Structural and functional network characteristics and facility delivery among women in rural Ghana

Abstract 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 ne...

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Main Authors: Leslie E. Cofie, Clare Barrington, Kavita Singh, Sodzi Sodzi-Tettey, Susan Ennett, Suzanne Maman
Format: Article
Language:English
Published: BMC 2017-12-01
Series:BMC Pregnancy and Childbirth
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12884-017-1611-2
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author Leslie E. Cofie
Clare Barrington
Kavita Singh
Sodzi Sodzi-Tettey
Susan Ennett
Suzanne Maman
author_facet Leslie E. Cofie
Clare Barrington
Kavita Singh
Sodzi Sodzi-Tettey
Susan Ennett
Suzanne Maman
author_sort Leslie E. Cofie
collection DOAJ
description Abstract 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.
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spelling doaj.art-664d87d56f3b4ab088953c4c0d382a3f2022-12-21T17:33:32ZengBMCBMC Pregnancy and Childbirth1471-23932017-12-0117111310.1186/s12884-017-1611-2Structural and functional network characteristics and facility delivery among women in rural GhanaLeslie E. Cofie0Clare Barrington1Kavita Singh2Sodzi Sodzi-Tettey3Susan Ennett4Suzanne Maman5Center for Interdisciplinary Research in Women’s Health, University of Texas Medical BranchDepartment of Health Behavior, University of North Carolina, Gillings School of Global Public HealthCarolina Population Center, University of North CarolinaInstitute for Healthcare ImprovementDepartment of Health Behavior, University of North Carolina, Gillings School of Global Public HealthDepartment of Health Behavior, University of North Carolina, Gillings School of Global Public HealthAbstract 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.http://link.springer.com/article/10.1186/s12884-017-1611-2Social networksMaternal healthHealth facility deliveryHomebirthGhana
spellingShingle Leslie E. Cofie
Clare Barrington
Kavita Singh
Sodzi Sodzi-Tettey
Susan Ennett
Suzanne Maman
Structural and functional network characteristics and facility delivery among women in rural Ghana
BMC Pregnancy and Childbirth
Social networks
Maternal health
Health facility delivery
Homebirth
Ghana
title Structural and functional network characteristics and facility delivery among women in rural Ghana
title_full Structural and functional network characteristics and facility delivery among women in rural Ghana
title_fullStr Structural and functional network characteristics and facility delivery among women in rural Ghana
title_full_unstemmed Structural and functional network characteristics and facility delivery among women in rural Ghana
title_short Structural and functional network characteristics and facility delivery among women in rural Ghana
title_sort structural and functional network characteristics and facility delivery among women in rural ghana
topic Social networks
Maternal health
Health facility delivery
Homebirth
Ghana
url http://link.springer.com/article/10.1186/s12884-017-1611-2
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AT sodzisodzitettey structuralandfunctionalnetworkcharacteristicsandfacilitydeliveryamongwomeninruralghana
AT susanennett structuralandfunctionalnetworkcharacteristicsandfacilitydeliveryamongwomeninruralghana
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