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Measuring coordination between women’s self-help groups and local health systems in rural India: a social network analysis

OBJECTIVES: To 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. DESIGN: A pretest, post-test programm...

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Autores principales: Ruducha, Jenny, Hariharan, Divya, Potter, James, Ahmad, Danish, Kumar, Sampath, Mohanan, P S, Irani, Laili, Long, Katelyn N G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6701569/
https://www.ncbi.nlm.nih.gov/pubmed/31399457
http://dx.doi.org/10.1136/bmjopen-2019-028943
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author Ruducha, Jenny
Hariharan, Divya
Potter, James
Ahmad, Danish
Kumar, Sampath
Mohanan, P S
Irani, Laili
Long, Katelyn N G
author_facet Ruducha, Jenny
Hariharan, Divya
Potter, James
Ahmad, Danish
Kumar, Sampath
Mohanan, P S
Irani, Laili
Long, Katelyn N G
author_sort Ruducha, Jenny
collection PubMed
description OBJECTIVES: To 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. DESIGN: A pretest, post-test programme evaluation using social network survey to analyse changes in network structure and connectivity between key individuals and groups. SETTING: The study was conducted in 18 villages located in three districts in Uttar Pradesh, India. INTERVENTION: To improve linkages and coordination between SHGs and government health providers by building capacity in leadership, management and community mobilisation skills of the SHG federation. PARTICIPANTS: A 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 MEASURES: Social network analysis measured degree centrality, density and centralisation to assess changes in health services coordination networks at the village and block levels. RESULTS: The 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. CONCLUSIONS: The 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.
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spelling pubmed-67015692019-09-02 Measuring coordination between women’s self-help groups and local health systems in rural India: a social network analysis Ruducha, Jenny Hariharan, Divya Potter, James Ahmad, Danish Kumar, Sampath Mohanan, P S Irani, Laili Long, Katelyn N G BMJ Open Global Health OBJECTIVES: To 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. DESIGN: A pretest, post-test programme evaluation using social network survey to analyse changes in network structure and connectivity between key individuals and groups. SETTING: The study was conducted in 18 villages located in three districts in Uttar Pradesh, India. INTERVENTION: To improve linkages and coordination between SHGs and government health providers by building capacity in leadership, management and community mobilisation skills of the SHG federation. PARTICIPANTS: A 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 MEASURES: Social network analysis measured degree centrality, density and centralisation to assess changes in health services coordination networks at the village and block levels. RESULTS: The 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. CONCLUSIONS: The 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. BMJ Publishing Group 2019-08-08 /pmc/articles/PMC6701569/ /pubmed/31399457 http://dx.doi.org/10.1136/bmjopen-2019-028943 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Global Health
Ruducha, Jenny
Hariharan, Divya
Potter, James
Ahmad, Danish
Kumar, Sampath
Mohanan, P S
Irani, Laili
Long, Katelyn N G
Measuring coordination between women’s self-help groups and local health systems in rural India: a social network analysis
title Measuring coordination between women’s self-help groups and local health systems in rural India: a social network analysis
title_full Measuring coordination between women’s self-help groups and local health systems in rural India: a social network analysis
title_fullStr Measuring coordination between women’s self-help groups and local health systems in rural India: a social network analysis
title_full_unstemmed Measuring coordination between women’s self-help groups and local health systems in rural India: a social network analysis
title_short Measuring coordination between women’s self-help groups and local health systems in rural India: a social network analysis
title_sort measuring coordination between women’s self-help groups and local health systems in rural india: a social network analysis
topic Global Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6701569/
https://www.ncbi.nlm.nih.gov/pubmed/31399457
http://dx.doi.org/10.1136/bmjopen-2019-028943
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