Inequitable Gender Norms From Early Adolescence to Young Adulthood in Uganda: Tool Validation and Differences Across Age Groups

• Published in: Journal of adolescent health 2017-02, Vol.60 (2), p.S15-S21
• Main Authors: Vu, Lung, M.D., Ph.D, Pulerwitz, Julie, Sc.D, Burnett-Zieman, Brady, M.P.H, Banura, Cecily, Ph.D, Okal, Jerry, Ph.D, Yam, Eileen, Ph.D
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Age; Age differences; Age Factors; Age groups; Age of onset; Child; Confirmatory factor analysis; Domestic Violence - psychology; Factor Analysis, Statistical; Female; GEM scale; Gender; Gender differences; Gender inequality; Gender norms; Gender roles; Health status; Humans; Inequality; Intimacy; Intimate partner violence; Male; Measurement; Measures; Norms; Pediatrics; Reproductive Rights - psychology; Rural communities; Rural urban differences; Scale validation; Sex Factors; Sexual behavior; Sexual Behavior - psychology; Sexual Partners - psychology; Social Norms; Surveys and Questionnaires; Teenagers; Uganda; Validity; Violence; Young Adult; Young adults; Youth
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2016.09.027

Abstract Purpose We aimed to describe and compare gender norms among 10- to 14-year-olds versus 15- to 24-year-olds and to conduct a rigorous evaluation of the GEM Scale's performance among these two age groups. Methods We conducted a two-stage cluster-sampled survey among 387 females and 583 males, aged 10–24 years, in rural and urban communities near Kampala, Uganda. We applied, assessed, and adapted the GEM Scale (Pulerwitz and Barker, 2008), which measures views toward gender norms in four domains. We describe levels of support for (in)equitable norms, by gender and age, and associations with key health outcomes (partner violence). Confirmatory factor analysis and multi-group measurement invariance analysis were used to assess scale performance. Results All participants reported high levels of support for inequitable gender norms; 10- to 14-year-olds were less gender equitable than their older counterparts. For example, 74% of 10- to 14-year-olds and 67% of 15- to 24-year-olds agreed that “a woman should tolerate violence to keep her family together.” Comparing responses from males and females indicated similar support for gender inequity. Analyses confirmed a one-factor model, good scale fit for both age groups, and that several items from the scale could be dropped for this sample. The ideal list of items for each age group differed somewhat but covered all four scale domains in either case. An 18-item adapted scale was used to compare mean GEM Scale scores between the two age groups; responses were significantly associated with early sexual debut and partner violence. Conclusions Young people internalize gender norms about sexual and intimate relationships, and violence, at early ages. Programs to address negative health outcomes should explicitly address inequitable gender norms and more consistently expand to reach younger age groups. In this first application of the GEM Scale among 10- to 14-year-olds, we confirm that it is a valid measure in this setting.