Measuring coordination between women's self-help groups and local health systems in rural India: a social network analysis
| Autor: | Jenny Ruducha, Divya Hariharan, Katelyn N. G. Long, Danish Ahmad, Laili Irani, Sampath Kumar, P.S. Mohanan, James Potter |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Economic growth Capacity Building social network analysis health services coordination network lcsh:Medicine India Global Health Community Networks 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires multisectoral coordination Medicine Humans 030212 general & internal medicine Social determinants of health Cooperative Behavior Social network analysis Referral and Consultation Government Social network business.industry Research lcsh:R General Medicine self-help groups bridging social capital Leadership Community mobilization Local government Community health Female Rural Health Services Emergencies business 030217 neurology & neurosurgery demand-side intervention Social capital Program Evaluation |
| Zdroj: | BMJ Open BMJ Open, Vol 9, Iss 8 (2019) |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesTo assess how the health coordination and emergency referral networks between women’s self-help groups (SHGs) and local health systems have changed over the course of a 2-year learning phase of the Uttar Pradesh Community Mobilization Project, India.DesignA pretest, post-test programme evaluation using social network survey to analyse changes in network structure and connectivity between key individuals and groups.SettingThe study was conducted in 18 villages located in three districts in Uttar Pradesh, India.InterventionTo improve linkages and coordination between SHGs and government health providers by building capacity in leadership, management and community mobilisation skills of the SHG federation.ParticipantsA purposeful sampling that met inclusion criteria. 316 respondents at baseline and 280 respondents at endline, including SHG members, village-level and block-level government health workers, and other key members of the community (traditional birth attendants, drug sellers, unqualified rural medical providers, pradhans or elected village heads, and religious leaders).Main outcome measuresSocial network analysis measured degree centrality, density and centralisation to assess changes in health services coordination networks at the village and block levels.ResultsThe health services coordination and emergency referral networks increased in density and the number of connections between respondents as measured by average degree centrality have increased, along with more diversity of interaction between groups. The network expanded relationships at the village and block levels, reflecting the rise of bridging social capital. The accredited social health activist, a village health worker, occupied the central position in the network, and her role expanded to sharing information and coordinating services with the SHG members.ConclusionsThe creation of new partnerships between traditionally under-represented communities and local government can serve as vehicle for building social capital that can lead to a more accountable and accessible community health delivery system. |
| Databáze: | OpenAIRE |
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