Role of Social Network Structures on Birth Attendant Decisions among Women in Nakuru County, Kenya

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dc.contributor.advisorMary Gitahien_US
dc.contributor.advisorGeorge Evans Owinoen_US
dc.contributor.authorMungai, John Mwangi
dc.date.accessioned2024-02-08T09:54:43Z
dc.date.available2024-02-08T09:54:43Z
dc.date.issued2023-10
dc.descriptionA Research Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Public Health (Monitoring and Evaluation) in the School of Health Sciences of Kenyatta University, October 2023.en_US
dc.description.abstractThree-fourths of maternal deaths occur from direct obstetric complications. These life-threatening pregnancy-related outcomes are avoidable through ensuring that mothers have access to adequate and proper maternal health services and prompt management of any complications during pregnancy or childbirth process. Most empirical studies that seek to assess maternal healthcare choices in the country focus on individual-level and environmental-level factors as the key barriers to healthcare service utilization. These studies make significant contributions concerning unravelling relevant variables linked to high maternal deaths. However, due to methodological and conceptual limitations, these research studies do not demonstrate the range of social influence mechanisms via which individual networks may influence behaviors and knowledge with a focus on maternal health. This study aimed at demonstrating the relationship between social network structures and birth attendant decisions among women in Nakuru County, Kenya. The study applied a mixed-method approach that employs a convergent parallel design. Interviewer-administered questionnaires and semi-structured interviews were used to collect quantitative and qualitative data among women of childbearing age and community health workers (CHWs), comprising a sample of 370 women and 18 CHWs, respectively. Chi-square tests for independence were used to assess whether the dependent variable and categorical independent variables are independent at p< 0.05 significance levels. Binomial logistic regression technique was employed to identify variables that are likely to be essential predictors for the dependent variable. Qualitative data from in-depth interviews with key informants was analyzed through content analysis using NVivo 10. Fifty percent of the mothers were married, 35% had a high school education or higher, 16% were employed, 64% lived in rural areas, 96% were Christians, and 65% delivered under skilled attendance. About 55% were embedded in homogeneous networks, 76% had high Skilled Birth Attendants (SBA) endorsement networks, and the average number of social networks was 2.4 (SD=1.1, median = 2). There was no significant relationship between social network size and birth attendant decision (χ2(2), p=.072). There was, however, a significant relationship between social network content and birth attendant decision (χ2(1)=55.604, p< 0.001). Social network homogeneity was also strongly related to birth attendant choice (χ2(1)=21.152, p<0.001). From the logistic regression model, women embedded in social networks with high SBA endorsement had 5.28 higher odds of giving birth in a health facility than their counterparts embedded in low SBA endorsement. When compared to their heterogeneous network counterparts, those embedded in a homogeneous network had a 70% reduction in odds of facility delivery. According to the study findings, social networks can either facilitate or constrain facility utilization during birth, and thus health education and mother mobilization interventions promoting facility birth should leverage on the role of social networks.en_US
dc.description.sponsorshipKenyatta Universityen_US
dc.identifier.urihttps://ir-library.ku.ac.ke/handle/123456789/27604
dc.language.isoenen_US
dc.publisherKenyatta Universityen_US
dc.subjectSocial Network Structuresen_US
dc.subjectBirth Attendant Decisionsen_US
dc.subjectWomenen_US
dc.subjectNakuru Countyen_US
dc.subjectKenyaen_US
dc.titleRole of Social Network Structures on Birth Attendant Decisions among Women in Nakuru County, Kenyaen_US
dc.typeThesisen_US
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