Igras, Kohli, Tier); Makerere University (
Bukuluki); London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy (
Cislaghi); Sesame Workshop (
Khan)
"...hope to spark conversations that can raise our field's awareness of the need to engage with the ethical questions that arise in the design and implementation of NSI and to set a foundation for the development of practical tools and guidelines."
The past few decades have seen growing use of norms-shifting interventions (NSI) in low and middle-income countries (LMICs) to promote social and health behaviour change (SBC) toward achievement of the United Nations' 2030 Sustainable Development Goals (SDGs). One type of NSI, community-based NSI, seek to address gender, other inequalities, and the power structures that hold inequalities in place by creating and reinforcing positive norms that are rooted within communal values. In such contexts, designers and implementers, as community outsiders, must ask ethical questions such as: Whose voices and values, at which levels, should inform intervention design? Based on a literature review and the authors' conversations and collaborations with international and local non-governmental organisation (NGOs) working on NSI to improve community health, this article proposes ten ethical values and practical ways to engage ethically with the social complexities of NSI and the social change they seek.