Social network analysis predicts health behaviours and self-reported health in African villages.

Goylette F Chami,Maarten J Voors,Andreas A Kontoleon,Sebastian E Ahnert,Alain Barrat

doi:10.1371/journal.pone.0103500

Goylette F Chami, Maarten J Voors + Show 3 more

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https://doi.org/10.1371/journal.pone.0103500

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Abstract

The provision of healthcare in rural African communities is a highly complex and largely unsolved problem. Two main difficulties are the identification of individuals that are most likely affected by disease and the prediction of responses to health interventions. Social networks have been shown to capture health outcomes in a variety of contexts. Yet, it is an open question as to what extent social network analysis can identify and distinguish among households that are most likely to report poor health and those most likely to respond to positive behavioural influences. We use data from seven highly remote, post-conflict villages in Liberia and compare two prominent network measures: in-degree and betweenness. We define in-degree as the frequency in which members from one household are named by another household as a friends. Betweenness is defined as the proportion of shortest friendship paths between any two households in a network that traverses a particular household. We find that in-degree explains the number of ill family members, whereas betweenness explains engagement in preventative health. In-degree and betweenness independently explained self-reported health and behaviour, respectively. Further, we find that betweenness predicts susceptibility to, instead of influence over, good health behaviours. The results suggest that targeting households based on network measures rather than health status may be effective for promoting the uptake of health interventions in rural poor villages.

Highlights

Infectious diseases remain a leading cause of morbidity and mortality in developing countries
We demonstrate the ability of social network indicators to predict health outcomes and to explain the susceptibility of a household to partake in health interventions in one of the most impoverished and under-researched developing country contexts
We examine medical care separately from poor health behaviours, as expenditure on formal care is a distinct type of behaviour when compared to preventative health (Tables S7–S8 in File S1)

Summary

Introduction

Infectious diseases remain a leading cause of morbidity and mortality in developing countries. Mostly in rural areas, are currently afflicted with one or more communicable diseases.[1,2,3,4,5] Many of these maladies are preventable with access to safe water, sanitation, and healthcare.[6] identification of people that are ill is a strenuous task in rural poor areas where access to formal medical care is scarce and infectious diseases are chronic.[7] behavioural modification to improve preventative health, such as the persuasion of households to use protected instead of open water sources and to use pit latrines instead of engaging in open defecation, proves challenging in practice.[8] Monitoring such behaviours is difficult, in particular for open defecation, as many of these behaviours are conducted in private. Indirect indicators, such as social popularity and influence, may offer a useful alternative to identify who is ill and whom to target for behavioural health interventions [9]

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