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Title Social and provider networks and women's contraceptive use: Evidence from Madagascar.
Full text https://escholarship.org/uc/item/1b49p1m7
Date 2021
Author(s) Comfort, Alison B; Harper, Cynthia C; Tsai, Alexander C; Moody, James; Perkins, Jessica M; Rasolofomana, Justin Ranjalahy; Alperin, Cora; Ranjalahy, Anja Noeliarivelo; Heriniaina, Ravo; Krezanoski, Paul J
Abstract ObjectivesWomen may differ by whether they rely on health providers and/or social ties for seeking information and advice about family planning. It is unknown whether these differences matter for contraceptive outcomes. This study assessed the association between women's family planning (FP) network (social and/or provider ties) and contraceptive use.Study designThis cross-sectional, egocentric network study was conducted among reproductive-age women (n = 193) in rural Madagascar. Data included socio-demographics and contraceptive use. Respondents listed who they relied on for contraceptive information, advice or guidance and provided ties' gender, age, relationship, and perceived support of contraceptive use. The primary outcome was current contraceptive use. Predictors included having a FP network (0/1) and FP network composition (no network, social ties only, provider ties only, both provider and social ties), respectively. Analyses were conducted using a generalized linear model specifying a Poisson distribution, with covariate adjustment and cluster robust standard errors.ResultsHaving a network of individuals to turn to for contraceptive information compared to having no FP network was positively associated with contraceptive use (adjusted relative risk [aRR] 4.4, 95% confidence interval [CI] 2.00-9.87). Having a social network, a provider network, or a combination of social and provider network were all positively associated with contraceptive use (aRR 4.30 [CI 1.92-9.66], aRR 4.46 [CI 2.04-9.75], aRR 4.72 [CI 1.93-11.50], respectively), compared to having no FP network.ConclusionsContraceptive use was higher among women who relied on social ties, provider ties or both for contraceptive information and advice, compared to women with no FP network. These findings suggest that FP interventions should use a multicomponent approach taking into account both social and provider networks.ImplicationsIt is unknown whether differences in whether women rely on social ties (friends, partner, family members) vs. providers for contraceptive information and advice affect contraceptive outcomes. Women are just as likely to use contraception whether they rely on social ties, provider ties, or both for contraceptive information and advice.
Subject(s) Humans; Contraceptive Agents; Contraception; Cross-Sectional Studies; Contraception Behavior; Family Planning Services; Madagascar; Female; Community health workers; Contraceptives; Family planning; Social networks; Sub-Saharan Africa; Prevention; Clinical Research; Contraception/Reproduction; Good Health and Well Being; Clinical Sciences; Paediatrics and Reproductive Medicine; Public Health and Health Services; Obstetrics & Reproductive Medicine
Coverage 147 - 154
Publisher eScholarship, University of California
Type of publication article
Format application/pdf
Source Contraception, vol 104, iss 2
Rights public
Identifier qt1b49p1m7
Repository Berkeley - University of California
Added to C-A: 2023-07-17;10:03:58