Who do the women trust for maternity care: A knowledge network–based study in rural India

Abstract

Background: Knowledge about the causes of critical ailments and risks during a maternity episode is crucial for women’s health. Although maternity-care knowledge is present both in explicit and tacit forms, there is a lack of requisite knowledge among women. Rural women rely on their community for such knowledge. Objective: This article sought to analyse knowledge-sharing practices of rural women in India in relation to critical decisions during a maternity episode. Method: Primary data were gathered through interview of 306 married women, who had had at least one childbirth during the previous 5 years, and were collected using structured interviews conducted in 10 villages of two districts in West Bengal, India. Their knowledge level of risks and networks of communication was examined for four critical decisions: (i) general health, (ii) choice of delivery method, (iii) antenatal check-up visits and (iv) nutrition. Results: This empirical study using degree-centrality method demonstrated that the pattern of knowledge flow is not uniform for different types of decisions. Many women were not aware of critical danger signs during pregnancy episodes. Only 28% of participants could mention at least three danger signs during pregnancy episodes. For the purposes of this study, these women were considered “knowledgeable.” Discussion: Maternal health in the community could be improved by redesigning the knowledge network for sharing the maternity-care knowledge of risks and danger signs. This research highlights the influence of culture on maternity-related knowledge-sharing in rural India and uncovers structural holes in the knowledge network. Implications: Results of this research could be used to design policies and programs to create community-based knowledge networks for maternity care.