Evidence for inclusive and gender-sensitive programming

Adolescent girls in rural India face persistent socio-cultural barriers that limit their empowerment and well-being. This study examines the relationship between empowerment and well-being among adolescent girls in a disadvantaged rural setting in Karnataka, India. Empowerment dimensions were constructed using Rowlands' (1995) framework, with contextualized statements from adolescent girls serving as variables. "Power within" captured self-esteem and self-efficacy, with statements such as "I can express my ideas on marriage even if they differ from my parents' views." "Power with" assessed joint decision-making with parents, for example, "I take decisions jointly with my parents about my visits outside the village." "Power over" assessed negotiation skills, such as "I persuaded community leaders to stop a child marriage." Well-being domains, adapted from UNICEF's National Adolescent Assessment Cards (NAAC) framework, included Health and Well-being, Education, Protection (from parental and teacher violence), and Participation (in social groups).
Quantitative analysis of 797 adolescent girls across 51 purposively selected villages, complemented by 15 qualitative case studies, revealed significant associations between empowerment dimensions and well-being outcomes. High "power within" (70%, p<0.0001) predicted better access to health services and higher educational aspirations. "Power with" linked to stronger participation in social networks and reduced exposure to teacher violence, while "power over" correlated with improved negotiation skills, reduced parental violence, and shifts in discriminatory norms.
These findings underscore that a multidimensional, context-driven empowerment framework grounded in girls' voices fosters trust, strengthens family and community engagement, and enhances both agency and well-being outcomes.

In Uganda, adolescents navigate relationships where silence and stigma constrain communication. To address this, the SHARE project implemented a multi-channel SBCC approach in Buyende and Adjumani districts. Activities included youth dialogues, theatre for change, radio programming, parenting sessions, and training for mentors, health and para-social workers. The approach reflected Right To Play's participatory and playful approaches to make communication engaging and inclusive. IEC materials were co-developed with adolescents, parents, and community leaders and translated into Arabic, Dinka, Madi, and Lusoga to reach refugee and minority-language groups.
Evaluation used a repeated cross-sectional design with matched comparison sites. At midterm, adolescents in treatment areas demonstrated significant improvements in several domains. SRH service use increased, confidence in contraceptive negotiation strengthened, and adolescent participation in SRHR advocacy rose, with difference-in-differences models confirming statistically significant treatment effects. Caregiver support and communication also improved.
Attitudes rejecting SGBV increased in treatment areas from 19% to 59%, but since comparison areas also improved, no statistically significant treatment effect was detected. This suggests wider contextual influences beyond the intervention.
Qualitative data reinforced these findings. Adolescents described greater confidence in discussing relationships, and parents and teachers observed more open communication with young people. Challenges included low father participation and uneven shifts in community norms.
Lessons highlight the importance of engaging adolescents and gatekeepers simultaneously, ensuring language inclusion, and reinforcing messages through both interpersonal and media channels. The SHARE experience contributes evidence that gender-transformative SBCC can strengthen adolescent agency and create more supportive environments for young people.

Inclusion and equity in Social and Behavior Change Communication (SBCC) are most effective when they go beyond messaging to create platforms that amplify lived experiences, elevate marginalized voices, and challenge entrenched social norms. Traditional health communication has often focused on top-down dissemination of information, yet evidence shows that lasting transformation requires dialogue, co-creation, and community ownership. Storytelling, when rooted in dignity and authenticity, is a powerful driver of this process bridging the gap between data, personal experience, and policy influence.
In Uganda, Amref Health Africa has embraced this approach through its flagship initiatives the Heroes for Gender Transformative Action programme and the Saving Lives and Livelihoods (SLL) project. These programmes recognize that inequities in safe motherhood, immunization, and gender relations are reinforced by harmful social norms and weak health-seeking behaviors. To respond, Amref piloted media excursions as an innovative model that integrates storytelling and dialogue with the power of the press.
Over a two-year period, 30 journalists from diverse regions of Uganda were engaged and immersed in community contexts where issues of sexual and reproductive health, maternal care, gender-based violence, and immunization converge. Rather than reporting from afar, journalists directly interacted with women, youth, health workers, and local leaders. This experiential engagement enabled them to document survivor-centered narratives, highlight systemic barriers, and give visibility to underrepresented perspectives.
By turning communities into active storytellers and journalists into co-creators of dialogue, the excursions reframed health communication as a participatory, equity-driven, and policy-relevant process.