Alison B Comfort1, Cynthia C Harper2, Alexander C Tsai3, James Moody4, Jessica M Perkins5, Justin Ranjalahy Rasolofomana6, Cora Alperin7, Anja Noeliarivelo Ranjalahy8, Ravo Heriniaina9, Paul J Krezanoski10. 1. University of California San Francisco, San Francisco, CA, United States; Opportunity Solutions International, San Francisco, CA, United States. Electronic address: alison.comfort@ucsf.edu. 2. University of California San Francisco, San Francisco, CA, United States. 3. Center for Global Health and Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States. 4. Duke University, Durham NC, United States. 5. Peabody College of Education and Human Development, Vanderbilt University, Nashville, TN, United States. 6. Institut National de Santé Publique et Communautaire, Ex-Ecole de Médecine de Befelatanana, Antananarivo, Madagascar. 7. University of Chicago, Chicago, IL, United States. 8. TANDEM SARL, Antananarivo, Madagascar. 9. Opportunity Solutions International, Ambalavao, Madagascar. 10. University of California San Francisco, San Francisco, CA, United States; Opportunity Solutions International, San Francisco, CA, United States.
Abstract
OBJECTIVES: Women 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 DESIGN: This 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. RESULTS: Having 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. CONCLUSIONS: Contraceptive 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. IMPLICATIONS: It 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.
OBJECTIVES: Women 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 DESIGN: This 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. RESULTS: Having 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. CONCLUSIONS: Contraceptive 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. IMPLICATIONS: It 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.
Authors: Alison B Comfort; Cynthia C Harper; Alexander C Tsai; Jessica M Perkins; James Moody; Justin Ranjalahy Rasolofomana; Cora Alperin; Margaret Schultz; Anja Noeliarivelo Ranjalahy; Ravo Heriniaina; Paul J Krezanoski Journal: BMC Public Health Date: 2021-01-25 Impact factor: 3.295
Authors: Jessica M Perkins; Viola N Nyakato; Bernard Kakuhikire; Pamela K Mbabazi; H Wesley Perkins; Alexander C Tsai; S V Subramanian; Nicholas A Christakis; David R Bangsberg Journal: AIDS Behav Date: 2018-02
Authors: Alison B Comfort; Alison M El Ayadi; Carol S Camlin; Alexander C Tsai; Hadija Nalubwama; Josaphat Byamugisha; Dilys M Walker; James Moody; Tatyana Roberts; Umar Senoga; Paul J Krezanoski; Cynthia C Harper Journal: BMC Pregnancy Childbirth Date: 2022-09-16 Impact factor: 3.105