Mothers' management of childhood diseases in Yorubaland: the influence of cultural beliefs

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Social Interaction and Contraceptive Change in Northern Ghana

The role of diffusion in reproductive change has received great attention in the literature. Underlying the various studies is the assumption that the information or behaviour of one person can have spillover effects on the motivations of another (Montgomery and Casterline, 1998). Two fundamental components of diffusion are identified: social learning and social influence. Social learning refers to the acquisition of information from others, which in the case of fertility control may include information on the types of contraceptive methods available, the health side effects of the methods and the cost of the methods. Social influence, on the other hand, refers to the power that individuals exercise over each other through authority, deference, and social conformity pressures. Using data obtained from the 1995 and 1998 demographic and health panel surveys we examine the impact of social interaction on the adoption of contraception in the Kassena-Nankana district of Northern Ghana. Three major distinct groups of respondents were defined by the social interaction variable: women whose family planning discussion partners are contraceptive users or encouragers (or both); women whose family planning conversational partners are neither users nor encouragers; women who reported never having discussed family planning with their social network partners. While the social interaction variable pertains to the time of the 1995 survey, contraceptive use is at the time of the 1998 survey. Results from this study suggest that social interaction about family planning triggers changes in contraceptive behaviour in the rural areas of Northern Ghana. For the majority of women, the decision to initiate family planning practice is facilitated by informal discussions with social network partners who encourage contraceptive adoption.Beaucoup a \ue9t\ue9 dit et \ue9crit sur le r\uf4le de la diffusion dans l'\ue9volution de la reproduction avec comme hypoth\ue8se sous-jacente que l'information \ue0 propos de ou le comportement d'une personne peut avoir des effets d'entra\ueenement sur les motivations d'une autre personne (Montgomery and Casterline, 1998). La diffusion comporte deux composantes principales : l'apprentissage social et l'impact social. L'apprentissage social porte sur l'acquisition de l'information \ue0 partir d'autres personnes, ce qui, en mati\ue8re de contr\uf4le de la f\ue9condit\ue9, concerne l'information sur les types de contraceptions disponibles, les effets secondaires sur la sant\ue9 des m\ue9thodes ainsi que le co\ufbt des m\ue9thodes. Pour ce qui concerne l'impact social, il s'agit du pouvoir que les personnes peuvent exercer les unes sur les autres par l'autorit\ue9, le respect, les pesanteurs de la conformit\ue9 sociale. En utilisant les donn\ue9es des Enqu\ueates d\ue9mographiques et de sant\ue9 de 1995 et 1998, nous examinons l'impact possible de l'interaction sociale sur l'adoption de la contraception dans la r\ue9gion Kassena-Nankana du Nord du Ghana. Pour les besoins de la variable interaction sociale, trois grands groupes de personnes ont \ue9t\ue9 interrog\ue9es : les femmes dont les partenaires dans les focus group utilisent et/ou encouragent l'utilisation de la contraception ; celles dont les partenaires dans les focus group ne sont ni utilisateurs ni n'encouragent l'utilisation de la contraception ; celles ayant admis n'avoir jamais discut\ue9 de la contraception avec les r\ue9seaux sociaux de leurs partenaires. Si la variable interaction sociale porte sur l'enqu\ueate de 1995, celle sur l'utilisation de la contraception porte sur l'enqu\ueate de 1998. Les r\ue9sultats obtenus montrent que l'interaction sociale en ce qui concerne le planning familial entra\ueene des changements dans le comportement en mati\ue8re de contraception dans les zones rurales du Nord du Ghana. Pour la majeure partie des femmes, la d\ue9cision de commencer le planning familial est largement facilit\ue9e par des discussions informelles avec les membres des r\ue9seaux sociaux qui encouragent l'adoption de la contraception

Socioeconomic inequality in exclusive breastfeeding behavior and ideation factors for social behavioral change in three north-western Nigerian states: A cross-sectional study

Background: Socioeconomic inequalities could mitigate the impact of social and behavior change (SBC) interventions aimed at improving positive ideation towards the practice of exclusive breastfeeding. This study explores the empirical evidence of inequalities in the practice of exclusive breastfeeding (EBF) and associated ideational dimensions and domains of the theory of Strategic Communication and Behavior Change in three north-western Nigeria states. Methods: We used cross-sectional data from 3007 randomly selected women with under-two-year-old children; the convenient regression method was applied to estimate the concentration indexes (CIxs) of exclusive breastfeeding behavior, ranked by household wealth index. Inequality was decomposed to associated ideational factors and sociodemographic determinants. Avoidable inequalities and the proportion of linear redistribution to achieve zero inequality were estimated. Results: Women from wealthier households were more likely to practice exclusive breastfeeding CIx = 0.1236, p-value = 0.00). Attendance of at least four antenatal clinic visits (ANC 4+) was the most significant contributor to the inequality, contributing CIx = 0.0307 (p-value = 0.00) to the estimated inequality in exclusive breastfeeding practice. The elasticity of exclusive breastfeeding behavior with respect to partners influencing decision to breastfeed and ANC4+, were 0.1484 (p-value = 0.00) and 0.0825 (p-value = 0.00) respectively. Inequality in the regular attendance at community meetings (CIx = 0.1887, p-value =0.00); ANC 4+) (CIx = 0.3722, p-value = 0.00); and maternal age (CIx = 0.0161, p-value = 0.00) were pro-rich. A 10.7% redistribution of exclusive breastfeeding behavior from the wealthier half to the poorer half of the population could eliminate the inequality (line of zero inequality). Inequalities were mainly in the cognitive and social norms dimension and were all pro-poor. Conclusion: Socioeconomic inequalities exist in exclusive breastfeeding behaviors and in associated ideation factors in the three states but are mostly avoidable. A 10.7% redistribution from wealthier to the poorer half of the population will achieve elimination. Messaging for SBC communication interventions to improve breastfeeding practices could be more effective by targeting the mitigation of these inequalities