Family networks and healthy behaviour: evidence from Nepal. Issue 2 (22nd May 2018)

• Record Type: Journal Article
• Authors: Skordis, Jolene; Pace, Noemi; Vera-Hernandez, Marcos; Rasul, Imran; Fitzsimons, Emla; Osrin, David; Manandhar, Dharma; Costello, Anthony
• Editors: Gusmano, Michael K.; Helderman, Jan-Kees
• Is Part Of: Health economics, policy and law. Volume 14:Issue 2(2019)
• Page Start: 231
• Page End: 248
• Publication Date: 2018-05-22
• Subjects: Medical economics -- Periodicals; Medical policy -- Periodicals; Medical laws and legislation -- Periodicals; 362.1
• DOI: 10.1017/S1744133118000130
• Languages: English
• ISSNs: 1744-1331

Abstract

Abstract: Models of household decision-making commonly focus on nuclear family members as primary decision-makers. If extended families shape the objectives and constraints of households, then neglecting the role of this network may lead to an incomplete understanding of health-seeking behaviour. Understanding the decision-making processes behind care-seeking may improve behaviour change interventions, better intervention targeting and support health-related development goals. This paper uses data from a cluster randomised trial of a participatory learning and action cycle (PLA) through women's groups, to assess the role of extended family networks as a determinant of gains in health knowledge and health practice. We estimate three models along a continuum of health-seeking behaviour: one that explores access to PLA groups as a conduit of knowledge, another measuring whether women's health knowledge improves after exposure to the PLA groups and a third exploring the determinants of their ability to act on knowledge gained. We find that, in this context, a larger network of family is not associated with women's likelihood of attending groups or acquiring new knowledge, but a larger network of husband's family is negatively associated with the ability to act on that knowledge during pregnancy and the postpartum period.