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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Format: | Article |
Language: | English |
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BMC
2017-12-01
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Series: | BMC Pregnancy and Childbirth |
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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. |
first_indexed | 2024-12-23T19:46:14Z |
format | Article |
id | doaj.art-664d87d56f3b4ab088953c4c0d382a3f |
institution | Directory Open Access Journal |
issn | 1471-2393 |
language | English |
last_indexed | 2024-12-23T19:46:14Z |
publishDate | 2017-12-01 |
publisher | BMC |
record_format | Article |
series | BMC Pregnancy and Childbirth |
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 |
work_keys_str_mv | AT leslieecofie structuralandfunctionalnetworkcharacteristicsandfacilitydeliveryamongwomeninruralghana AT clarebarrington structuralandfunctionalnetworkcharacteristicsandfacilitydeliveryamongwomeninruralghana AT kavitasingh structuralandfunctionalnetworkcharacteristicsandfacilitydeliveryamongwomeninruralghana AT sodzisodzitettey structuralandfunctionalnetworkcharacteristicsandfacilitydeliveryamongwomeninruralghana AT susanennett structuralandfunctionalnetworkcharacteristicsandfacilitydeliveryamongwomeninruralghana AT suzannemaman structuralandfunctionalnetworkcharacteristicsandfacilitydeliveryamongwomeninruralghana |