Abstract
BackgroundRural women in West Bengal have been found to have low rates of formal education, poor health knowledge, high rates of malnutrition and anemia, and low levels of empowerment. Despite these difficult circumstances, some women have positive health outcomes compared to women with similarly disadvantaged backgrounds. The purpose of this study is to identify factors associated with positive health outcomes among women with primary education or less.MethodsMultivariable regression models were built for outcomes of positive deviance to better characterize the factors in a woman’s life that most impact her ability to deviate from the status quo.ResultsPositive deviants in this context are shown to be women who are able to earn an income, who have access to information through media sources, and who, despite little schooling, have marginally higher levels of formal education that lead to improved health outcomes.ConclusionsStudy findings indicate that positive deviant women in disadvantaged circumstances can achieve positive outcomes amidst a host of contextual barriers that would predict poor health outcomes. Focusing on areas such as enhancing access to media sources, facilitating self-help groups for married women, and promoting prolonged education and delayed marriage for girls may improve health knowledge and behavior among married women with low levels of education.
Highlights
Rural women in West Bengal have been found to have low rates of formal education, poor health knowledge, high rates of malnutrition and anemia, and low levels of empowerment
Women that reported greater health knowledge thought the ideal age to finish school was nearly 1 year older compared to women who responded incorrectly to a series of health related questions (β=0.871, p < 0.05, [95% CI: 0.23, 1.51])
Relative to our analysis on a woman’s ability to travel alone to another village for health services, the data did not address availability of health services within their own village or whether other reasons for travel to another village, like employment, were the primary motives to travel alone. Both of these questions offer interesting points of exploration in future studies. This was an exploratory analysis of factors associated with positive health outcomes among rural women in West Bengal with low levels of formal education
Summary
Rural women in West Bengal have been found to have low rates of formal education, poor health knowledge, high rates of malnutrition and anemia, and low levels of empowerment. Despite these difficult circumstances, some women have positive health outcomes compared to women with disadvantaged backgrounds. Positive deviance is founded on the idea that the most appropriate solutions to challenges are not found externally, but rather already exist within a given population [24] This relies upon a community’s existing resources and strengths to achieve sustainable and culturally appropriate improvements to health. Programs focused on identifying, understanding, and utilizing positive deviants have been shown to improve nutritional status [25,26], obesity [27], pregnancy outcomes [28], HIV/AIDS prevention behavior [29], psychosocial outcomes such as more responsive parenting, and breastfeeding [30]
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