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. 2021 May 26;18(1):108.
doi: 10.1186/s12978-021-01164-1.

Reproductive health decision making among nomadic pastoralists in North Eastern Kenya: a qualitative social network analysis

Leah Kenny  1   2 , Rahma Hassan  3 , Loraine J Bacchus  4 , Matthew Smith  5 , Bettina Shell-Duncan  6 , Nana Apenem Dagadu  7 , Angela Muriuki  8 , Abdullahi Hussein Aden  8 , Ibrahim Abdirizak Jelle  8 , Beniamino Cislaghi #  4 , Mazeda Hossain #  4   9
Affiliations

Reproductive health decision making among nomadic pastoralists in North Eastern Kenya: a qualitative social network analysis

Leah Kenny et al. Reprod Health. .

Abstract

Background: To our knowledge, no studies exist on the influence of nomadic pastoralist women's networks on their reproductive and sexual health (RSH), including uptake of modern family planning (FP).

Methods: Using name generator questions, we carried out qualitative egocentric social network analysis (SNA) to explore the networks of four women. Networks were analyzed in R, visuals created in Visone and a framework approach used for the qualitative data.

Results: Women named 10-12 individuals. Husbands were key in RSH decisions and never supported modern FP use. Women were unsure who supported their use of modern FP and we found evidence for a norm against it within their networks.

Conclusions: Egocentric SNA proves valuable to exploring RSH reference groups, particularly where there exists little prior research. Pastoralist women's networks likely change as a result of migration and conflict; however, husbands make RSH decisions and mothers and female neighbors provide key support in broader RSH issues. Interventions to increase awareness of modern FP should engage with women's wider networks.

Keywords: Family planning; Nomadic pastoralist; Reproductive health; Social network; Social norms.

Plain language summary

Few studies have asked nomadic women in Kenya to name the important individuals in their lives when it comes to making reproductive and sexual health decisions, including their use of family planning. These important individuals are described as a woman’s “network”. We used a survey and open-ended interview format to identify the individuals in four nomadic women’s networks (“social network analysis”). Data was analysed in R and we created a visual map of these networks. Women named 10–12 individuals. Women’s husbands made reproductive health decisions and did not approve of modern family planning use. Apart from their husbands, women did not know who in their network approved of their use of family planning. Female neighbors and mothers provided important support to women. Interventions to increase awareness of modern FP should engage with everyone in a woman’s network.

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Conflict of interest statement

Authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Women’s social network maps. Egocentric maps for each woman (ego) presented individually, with ego at the centre of their social network. The maps include the relationships between ego and those in her network. Individuals named as decision makers and the five influencers in issues relating to RSH have been highlighted. Maps also include the size and gender make-up of the wider network. A EGO1 nomadic; B EGO2 nomadic; C EGO3 semi nomadic; D EGO4 semi nomadic
Fig. 2
Fig. 2
Comparing perceived and tangible support for modern FP amongst five influencers. Who women (ego) believed would support their use of modern FP (left hand side) compared with their response to whether they supported ego’s use of modern FP. A line between ego and an influencer indicates either perceived or tangible support for modern FP. No line indicates no support (unless data is missing)
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