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Cited by 21Global Maternal and Child HealthMaternal and Perinatal Health InterventionsMaternal and Neonatal Healthcare

A qualitative study of women’s network social support and facility delivery in rural Ghana

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Cofie, Leslie E., Barrington, Clare, Sodzi-Tettey, Sodzi, Ennett, Susan, Maman, Suzzane, Singh, Kavita·2018·PLOS ONE
DOI 10.1371/journal.pone.0206429PMC PMC6219853
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Abstract

Similar to many sub-Saharan African countries, maternal mortality in Ghana ranks among the highest (39th) globally. Prior research has demonstrated the impact of social network characteristics on health facility delivery in sub-Saharan Africa. However, in-depth examination of the function of all members in a woman's network, in providing various types of support for the woman's pregnancy and related care, is limited. We qualitatively explore how women's network social support influences facility delivery. Qualitative data came from a mixed methods evaluation of a Maternal and Newborn Health Referral project in Ghana. In 2015 we conducted in-depth interviews with mothers (n = 40) and husbands (n = 20), and 4 focus group interviews with mothers-in-law. Data were analyzed using narrative summaries and thematic coding procedures to first examine women's network composition during their pregnancy and childbirth experiences. We then compared those who had homebirths versus facility births on how network social support influenced their place of childbirth. Various network members were involved in providing women with social support. We found differences in how informational and instrumental support impacted women's place of childbirth. Network members of women who had facility delivery mobilized resources to support women's facility delivery. Among women who had homebirth but their network members advocated for them to have facility delivery, members delayed making arrangements for the women's facility delivery. Women who had homebirth, and their network members advocated homebirth, received support to give birth at home. Network support for women's pregnancy-related care affects their place of childbirth. Hence, maternal health interventions must develop strategies to prioritize informational and instrumental support for facility-based pregnancy and delivery care.

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  1. [2]Gabrysch S, Campbell OMR. Still too far to walk: literature review of the determinants of delivery service use. BMC pregnancy and childbirth. 2009; 9: 34–. 10.1186/1471-2393-9-34 19671156 PMC2744662 · DOI · Paper page
  2. [3]Say L, Chou D, Gemmill A, Tunçalp Ö, Moller A-B, Daniels J, et al Global causes of maternal death: a WHO systematic analysis. The Lancet Global Health. 2014; 2(6): e323– e33. 10.1016/S2214-109X(14)70227-X 25103301 · DOI · Paper page
  3. [8]Moyer Ca, Mustafa A. Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review. Reproductive health. 2013; 10(1): 40–. 23962135 PMC3751820
  4. [9]Tey N-P, Lai S-l. Correlates of and barriers to the utilization of health services for delivery in South Asia and Sub-Saharan Africa. TheScientificWorldJournal. 2013; 2013: 423403–. 10.1155/2013/423403 24288482 PMC3830882 · DOI
  5. [10]Crissman HP, Engmann CE, Adanu RM, Nimako D, Crespo K, Moyer CA. Shifting norms: pregnant women's perspectives on skilled birth attendance and facility-based delivery in rural Ghana. African Journal of Reproductive Health. 2013; 17(1): 15– 26. 24069731
  6. [11]Gething PW, Johnson FA, Frempong-Ainguah F, Nyarko P, Baschieri A, Aboagye P, et al Geographical access to care at birth in Ghana: a barrier to safe motherhood. BMC public health. 2012; 12(1): 991–. 23158554 PMC3533981
  7. [12]Doku D, Neupane S, Doku PN. Factors associated with reproductive health care utilization among Ghanaian women. BMC international health and human rights. 2012; 12(1): 29–. 23130571 PMC3538706
  8. [13]Akazili J, Doctor HV, Abokyi L, Hodgson A, Phillips JF. Is there any relationship between antenatal care and place of delivery? Findings from rural northern Ghana. 2011; 18(1): 62– 73.
  9. [14]Sakeah E, Doctor HV, McCloskey L, Bernstein J, Yeboah-Antwi K, Mills S. Using the community-based health planning and services program to promote skilled delivery in rural Ghana: socio-demographic factors that influence women utilization of skilled attendants at birth in northern Ghana. BMC public health. 2014; 14(1): 344–. 24721385 PMC4020603
  10. [15]D'Ambruoso L, Abbey M, Hussein J. Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana. BMC public health. 2005; 5: 140–. 10.1186/1471-2458-5-140 16372911 PMC1343547 · DOI · Paper page
  11. [16]Say L, Raine R. Public health reviews A systematic review of inequalities in the use of maternal health care in developing countries: examining the scale of the problem and the importance of context Public health reviews. 2007; 035659(August 2006). PMC2636485 18038064
  12. [17]Valente TW, Watkins SC, Jato MN, van der Straten A, Tsitsol LPM. Social network associations with contraceptive use among comeroonian women in voluntary associations. Social Science & Medecine. 1997; 45(5): 677– 87. 9226791
  13. [18]Da Luke, Harris JK. Network analysis in public health: history, methods, and applications. Annual review of public health. 2007; 28: 69– 93. 10.1146/annurev.publhealth.28.021406.144132 17222078 · DOI
  14. [19]Berkman LF, Glass T, Brissette I, Seeman TE. From social integration to health: Durkheim in the new millennium. Social science & medicine (1982). 2000; 51(6): 843– 57. 10972429
  15. [20]Fischer CS. To dwell among friends: personal networks in town and city. Chicago: University of Chicago Press 1982.
  16. [21]Laumann EO. Bonds of pluralism: the form and substance of urban social networks. New York,: J. Wiley 1973.
  17. [22]Israel BA. Social networks and health status: linking theory, research, and practice. Patient Couns Health Educ. 1982; 4(2): 65– 79. 10258419
  18. [23]Mitchell RE, Trickett EJ. Task force report: social networks as mediators of social support: an analysis of the effects and determinants of social networks. Community Ment Health J. 1980; 16(1): 27– 44. 7371381
  19. [24]House JS, Umberson D, Landis KR. Structures And Processes Of Social Support. Annual Review of Sociology. 1988; 14(1): 293– 318.
  20. [25]Seeman TE, Berkman LF. Structural characteristics of social networks and their relationship with social support in the elderly: who provides support. Social science & medicine (1982). 1988; 26(7): 737– 49. 3358145
  21. [26]Thoits PA. Stress, coping, and social support processes: where are we? What next? J Health Soc Behav. 1995;Spec No(1995): 53– 79. 7560850
  22. [27]House JS. Work stress and social support Reading, Mass.: Addison-Wesley 1981.
  23. [28]Balaji AB, Claussen AH, Smith DC, Visser SN, Morales MJ, Perou R. Social support networks and maternal mental health and well-being. Journal of women's health (2002). 2007; 16(10): 1386– 96. 18062754
  24. [31]Parkhurst JO, Rahman SA, Ssengooba F. Overcoming access barriers for facility-based delivery in low-income settings: insights from Bangladesh and Uganda. Journal of health, population, and nutrition. 2006; 24(4): 438– 45. 17591340 PMC3001147
  25. [32]Gupta S, Sussman DA, Doubeni CA, Anderson DS, Day L, Deshpande AR, et al Challenges and possible solutions to colorectal cancer screening for the underserved. J Natl Cancer Inst. 2014 4; 106(4): dju032 10.1093/jnci/dju032 24681602 PMC3982886 · DOI
  26. [34]Cofie LE, Barrington C, Singh K, Sodzi-Tettey S, Akaligaung A. Birth location preferences of mothers and fathers in rural Ghana: Implications for pregnancy, labor and birth outcomes. BMC Pregnancy Childbirth. 2015 8; 15: 165 10.1186/s12884-015-0604-2 26265087 PMC4534058 · DOI
  27. [36]Carrington PJ, Scott J, Wasserman S. Models and methods in social network analysis Cambridge; New York: Cambridge University Press 2005.
  28. [37]McCarty C. Structure in personal networks. Journal of Social Structure 2002.
  29. [38]Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field methods. 2006; 1: 59– 82.
  30. [41]Sandelowski M. Qualitative analysis: what it is and how to begin. Res Nurs Health. 1995 8; 18(4): 371– 5. 7624531
  31. [42]Ono M, Matsuyama A, Karama M, Honda S. Association between social support and place of delivery: a cross-sectional study in Kericho, Western Kenya. BMC pregnancy and childbirth. 2013; 13(1): 214–. 24261639 PMC4222494
  32. [43]Carter M. Husbands and maternal health matters in rural Guatemala: wives' reports on their spouses' involvement in pregnancy and birth. Social science & medicine (1982). 2002; 55(3): 437– 50. 12144151
  33. [44]Kwambai TK, Dellicour S, Desai M, Ameh Ca, Person B, Achieng F, et al Perspectives of men on antenatal and delivery care service utilisation in rural western Kenya: a qualitative study. BMC pregnancy and childbirth. 2013; 13(1): 134–. 23800139 PMC3691751
  34. [45]Stephenson R, Baschieri A, Clements S, Hennink M, Madise N. Contextual influences on the use of health facilities for childbirth in Africa. American journal of public health. 2006; 96(1): 84– 93. 10.2105/AJPH.2004.057422 16317204 PMC1470452 · DOI
  35. [46]Danforth EJ, Kruk ME, Rockers PC, Mbaruku G, Galea S. Household decision-making about delivery in health facilities: evidence from Tanzania. J Health Popul Nutr. 2009 10; 27(5): 696– 703. 19902806 PMC2928090
  36. [47]Kruk ME, Rockers PC, Mbaruku G, Paczkowski MM, Galea S. Community and health system factors associated with facility delivery in rural Tanzania: a multilevel analysis. Health Policy. 2010 10; 97(2–3): 209– 16. 10.1016/j.healthpol.2010.05.002 20537423 · DOI
  37. [48]White D, Dynes M, Rubardt M, Sissoko K, Stephenson R. The influence of intrafamilial power on maternal health care in Mali: perspectives of women, men and mothers-in-law. Int Perspect Sex Reprod Health. 2013 6; 39(2): 58– 68. 10.1363/3905813 23895882 · DOI
  38. [49]Speizer IS, Story WT, Singh K. Factors associated with institutional delivery in Ghana: the role of decision-making autonomy and community norms. BMC Pregnancy Childbirth. 2014 11; 14: 398 10.1186/s12884-014-0398-7 25427853 PMC4247879 · DOI
  39. [50]Mills S, Bertrand JT. Use of health professionals for obstetric care in northern Ghana. Studies in family planning. 2005; 36(1): 45– 56. 15828524
  40. [51]Jansen I. Decision making in childbirth: the influence of traditional structures in a Ghanaian village. International nursing review. 2006; 53(1): 41– 6. 10.1111/j.1466-7657.2006.00448.x 16430759 · DOI
  41. [52]Gupta ML, Aborigo RA, Adongo PB, Rominski S, Hodgson A, Engmann CM, et al Grandmothers as gatekeepers? The role of grandmothers in influencing health-seeking for mothers and newborns in rural northern Ghana. Glob Public Health. 2015 10; 10(9): 1078– 91. 10.1080/17441692.2014.1002413 25635475 · DOI
  42. [53]Alexander A, Mustafa A, Emil SAV, Amekah E, Engmann C, Adanu R, et al Social Support During Delivery in Rural Central Ghana: a Mixed Methods Study of Women'S Preferences for and Against Inclusion of a Lay Companion in the Delivery Room. Journal of Biosocial Science. 2014; 46(05): 669– 85. 23965280

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Authors
Cofie, L. E., Barrington, C., Sodzi-Tettey, S., Ennett, S., Maman, S., & Singh, K.
Affiliations
  • East Carolina University (US)
  • University of North Carolina at Chapel Hill (US)
Corresponding author
Cofie, Leslie E.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2018-11-06
Volume
13
Issue
11
Pages
e0206429
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0206429
PMC
PMC6219853
OpenAlex
W2900159942
Cited by
21
References
2
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 1
FWCI
1.93
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • The Scholarship East Carolina University's Institutional Repository (East Carolina University) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Bill and Melinda Gates Foundation (OPP48930)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
social support networks, institutional delivery, home birth, maternal health, place of childbirth, information support, instrumental support, maternal mortality, obstetric care, husbands, mother-in-law, rural Ghana
MeSH terms
Adolescent, Adult, Female, Ghana, Health Facilities, Home Childbirth, Humans, Male, Maternal Health Services, Pregnancy, Surveys and Questionnaires, Rural Population, Social Support, Delivery, Obstetric, Young Adult

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