Across Africa, cultural traditions play an important role in community life and hold significant relevance. These include rites of passage that celebrate the transition from childhood to adulthood and a variety of matrimonial traditions, such as paying a bride price. Some harmful traditions and gendered norms remain, such as early child marriages and female genital mutilation (FGM). These traditions have significant health and human rights implications, especially for women and girls. As such, communities often find themselves navigating a difficult balance between the desire to preserve cultural identity and the need to act on growing evidence about the harms associated with certain practices. 

This tension is evident in Kossoye, a rural village in the Amhara region of Northern Ethiopia, where a newborn’s first meal is often not breast milk but a prelacteal feed known locally as ‘makamesha’ – usually butter, cow’s milk, or ersho (a yeast starter) (Rogers et al., 2011). Breast milk is only fed to newborns later, sometimes after days have passed (Legesse et al., 2014). This is because mothers in this village are taught to believe that the first milk (the colostrum) is unclean, whereas makamesha is gentle, simple, ceremonial, and safe (Rogers et al., 2011). Practices like this can explain why, on average, one in five mothers in Ethiopia discard the colostrum (Nigussie et al., 2020). This is contrary to evidence that it is the most immunologically protective food a newborn will ever have, rich in antibodies that guard against infection and early mortality. Mothers, even if they have heard otherwise from other sources, often resist shifting away from this practice because they value the advice passed down through generations in their community (Rogers et al., 2011).

This dilemma presents a fundamental challenge for social and behavior change (SBC) programs: new information alone is rarely enough to change behavior. While one could cast judgment on these mothers, a deeper investigation would explain the barriers to behavior change they contend with, the motivations behind their actions, and the real reasons these traditions persist.  The mother in Kossoye is likely not uninformed about breast milk nor indifferent to her newborn. She is simply doing what her mother and grandmother told her was right in a relatively stressful time of her life. Informing her that the makamesha could cause harm or that the colostrum she has been taught to discard is important for her child’s well-being is unlikely to lead to behavior change.

Lasting change is more likely to stick when new behaviors are introduced in ways that respect cultural values and build on existing beliefs, identities, and community aspirations – allowing communities to preserve what they value while embracing practices that improve health and well-being. This is not unique to Africa. Across cultures, every generation is confronted with the task of upholding certain norms and traditions while building a new way forward. 

Ethiopia’s work to end harmful traditional practices like female genital mutilation (FGM) and early marriage has not been as effective as policymakers and researchers would have hoped. As of 2016, around two in three women aged 15 to 49 have undergone FGM in Ethiopia, and four in ten girls are married before their eighteenth birthday, according to the Ethiopia Demographic and Health Survey (EDHS) conducted in 2016. The country has strong laws against both practices and decades of awareness-raising and behavior-change programming by a variety of organizations. Regardless, progress has been hard-fought and uneven across regions with different demographics and beliefs. 

In 2023 and 2024, Busara and UNICEF conducted fieldwork across Amhara, Afar, Somali, Gambella, Oromia, South West, Sidama, and the Southern Nations, Nationalities, and Peoples’ Region (SNNPR). We aimed to understand the behavioral factors underlying these harmful traditional practices and use this understanding to reshape community narratives around FGM and early marriage through interventions. Through research, we sought to reshape narratives about these practices by highlighting how community members can support and uplift girls while maintaining community through a different set of culturally resonant practices. 

We first conducted qualitative in-depth interviews to understand the behavioral factors behind the continued practice of FGM and early child marriages with 80 parents and caregivers and 48 adolescents. We supplemented this using insights from 8 focus group discussions with 48 key community figures like community elders, religious leaders, healthcare workers, and teachers

A consistent finding was that community members engaging in FGM or arranging early marriages for their daughters were rarely uninformed about the harm. They were weighing that harm against a set of perceived benefits. In essence, they believe that they are doing right by their daughters when they engage in these harmful traditions; that they are maintaining their culture while protecting girls from promiscuity, judgment, ostracization, and other perceived consequences of abstention. In the words of a 44-year-old father in Gambella, “girls who remain unmarried past the community age of marriage will be out of the marriage market. Boys will consider them as prostitutes.” 

Health-focused campaigns have consistently described the documented harms, raising awareness about the harmful effects of these traditional practices that infringe on girls’ rights to happiness, health, and education. They speak, however, to only one side of the calculation that community members make. Interventions that merely emphasize the negative aspects of these practices fail to adequately target their drivers, such as the perceived social and personal costs of not engaging in FGM and early child marriage. For key decision-makers within families, the fears often outweigh any knowledge they hold about the harmful effects of these practices on girls themselves. 

To address this gap, we began by identifying the primary behavioral barriers that sustain each harmful traditional practice and make behavior change difficult. For FGM, these included the beliefs that circumcision prevents sexually and socially deviant behavior in girls, that FGM is necessary to maintain community culture, and that uncircumcised girls will not be widely accepted by society. For early marriage, these included the beliefs that girls should get married when their peers do (and follow the community norm), that a daughter whose marriage is delayed until adulthood will be perceived as flawed, and that families who delay their daughters’ marriage until adulthood will be spoken of poorly.

We then conducted 5 co-design workshops with community members to translate those barriers into different intervention concepts that draw on contextual knowledge and resources. Those concepts became two core campaign narratives paired with concrete intervention activities such as role-plays, ideation on traditions worth keeping, anonymous experience-sharing, and pledges marked with thumbprints. 

The first narrative, ‘Our Heritage of Wholeness’, addressed FGM. It reframed heritage as something that communities actively shape by highlighting that every generation already decides what is worth passing on: they curate traditions in food, prayer, ways of life, and the values they hand down to their children. This narrative extends that logic to FGM, emphasizing that girls are born whole – as God intended – to remind communities that their task is to preserve the traditions that enrich them while setting aside those that cause harm. In doing so, it offers parents and elders a way to remain custodians of culture while abstaining from FGM – honoring a girl’s wholeness as the inheritance most worth protecting.

Our second narrative, ‘We are the Community that Uplifts Her’, addressed early marriage. It reframed what a community takes pride in, highlighting that parents and elders already act collectively to secure their daughters’ futures: they weigh reputation, readiness, and community belonging together. This narrative extends that logic to early marriage, emphasizing that a girl is ready when she is physically, mentally, and emotionally mature and that the community can take more pride in safeguarding girls’ current dreams and aspirations by waiting for her to finish school, find her footing, and step into marriage on her own terms. 

To evaluate these narratives, we conducted a mixed-methods pre-test of the intervention activities associated with these narratives with 256 participants across the same eight regions. Our testing offered early but encouraging signs that both narratives could shift norms and behavior around FGM and early marriage. 

Participants exposed to the FGM interventions were less likely than an unexposed control group to associate FGM as being necessary to regulate women’s behavior, more likely to view the practice as unnecessary, and more willing to take a costly action to oppose it (completing a task in order to receive anti-FGM badges that they could wear and share with neighbors). Participants exposed to the early marriage interventions placed greater value on frequent conversations with their daughters about education, careers, and marriage. They also reported a strong inclination to continue the conversation by disseminating what they had learned through stickers, pledges, and their own retellings.  In one of the two early marriage interventions, participants ranked education above marriage as a desired outcome for girls as compared to an unexposed control group. 

Other beliefs proved more difficult to change and likely require more targeted messaging. Perceptions linking FGM to women’s sexual promiscuity barely shifted. In regions where some kinds of FGM are widely accepted, participants tended to construe our narratives as only pertaining to the more extreme forms of FGM that they had already abandoned. Similarly, the perceived importance placed on marriage for girls did not shift, even as the importance of girls pursuing education and work rose in participants’ rankings.

Conclusion

Consider again the spoonful of makamesha that a mother in Kossoye village feeds her newborn child. She does so because she trusts community knowledge and norms during a relatively stressful time in her life. As such, providing new information is unlikely to lead to behavior change on its own. The same is true of the father in Gambella, who worries about his daughter’s future and chooses to marry her off early, or the community elder who weighs her granddaughter’s standing in the village before engaging an FGM practitioner. 

In Ethiopia’s Kembata Zone, an organization named Kembatti Mentti Gezzimma (KMG) worked directly with communities for whom FGM marked a girl’s passage from childhood to adulthood. Instead of directing community members to abandon the rite, the intervention guided them in reimagining it, resulting in “Whole Body, Healthy Life” public awarding and coming-of-age ceremonies for girls in the community. KMG’s approach aimed to preserve the public recognition and celebration previously associated with FGM while discarding the harmful practice. This intervention, in tandem with other FGM initiatives, led to a 92% reduction in the number of people practicing FGM in Kembatta over a decade, as noted by Stern & Anderson (2015). Busara’s and UNICEF’s collaboration to end FGM and early marriages builds on similar insights: lasting change is more likely when interventions work with communities’ values rather than against them. The narratives ‘Our Heritage of Wholeness and We Are the Community that Uplifts Her’ represent early efforts to reframe harmful practices by preserving the underlying cultural aspirations—that is, identity, belonging, recognition, and the transition to adulthood—while rejecting the violence and harm inflicted on girls. Rather than asking communities to choose between culture and children’s rights, these narratives invite them to envision traditions that honor both. In doing so, they demonstrate how behavioral science and community-led storytelling can help transform deeply rooted social norms while safeguarding the values communities seek to preserve.

References

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