{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:09:59Z","timestamp":1790392199722,"version":"4.1.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T00:00:00Z","timestamp":1599696000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T00:00:00Z","timestamp":1599696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004441","name":"Swedish International Development Cooperation Agency","doi-asserted-by":"crossref","award":["G41102"],"award-info":[{"award-number":["G41102"]}],"id":[{"id":"10.13039\/100004441","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Department for International Development","award":["DFID 203529-102"],"award-info":[{"award-number":["DFID 203529-102"]}]},{"DOI":"10.13039\/100001275","name":"Oak Foundation","doi-asserted-by":"publisher","award":["OCAY-16-732"],"award-info":[{"award-number":["OCAY-16-732"]}],"id":[{"id":"10.13039\/100001275","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UNICEF","award":["N\/a"],"award-info":[{"award-number":["N\/a"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The shaping of gender beliefs and attitudes in early adolescence affects the way young people internalize and self-enforce prevalent notions of masculinity and femininity, with lifelong consequences for sexual and reproductive health. This cross-sectional study examines determinants of gender attitudes among some of the poorest and most vulnerable adolescents in Tanzania using an ecological model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data come from baseline interviews with 2458 males and females aged 14\u201319\u2009years conducted as part of a larger impact evaluation. Structural equation models are used to examine how factors at the community-, household-, and individual-levels influence gender attitudes in the four domains measured by the Gender Equitable Men (GEM) Scale (i.e. violence, sexual relationships, reproductive health and disease prevention, and domestic chores and daily life).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A structural equation model of the four latent domains of the GEM scale regressed on individual, social-interactional and structural level characteristics indicated that secondary school attendance was associated with more equitable gender attitudes, while females held less equitable attitudes than males in the sample. Having had sexual intercourse was associated with more gender equitable attitudes among females, but the reverse was true among males.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Addressing gender inequity requires understanding gender socialisation at the socio-interactional level. As females had more inequitable gender attitudes than males in the study, a special emphasis on highlighting the rights of women to girls should be considered. This study will inform future analysis of programme impacts on gender attitudes and sexual and reproductive health.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12905-020-01057-8","type":"journal-article","created":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T07:03:46Z","timestamp":1599721426000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Examining determinants of gender attitudes: evidence among Tanzanian adolescents"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0419-2049","authenticated-orcid":false,"given":"Tia","family":"Palermo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yekaterina","family":"Chzhen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Balvin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lusajo","family":"Kajula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Tanzania Adolescent Cash Plus Evaluation Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tia","family":"Palermo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Groppo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacobus","family":"de\u00a0Hoop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lusajo","family":"Kajula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Prencipe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Waidler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Choumert\u00a0Nkolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Respichius","family":"Mitti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Sivewright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"Leuveld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhoke","family":"Munanka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Luchemba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tumpe","family":"Mnyawami\u00a0Lukongo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aroldia","family":"Mulokozi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Gilbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Quarles van\u00a0Ufford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke","family":"Le\u00a0Kirkegaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Eetaama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,10]]},"reference":[{"key":"1057_CR1","unstructured":"John N, Stoebenau K, Ritter S, Edmeades J, Balvin N. Gender socialization during adolescence in low- and middle-income countries: conceptualization, influences and outcomes. Florence: UNICEF Office of Research - Innocenti; 2017. Innocenti Discussion Paper. https:\/\/www.unicef-irc.org\/publications\/885-gender-socialization-during-adolescence-in-low-and-middle-income-countries-conceptualization.html."},{"issue":"2","key":"1057_CR2","doi-asserted-by":"publisher","first-page":"S15","DOI":"10.1016\/j.jadohealth.2016.09.027","volume":"60","author":"L Vu","year":"2017","unstructured":"Vu L, Pulerwitz J, Burnett-Zieman B, Banura C, Okal J, Yam E. Inequitable gender norms from early adolescence to young adulthood in Uganda: tool validation and differences across age groups. J Adolesc Health. 2017;60(2):S15\u201321.","journal-title":"J Adolesc Health"},{"issue":"9915","key":"1057_CR3","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/S0140-6736(14)60039-8","volume":"383","author":"GC Patton","year":"2014","unstructured":"Patton GC, Ross DA, Santelli JS, Sawyer SM, Viner RM, Kleinert S. Next steps for adolescent health: a lancet commission. Lancet. 2014;383(9915):385\u20136.","journal-title":"Lancet"},{"key":"1057_CR4","doi-asserted-by":"crossref","unstructured":"George AS, Amin A, de Abreu Lopes CM, Ravindran TS. Structural determinants of gender inequality: why they matter for adolescent girls\u2019 sexual and reproductive health. BMJ. 2020;368:l6985.","DOI":"10.1136\/bmj.l6985"},{"key":"1057_CR5","volume-title":"Unequal, unfair, ineffective and inefficient: gender inequity in health: why it exists and how we can change it: final report to the WHO Commission on social determinants of health: World Health Organization","author":"G Sen","year":"2007","unstructured":"Sen G, \u00d6stlin P, George A. Unequal, unfair, ineffective and inefficient: gender inequity in health: why it exists and how we can change it: final report to the WHO Commission on social determinants of health: World Health Organization; 2007."},{"key":"1057_CR6","volume-title":"Momentum toward equality: results from the international men and gender equality survey (IMAGES) in Tanzania","author":"R Levtov","year":"2018","unstructured":"Levtov R, Vlahicova K, Barker G, Stiefvater E, Daimon L, Mulokozi AD. Momentum toward equality: results from the international men and gender equality survey (IMAGES) in Tanzania. Washington, DC: Promundo-US, Uzazi na Malezi Bora Tanzania, and Tanzania Commission for AIDS; 2018."},{"issue":"1","key":"1057_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/00220381003600366","volume":"47","author":"A Peterman","year":"2011","unstructured":"Peterman A. Women's property rights and gendered policies: implications for women's long-term welfare in rural Tanzania. J Dev Stud. 2011;47(1):1\u201330.","journal-title":"J Dev Stud"},{"key":"1057_CR8","volume-title":"The global gender gap report","author":"World Economic Forum","year":"2018","unstructured":"World Economic Forum. The global gender gap report. Geneva: World Economic Forum; 2018."},{"key":"1057_CR9","volume-title":"Tanzania Demographic and Health Survey and Malaria Indicator Survey 2015\u20132016","author":"Ministry of Health CD, Gender, Elderly and Children [Dar es Salaam];, Ministry of Health [Zanzibar], National Bureau of Statistics [Dar es Salaam], Office of Chief of Government Statistician [Zanzibar], ICF","year":"2016","unstructured":"Ministry of Health CD, Gender, Elderly and Children [Dar es Salaam];, Ministry of Health [Zanzibar], National Bureau of Statistics [Dar es Salaam], Office of Chief of Government Statistician [Zanzibar], ICF. Tanzania Demographic and Health Survey and Malaria Indicator Survey 2015\u20132016. Dar es Salaam, Tanzania and Rockville: MoHCDGEC, MoH, NBS, OCGS, and ICF; 2016."},{"issue":"6","key":"1057_CR10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0157805","volume":"11","author":"A K\u00e5gesten","year":"2016","unstructured":"K\u00e5gesten A, Gibbs S, Blum RW, Moreau C, Chandra-Mouli V, Herbert A, et al. Understanding factors that shape gender attitudes in early adolescence globally: a mixed-methods systematic review. PLoS One. 2016;11(6):e0157805.","journal-title":"PLoS One"},{"key":"1057_CR11","volume-title":"Ujana Salama: a cash plus model on youth well-being and safe, healthy transitions: Baseline Evaluation Report","author":"Tanzania Cash Plus Evaluation Team","year":"2018","unstructured":"Tanzania Cash Plus Evaluation Team. Ujana Salama: a cash plus model on youth well-being and safe, healthy transitions: Baseline Evaluation Report. 2018."},{"key":"1057_CR12","volume-title":"Cash Plus: An Adolescent Livelihood, Health and Well-being Intervention as part of Tanzania's Productive Social Safety Net Programme","author":"UNICEF","year":"2017","unstructured":"UNICEF. Cash Plus: An Adolescent Livelihood, Health and Well-being Intervention as part of Tanzania's Productive Social Safety Net Programme. Florence and Dar es Salaam: UNICEF; 2017."},{"key":"1057_CR13","volume-title":"Compendium of gender scales","author":"G Nanda","year":"2011","unstructured":"Nanda G. Compendium of gender scales. Washington, DC: FHI 360\/C-Change; 2011."},{"issue":"1","key":"1057_CR14","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1186\/1471-2458-11-109","volume":"11","author":"T Abramsky","year":"2011","unstructured":"Abramsky T, Watts CH, Garcia-Moreno C, Devries K, Kiss L, Ellsberg M, et al. What factors are associated with recent intimate partner violence? Findings from the WHO multi-country study on women's health and domestic violence. BMC Public Health. 2011;11(1):109.","journal-title":"BMC Public Health"},{"issue":"1","key":"1057_CR15","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1080\/17290376.2006.9724863","volume":"3","author":"LS Tladi","year":"2006","unstructured":"Tladi LS. Poverty and HIV\/AIDS in South Africa: an empirical contribution. SAHARA-J. 2006;3(1):369\u201381.","journal-title":"SAHARA-J"},{"issue":"8","key":"1057_CR16","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1080\/09540120701294286","volume":"19","author":"RK Maganja","year":"2007","unstructured":"Maganja RK, Maman S, Groves A, Mbwambo JK. Skinning the goat and pulling the load: transactional sex among youth in Dar Es Salaam, Tanzania. AIDS Care. 2007;19(8):974\u201381.","journal-title":"AIDS Care"},{"key":"1057_CR17","volume-title":"Progress of the World's Women 2015-2016: transforming economies, realizing rights","author":"UNWOMEN","year":"2015","unstructured":"UNWOMEN. Progress of the World's Women 2015-2016: transforming economies, realizing rights. New York: UNWOMEN; 2015."},{"key":"1057_CR18","volume-title":"The progress of the primary education development plan (PEDP) in Tanzania: 2002-2004","author":"E Davidson","year":"2004","unstructured":"Davidson E. The progress of the primary education development plan (PEDP) in Tanzania: 2002-2004. Dar Es Salaam: HakiElimu; 2004."},{"issue":"1","key":"1057_CR19","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1023\/A:1021841312539","volume":"32","author":"N Gupta","year":"2003","unstructured":"Gupta N, Mahy M. Sexual initiation among adolescent girls and boys: trends and differentials in sub-Saharan Africa. Arch Sex Behav. 2003;32(1):41\u201353.","journal-title":"Arch Sex Behav"},{"key":"1057_CR20","volume-title":"Ujana Salama: a cash plus model on youth well-being and safe, healthy transitions: trial design, methods and baseline findings","author":"Tanzania Cash Plus Evaluation Team","year":"2018","unstructured":"Tanzania Cash Plus Evaluation Team. Ujana Salama: a cash plus model on youth well-being and safe, healthy transitions: trial design, methods and baseline findings. 2018."},{"issue":"Suppl 2","key":"1057_CR21","doi-asserted-by":"publisher","first-page":"S35","DOI":"10.1097\/01.aids.0000327435.28538.18","volume":"22","author":"A Greig","year":"2008","unstructured":"Greig A, Peacock D, Jewkes R, Msimang S. Gender and AIDS: time to act. AIDS (London, England). 2008;22(Suppl 2):S35.","journal-title":"AIDS (London, England)"},{"issue":"6","key":"1057_CR22","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1007\/s10461-015-1152-5","volume":"20","author":"TJ Yamanis","year":"2016","unstructured":"Yamanis TJ, Fisher JC, Moody JW, Kajula LJ. Young men\u2019s social network characteristics and associations with sexual partnership concurrency in Tanzania. AIDS Behav. 2016;20(6):1244\u201355.","journal-title":"AIDS Behav"},{"issue":"4","key":"1057_CR23","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1037\/0012-1649.41.4.625","volume":"41","author":"M Gardner","year":"2005","unstructured":"Gardner M, Steinberg L. Peer influence on risk taking, risk preference, and risky decision making in adolescence and adulthood: an experimental study. Dev Psychol. 2005;41(4):625.","journal-title":"Dev Psychol"},{"issue":"3","key":"1057_CR24","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1007\/s10508-014-0406-z","volume":"44","author":"M Sommer","year":"2015","unstructured":"Sommer M, Likindikoki S, Kaaya S. \u201cBend a fish when the fish is not yet dry\u201d: adolescent boys\u2019 perceptions of sexual risk in Tanzania. Arch Sex Behav. 2015;44(3):583\u201395.","journal-title":"Arch Sex Behav"},{"issue":"12","key":"1057_CR25","doi-asserted-by":"publisher","first-page":"e0206074","DOI":"10.1371\/journal.pone.0206074","volume":"13","author":"SK Settergren","year":"2018","unstructured":"Settergren SK, Mujaya S, Rida W, Kajula LJ, Kamugisha H, Mbwambo JK, et al. Cluster randomized trial of comprehensive gender-based violence programming delivered through the HIV\/AIDS program platform in Mbeya Region, Tanzania: Tathmini GBV study. PloS One. 2018;13(12):e0206074.","journal-title":"PloS One"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-020-01057-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-020-01057-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-020-01057-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T23:11:45Z","timestamp":1631229105000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-020-01057-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,10]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1057"],"URL":"https:\/\/doi.org\/10.1186\/s12905-020-01057-8","relation":{},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,10]]},"assertion":[{"value":"8 August 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 September 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study obtained Ethical Clearance from the Tanzania Commission for Science and Technology (COSTECH) in Tanzania. Informed assent and parental consent was obtained for all unmarried adolescents ages 14\u201317\u2009years, and written informed consent was obtained directly for those aged 18 and 19\u2009years and emancipated (married) adolescents aged 14\u201317\u2009years. This consent procedure for married adolescents under the age of 18\u2009years falls under the Marriage Act of 1972, which allows girls to be married at age 15 and males at age 18. In Tanzania, legal interpretation of this law confirms that, for matters within ones\u2019 capability (in this case the household or person), then the married minor is a legal respondent. Subsequently, in 2016, a Tanzanian high court ruled provisions allowing marriage under the age of 18\u2009years unconstitutional, and this ruling was then challenged. Finally, in October 2019, the high court upheld the 2016 ruling, which has not yet been operationalized and enforced in the country. Thus, current legal interpretation confirms that married adolescents are considered to have the legal capacity to give consent to participate in research. In our sample, there were no married males under the age of 18 and no married females under the age of 15.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no competing financial and non-financial interests to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"195"}}