Interpersonal communication regarding pregnancy-related services: friends versus health professionals as conduits for information

BACKGROUND: Social network characteristics influence a wide range of health behaviors but few studies examine the relationship between social network characteristics and pregnancy-related outcomes. METHODS: Using a baseline survey from a behavior change pilot project in the Upper West region of Ghana, we examine four outcomes: (1) early antenatal care, (2) having at least four antenatal care visits, (3) skilled birth attendance, and (4) postpartum care. We collected demographic and network data from 1606 women of reproductive age who had a child in the five years preceding the survey. We estimated associations by regressing the four pregnancy-related outcomes on the demographic and network characteristics. RESULTS: The results suggest that there is little interpersonal communication about pregnancy-related issues, as 60.2% of respondents reported talking to no one. For those women who did talk to someone, communication with a health professional had the strongest association with accessing services (e.g., Adjusted Odds Ratio [AOR] = 8.02, p < 0.01, for having a facility birth). Communicating with friends was also significantly associated with outcomes (AOR = 4.23, p < 0.0, for having a facility birth). CONCLUSIONS: This study provides evidence that there was little social communication about pregnancy-related issues in these communities at that time, indicating that an intervention to promote such communication could be successful. In addition, women who reported discussing pregnancy-related issues with friends or a health professional were more likely to access a birth facility and have a skilled birth attendant than those who reported discussing the same topics with their partner.