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Health Econ Policy Law. 2019 Apr;14(2):231-248. doi: 10.1017/S1744133118000130. Epub 2018 May 22.

Family networks and healthy behaviour: evidence from Nepal.

Author information

1
1Centre for Global Health Economics,University College London,London,UK.
2
2Department of Economics,University Ca' Foscari of Venice,Venezia,Italy.
3
3Department of Economics,University College London,London,UK.
4
4Institute of Education,University College London,London,UK.
5
5Centre for Global Health Economics,University College London,London,UK.
6
6Maternal and Infant Research Activity (MIRA),Kathmandu, Nepal.
7
7University College London, Institute for Global Health,London, UK.

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.

PMID:
29785890
DOI:
10.1017/S1744133118000130

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