‘The bigger the better’ – mothers' social networks and child nutrition in Andhra Pradesh

Abstract

Objective: It is hypothesised that mothers' social networks can positively affect child nutrition through the sharing of health knowledge and other resources. The present study describes the composition of mothers' networks, examines their association with child nutrition, and assesses whether health knowledge is shared within networks. Design and setting: Cross-sectional data for mothers of young children from Andhra Pradesh (south India) were combined with existing data from the Young Lives study, in which the mothers were participating (n ¼ 282). Results: The composition of social networks varied between urban and rural areas, with urban networks being larger, more female, more literate and with a greater proportion of members living outside the household and being non-family. There was a positive association between child's height-for-age Z-score and mother's network size and network literacy rate. The association with network literacy was stronger among the poorest households. Women commonly reported seeking or receiving health advice from network members. Conclusion: Big and literate social networks are associated with better child nutrition, especially among the poor. The dissemination of health knowledge between network members is a plausible way in which social networks benefit child nutrition in India. Further research into the underlying mechanisms is necessary to inform the development of interventions that channel health information through word of mouth to the most excluded and vulnerable families.

Measuring Social Networks for Medical Research in Lower-Income Settings

“…Third, women were nominated more often than men, and women reported significantly larger social networks than men, consistent with findings of adults in the United States and Australia [55]. Network size and gender composition in our study were consistent with those reported in a social network study of mothers in Southern India, where mean network size was 3.36, 78% of networks were composed of family members, and more female than male ties were nominated among the urban-dwelling sample compared to the rural-dwelling sample [56]. Finally, we found that while the majority (90%) of network ties resided in the same city as the participant, less than 5% of ties were neighbors.…”

The Place of Proximity

“…Women, in particular, appear to gain significantly from having support networks in place (Hurdle 2001), and women often look to each other as support partners (Adams et al 2002;Hung and Chung 2001;Moestue et al 2007;Savage et al 2007). Social support related to maternal and infant health is a particularly well-researched area, with studies depicting a range of positive benefits (Cohen 1988;Cohen and Syme 1985).…”

“…Adams et al (2002) show that among women in Mali there is a positive association between network size and child survival. Another study looking at transmission of health information in women's networks shows that women in India with larger and more literate networks had children with greater height-for-age Z scores (Moestue et al 2007).…”

Revisiting the child health-wealth nexus

“…Cleland and Jejeebhoy [49] also report lower fertility rates amongst women with little or no education but living in educated communities, compared to similarly educated women living in communities with lower overall education. Moestue, Huttly, Sarella et al [50] use a unique dataset on mothers’ networks to show that mothers from poorest household benefit the most from having a more ‘literate’ network in improving child health. Based on these findings, community-level factors are explicitly controlled for while modelling child health, and are the secondary variables of interest in this paper.…”