Abstract
Background: The Community Benefits Health (CBH) program introduced a community-based behavior change intervention to address social norms and cultural practices influencing maternal health and breastfeeding behaviors in rural Ghana. The purpose of this study was to determine if CBH influenced maternal health outcomes by stimulating community-level support in woman’s social networks.Methods: A mixed-methods study was conducted to evaluate changes in six antenatal/postpartum care, birth attendance, and breastfeeding behaviors in response to the CBH intervention and to assess how the program was implemented and to what extent conditions during implementation influenced the results.Results: We found increases in five of the six outcomes in both the intervention and control areas. Qualitative findings indicated that this may have resulted from program spillover. We considered the dose of exposure to program activities and found that women were significantly more likely to practice maternal health behaviors with increased exposure to program activities while controlling for study area and time.Conclusions: Overall, we determined that exposure to the CBH program significantly improved uptake of three of the six study outcomes, indicating that efforts aimed at increasing communication across women and their social networks may lead to improved health outcomes.
Highlights
IntroductionPrevious research in Ghana has found that women who live in communities where more women perceive higher use of facility delivery are more likely to deliver in a facility (Speizer, Story, & Singh, 2014)
The Community Benefits Health (CBH) program introduced a community-based behavior change intervention to address social norms and cultural practices influencing maternal health and breastfeeding behaviors in rural Ghana
Overall, we determined that exposure to the CBH program significantly improved uptake of three of the six study outcomes, indicating that efforts aimed at increasing communication across women and their social networks may lead to improved health outcomes
Summary
Previous research in Ghana has found that women who live in communities where more women perceive higher use of facility delivery are more likely to deliver in a facility (Speizer, Story, & Singh, 2014) While these studies show an association between community attitudes and a woman’s health-seeking decisions, they do not explain how the woman engages with the community, including the nature of her relationships, the types of advice or support received, and the characteristics of her social network that may increase her receptivity to these attitudes. Few, if any, studies have investigated interventions aimed to improve maternal health behaviors by influencing social networks and generating community-level social support
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