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Women’s social networks and birth attendant decisions: Application of the Network-Episode Model

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  • Edmonds, Joyce K.
  • Hruschka, Daniel
  • Bernard, H. Russell
  • Sibley, Lynn
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    Abstract

    This paper examines the association of women’s social networks with the use of skilled birth attendants in uncomplicated pregnancy and childbirth in Matlab, Bangladesh. The Network-Episode Model was applied to determine if network structure variables (density/kinship homogeneity/strength of ties) together with network content (endorsement for or against a particular type of birth attendant) explain the type of birth attendant used by women above and beyond the variance explained by women’s individual attributes. Data were collected by interviewing a representative sample of 246 women, 18–45 years of age, using survey and social network methods between October and December 2008. Logistic regression models were used to examine the associations. Results suggest that the structural properties of networks did not add to explanatory value but instead network content or the perceived advice of network members add significantly to the explanation of variation in service use. Testing aggregate network variables at the individual level extends the ability of the individual profile matrix to explain outcomes. Community health education and mobilization interventions attempting to increase demand for skilled attendants need to reflect the centrality of kinship networks to women in Bangladesh and the likelihood of women to heed the advice of their network of advisors with regard to place of birth.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0277953611006769
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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 74 (2012)
    Issue (Month): 3 ()
    Pages: 452-459

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    Handle: RePEc:eee:socmed:v:74:y:2012:i:3:p:452-459

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    Related research

    Keywords: Bangladesh; Network-Episode Model; Social networks; Skilled birth attendants; Health seeking behavior; Utilization; Childbirth; Maternal mortality;

    References

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    1. Valente, Thomas W. & Watkins, Susan C. & Jato, Miriam N. & Van Der Straten, Ariane & Tsitsol, Louis-Philippe M., 1997. "Social network associations with contraceptive use among Cameroonian women in voluntary associations," Social Science & Medicine, Elsevier, vol. 45(5), pages 677-687, September.
    2. Paul, Bimal Kanti & Rumsey, Deborah J., 2002. "Utilization of health facilities and trained birth attendants for childbirth in rural Bangladesh: an empirical study," Social Science & Medicine, Elsevier, vol. 54(12), pages 1755-1765, June.
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    4. Hans-Peter Kohler & Jere Behrman & Susan Watkins, 2001. "The density of social networks and fertility decisions: evidence from south nyanza district, kenya," Demography, Springer, vol. 38(1), pages 43-58, February.
    5. Jere Behrman & Hans-Peter Kohler & Susan Watkins, 2002. "Social networks and changes in contraceptive use over time: Evidence from a longitudinal study in rural Kenya," Demography, Springer, vol. 39(4), pages 713-738, November.
    6. Anson, Ofra, 2004. "Utilization of maternal care in rural HeBei Province, the People's Republic of China: individual and structural characteristics," Health Policy, Elsevier, vol. 70(2), pages 197-206, November.
    7. Duong, Dat V & Binns, Colin W & Lee, Andy H, 2004. "Utilization of delivery services at the primary health care level in rural Vietnam," Social Science & Medicine, Elsevier, vol. 59(12), pages 2585-2595, December.
    8. Amooti-Kaguna, B. & Nuwaha, F., 2000. "Factors influencing choice of delivery sites in Rakai district of Uganda," Social Science & Medicine, Elsevier, vol. 50(2), pages 203-213, January.
    9. Glei, Dana A. & Goldman, Noreen & Rodríguez, Germán, 2003. "Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter?," Social Science & Medicine, Elsevier, vol. 57(12), pages 2447-2463, December.
    10. Sunil, T.S. & Rajaram, S. & Zottarelli, Lisa K., 2006. "Do individual and program factors matter in the utilization of maternal care services in rural India? A theoretical approach," Social Science & Medicine, Elsevier, vol. 62(8), pages 1943-1957, April.
    11. Gayen, Kaberi & Raeside, Robert, 2007. "Social networks, normative influence and health delivery in rural Bangladesh," Social Science & Medicine, Elsevier, vol. 65(5), pages 900-914, September.
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