Perceived Social Networks and Newborn Health: Evidence from Self-Help Group Communities in Northern India

Abstract

The limitations of individual level interventions in changing behaviors to improve global maternal, newborn and child health have generated more interest in the patterns of social influence and decision making embedded in families, friends and communities. The purpose of this study is to expand the understanding of village dynamics in India and how first degree social and advice networks and cognitive perceptions of 185 recently delivered women (RDW) in areas with and without women's Self-Help Groups (SHGs) affect immediate breastfeeding. Data was collected in 6 blocks and 36 villages in Uttar Pradesh, India. The expansion of RDW's social worlds and creation of social capital through the organization of Self-Help Groups in their villages allowed us to examine basic relationships and advice formation as well as perceptions of interconnectedness of known groups. RDW living in SHG villages and blocks had consistently higher numbers of relationship ties, health advice ties and higher density of health advice networks than RDW living in the non-SHG areas. RDW's perceived knowing ties were also significantly higher between family and health workers in the SHG areas with related higher immediate breastfeeding rates. These results suggest that SHGs can accelerate community social capital and promote more accountability in the health system to engage with families and support the change from traditional to more evidence-based health practices.

The Knowledge of Danger Signs of Obstetric Complications Among Women in Rural India: Evaluating an Integrated Microfinance and Health Literacy Program

“…Women only micro nance-based Self-help groups (SHG) program is a novel intervention to address informational and nancial barriers to maternal care-seeking by improving maternal health literacy and providing access to credit (33,38). The provision of health knowledge through peer-network of SHGs is also postulated to shift social norms about maternal health outcomes by providing an enabling environment for discussion and change (39)(40)(41). Moreover, SHGs have now been placed under India's rural health programs facilitating coordination of health services with community health workers in villages (12,42).…”

“…Moreover, SHGs have now been placed under India's rural health programs facilitating coordination of health services with community health workers in villages (12,42). SHGs as a developmental model, permits the scaling of an added health intervention and allows the diffusion of new knowledge and skills through program channels over time in a social system (39,43).…”

“…The IMFHL program aimed to empower marginalised women by organising them in self-help groups comprising 10-15 households to adopt desired health behaviours and provide access credit for poverty reduction (44,45). Studies have shown that SHG membership fosters social capital and cohesion among member through group collectivisation, with membership in uencing social norms and behaviours (39,40,41). Previous studies in rural India suggested that SHG membership may increase access to social and health advice networks for mothers, including increased linkages to the health system (39,40).…”

“…Studies have shown that SHG membership fosters social capital and cohesion among member through group collectivisation, with membership in uencing social norms and behaviours (39,40,41). Previous studies in rural India suggested that SHG membership may increase access to social and health advice networks for mothers, including increased linkages to the health system (39,40). However, the potential of SHGs as a community network to reach non-members with new knowledge has not been studied.…”

“…While most studies attribute the change in health behaviours due to the in uence of program input, limited studies have explored the phenomenon of diffusion of health literacy from program members to non-members (44,39,46). Diffusion in this paper adopts a de nition that explains the process by which an innovation -in this case, the knowledge of maternal danger signs, is communicated through programmatic channels over time from members to non-members of a social system (43).…”