CORE Group Global Health Practitioner Conference 2019

1. Laurie Krieger, Ph.D.
Senior Advisor, Health and Social Science

2. Genesis of Norms in Modern Social
Science
 Emile Durkheim (1858-1917) (a founder of sociology and social
epidemiology—Suicide; anomie=normlessness)
 Max Weber (1864-1920) (never mentioned norms but wrote
much of the theory on norms; justify social hierarchies)
 William Ogburn (1886-1959) “Cultural Lag” (1922)
demonstrated convincingly that behavior often changes, then
culture, e.g., norms must catch up
 Talcott Parsons (1902-1979) Where do norms come from? How
members of society are socialized to norms; norms as rules to
guide behavior; function of norms

3. Anthropologists and norms
 Feminist anthropologists—1970s and 1980s (e.g.,
norms, social control and gender: from Weber and
Durkheim)
 Ideal and behavioral norms; normative conflict; use of
competing norms in daily life
Norms Several norms
can guide /
justify behavior
Conflicting
norms justify
different
behavior
Norms
Behavior
Norms
Norms
Norms
Behavior

4. What is your theory based on?
All have their strengths and weaknesses
 Philosophy:
 Based on logic
 Psychology:
 Empirical: based on experiments, observations of Western
individuals (often clinical patients going to psychologist
because they perceive they have a problem or university
students)
 Anthropology:
 Empirical, inductive--live/observe in community or study
group over period of often 1-2 years; observe culture in action,
compare what people say they do with what anthropologist
observes people doing; multi-method

5. Culture-sharers are more than a
bunch of individuals
Culture, although it changes, is the glue that holds people together now,
100 years from now, 100 years ago—people who don’t know each other
still share norms
We need a “Superorganic”
Doesn’t matter which definition of culture used:
All are somewhat constructivist, COGNITIVE, emphasize SHARED,
TRANSMITTED OVER GENERATIONS, CHANGING, ADAPTATION to
environment, etc.

6. Social Science—culture-- helps
reduce unexpected outcomes
Concepts of culture and society provide:
 knowledge of what to look for in formative research;
 what fits together with what—i.e., how to
operationalize the ecological approach;
 what may covary with change (e.g., OC use, work
outside the home, and female gender norms)

7. Knowledge to shift narrative to
different normative context
 Albania (Albania Family Planning Project): 2004-2007
 Withdrawal + abortionTFR 1.9
 Formative research on: the cultural embeddedness of FP,
marriage, gender, fertility, sex, their norms and associated
emotions (sexuality, marital trust, and male self-mastery)
 1) Contraception as marital sex aid & 2) added information to
shift male narrative away from self-mastery gender norm to
method effectiveness
 Outreach negotiation counseling
(ONC) by community nurses
 3 TV spots; call-in shows

8. Albania Results
 Contraceptive use went up nation-wide; can’t attribute
this only to AFPP because others working.
 In conservative ONC pilot areas, CPR 6%  68% in
about 3 months; less conservative areas, CPR 13%
59% in 3+ months
(can attribute this to
ONC + TV)
(same contraceptive
security + clinical training
as other project districts)

9. Take Aways
 Norms are embedded in and form part of the social and
cultural matrix
 Norms legitimate, justify, and guide behavior
 Norms reinforce the social structure but can be used to
circumvent power structures
 Several, even competing, norms can cover the same
situation. Norms: usually contextual, often competitive and
provide member s of a culture/society with freedom of action:
agency