TY - JOUR
T1 - Structural and functional network characteristics and facility delivery among women in rural Ghana
AU - Cofie, Leslie E.
AU - Barrington, Clare
AU - Singh, Kavita
AU - Sodzi-Tettey, Sodzi
AU - Ennett, Susan
AU - Maman, Suzanne
N1 - Funding Information:
We are grateful to the Carolina Population Center and its NIH Center grant (P2C HD050924) for general support.
Funding Information:
The Maternal and Newborn Referrals Project was funded by the Bill & Melinda Gates Foundation.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/12/19
Y1 - 2017/12/19
N2 - Background: Health facility births contribute to the prevention of maternal deaths. Although theoretical and empirical evidence suggest that social network characteristics influence facility delivery, examination of this relationship in sub-Saharan Africa is limited. We determined whether network structural and functional characteristics were associated with, or had an interactive effect on health facility delivery in rural Ghana. Methods: Data on mothers (n = 783) aged 15-49 years came from a Maternal and Newborn Health Referral (MNHR) project in Ghana, and included egocentric network data on women's social network characteristics. Using multivariate logistic regression we examined the relationship between facility delivery and women's network structure and functions, as well as the interaction between network characteristics and facility delivery. Results: Higher levels of instrumental support (e.g. help with daily chores or seeking health care [OR: 1.60, CI: 1.10-2.34]) and informational support (OR: 1.66, CI: 1.08-2.54) were significantly associated with higher odds of facility delivery. Social norms, such as knowing more women who had received pregnancy-related care in a facility, were significantly associated with higher odds of facility delivery (OR: 2.20, CI: 1.21-4.00). The number of network members that respondents lived nearby moderated the positive relationship between informational support and facility delivery. Additionally, informational support moderated the positive relationship between facility delivery and the number of women the respondents knew who had utilized a facility for pregnancy-related care. Conclusions: Social support from network members was critical to facilitating health facility delivery, and support was further enhanced by women's network structure and norms favoring facility delivery. Maternal health interventions to increase facility delivery uptake should target women's social networks.
AB - Background: Health facility births contribute to the prevention of maternal deaths. Although theoretical and empirical evidence suggest that social network characteristics influence facility delivery, examination of this relationship in sub-Saharan Africa is limited. We determined whether network structural and functional characteristics were associated with, or had an interactive effect on health facility delivery in rural Ghana. Methods: Data on mothers (n = 783) aged 15-49 years came from a Maternal and Newborn Health Referral (MNHR) project in Ghana, and included egocentric network data on women's social network characteristics. Using multivariate logistic regression we examined the relationship between facility delivery and women's network structure and functions, as well as the interaction between network characteristics and facility delivery. Results: Higher levels of instrumental support (e.g. help with daily chores or seeking health care [OR: 1.60, CI: 1.10-2.34]) and informational support (OR: 1.66, CI: 1.08-2.54) were significantly associated with higher odds of facility delivery. Social norms, such as knowing more women who had received pregnancy-related care in a facility, were significantly associated with higher odds of facility delivery (OR: 2.20, CI: 1.21-4.00). The number of network members that respondents lived nearby moderated the positive relationship between informational support and facility delivery. Additionally, informational support moderated the positive relationship between facility delivery and the number of women the respondents knew who had utilized a facility for pregnancy-related care. Conclusions: Social support from network members was critical to facilitating health facility delivery, and support was further enhanced by women's network structure and norms favoring facility delivery. Maternal health interventions to increase facility delivery uptake should target women's social networks.
KW - Ghana
KW - Health facility delivery
KW - Homebirth
KW - Maternal health
KW - Social networks
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U2 - 10.1186/s12884-017-1611-2
DO - 10.1186/s12884-017-1611-2
M3 - Article
C2 - 29258456
AN - SCOPUS:85038415370
SN - 1471-2393
VL - 17
JO - BMC Pregnancy and Childbirth
JF - BMC Pregnancy and Childbirth
IS - 1
M1 - 425
ER -