud, Hiiraan, and Bay regions demonstrated significant improvements in health indicators: access to health facilities rose from 88.7% to 95%, health-seeking behavior from 79.7% to 91%, antenatal care attendance from 75% to 82.1%, facility-assisted births from 62.7% to 90.7%, and postnatal care attendance from 6.9% to 20.3%. Religious leaders played a pivotal role in building trust and reducing stigma around SRH, especially in conservative communities.
The initiative underscores the effectiveness of locally led culturally sensitive SBCC strategies in fragile settings. It highlights the importance of embedding health interventions within existing social and religious structures to promote sustainable normative change. This intervention provides a scalable framework for practitioners and policymakers aiming to enhance SRH outcomes by harnessing trusted community voices and promoting local ownership.

Gender norms and religious influence shape sexual and reproductive health outcomes in Kenya and Nigeria, yet their combined relevance for HPV vaccination and maternal, newborn, and child health (MNCH) is not well understood. This study examines how gender norms and religious messaging relate to outcomes in settings where social expectations and faith leadership influence women's and girls' decision-making and access to care.
We use nationally representative survey data from Kenya (n = 5,885) and Nigeria (n = 12,167). Each country sample includes oversamples of adolescent girls and young women (AGYW) and adolescent girls' caregivers, allowing focused analysis of HPV vaccination and MNCH outcomes. Individual-level outcomes are paired with ward-level estimates of gender norms and religious influence produced through Fraym's machine-learning models, combining survey and spatial data to characterize community contexts. Multivariate, multilevel regression models adjust for sociodemographic characteristics.
Across both countries, equitable gender norms and supportive religious messaging are positively associated with HPV vaccination intentions and perceived vaccine importance, safety, and effectiveness. Restrictive norms and negative religious messaging are associated with greater vaccine misinformation. For MNCH outcomes among AGYW, equitable norms and supportive religious influence show stronger associations in Nigeria, while Kenyan associations are evident for MNCH knowledge indicators, reflecting high baseline agreement on practices.
These findings highlight the importance of integrating gender norm engagement with faith-based communication in SBCC programming. Strengthening partnerships with religious leaders and tailoring strategies to local normative landscapes may enhance the impact of HPV vaccination and MNCH interventions for girls and young women.

World Relief has collaborated with thousands of faith leaders globally to strengthen community development and social cohesion. In 2025, the organization strategically redirected its focus toward displaced populations —refugees, returnees, internally displaced persons (IDPs), and host communities—recognizing the church as a key, often overlooked, actor in humanitarian response. Drawing on two decades of experience training faith leaders, World Relief adapted existing community engagement frameworks for crisis contexts, integrating trauma-informed care, spiritual formation, and rapid implementation strategies suited to unstable environments. 
The pilot initiative was implemented across Rwanda, Malawi, and Burundi, where seven multi-day trainings engaged 609 faith leaders representing refugee camps and host communities. The curriculum emphasized trauma awareness, spiritual resilience, and community mobilization through participatory, contextually grounded learning. Qualitative data collected from staff debriefs and participant feedback revealed consistent patterns of adaptation and growth in leadership capacity. 
Results demonstrated that churches can serve as trusted, locally embedded platforms for mobilization and social support within displacement settings. Participants initiated seed projects, expanded collaboration across denominations, and strengthened outreach to vulnerable households. However, many pastors faced material scarcity and psychosocial stress, underscoring the need for holistic support to sustain engagement. 
The findings affirm that empowering faith leaders through trauma-informed, spiritually grounded approaches enhances both individual resilience and community recovery—positioning the church as a critical agent of stability and transformation in protracted crises.