Panelists will present interventions which exemplify different network-based methodologies, the first two not intentionally designed with a SN approach in mind, the last one using a SNA from formative research through design.
Network analysisacknowledgesthatindividualsinteractwith, learnfrom, and get information fromothers. This type of analysisis more interested in theserelationships and theircharacteristicsthanindividual’sdemographic and socioeconomiccharacteristics.
A SN focus helps us to viewing women not only as individuals but as members of informal social networks engage women, their husbands, friends, family members in a holistic way rather than simply as clients of FP?RH services. Social networks may encourage high fertility because:When women marry, their reproductive rights are transferred to her husband’s household.Support from material and practical networks spreads out the “costs” of raising children Children represent future network support
People often say that a FP method is ‘scaled up’ once it is found in the MOH’s FP norms and procedures and when providers have been trained in offering the method. But full scale integration of a new method (or any other kind of new service) touches on many systems elements in order to be sustained. As the slide shows, systems and services are interlinked. Political support and technical leadership provide the forward momentum.
Demographers posit that fertility declines are the result, in whole or in part, of the diffusion of new knowledge and ideas from one locale, social group, or individual to another.7Women and men may receive accurate RH information from established health institutions; but they also make their decisions based on stories that circulate in their informal social networks, and they supplement provider instructions with informal conversations. Observing, discussing, criticizing, and evaluating, people pass information from one to another and from public sources to groups.Communication along interpersonal channels and through multiple media channels provide information about the existence of new behaviors, narrows uncertainties regarding the consequences of new choices and reduces the costs of innovation by modifying social norms.
Individuals who are highly interconnected and centrally located within social networks are likely to hear about innovations earlier and have more opportunity to evaluate their benefits.9Studies of the diffusion of FP information have found that having a direct or indirect link to the source of information was associated with either increased knowledge or use of contraceptives. In addition, the composition of an individual’s personal network and their position within the network has been associated with FP knowledge, attitudes, and use.
Maybe delete this slide and the next? If keeping, add citations.
The idea of working through leaders of formal religious, cultural, kin-based, or community institutions. These leaders opinion leaders exert social influence over individuals in their broader networks, and are able sway the attitudes and behavior of their followers.What doesn’t work:Expecting that religious leaders have a thorough and consistent knowledge of the Qur’an.Relying on a unified religious hierarchy.Working with traditional leaders that occupy positions of cultural significance, but no longer hold power or control few resources.
Photo from buildafrica.org
Leaders are oftendefined as individualwhoreceived the most nominations (or has most connections) within the network or group
Photo of women: www.trickleup.org
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Community capacity to catalyze changes in attitudes and practices, using participatory action methods to identify significant positive change and identify the capacities which allowed them to bring about those changes (resource mobilization, sense of ownership, collective efficacy, social cohesion, participation and critical thinking and skills. – Catalyzing capacity and network properties of groups will be measure baseline and endlne
What are the benefits of using a social network approach to address FP? Nextwe will share with you presentations on three programs which applied SN approaches in different ways. The first two initiatives implemented by CARE in Ethiopia and CEDPA in Nigeria represent SN approaches, although they were not designed with SN approaches in mind.The last presentation will discuss an initiative which intentionally used SN methods and theory to conduct formative research and design an intervention to address unmet need in Mali. Think about the questions on this slide during these presentations and we will ask for your thoughts on them during the Q&A period.
For example: What is the social role "husband?" Someone can only be a husband if he is married to a woman. If he is not married, then he does not fit under the category of husband. Each one of these categories (i.e. husband, wife, child) can only be defined by regularities in the patterns of relationships with members of other categories Structural equivalence Two nodes are said to be exactly structurally equivalent if they have the same relationships to all other nodes. Example: Children of a specific couple (each child is structurally equivalent because they have the exact same two parents)Next level: Series of hamburger restaurants. There are managers and there are workers. Program examples:- Polygamous husbands (who are connected to more than one wife) are always named as a source of material support (but not monogamous husbands).Females who have only one connection are always named as source of practical supportOther points you might want to make:Pure structural equivalence can be quite rare in social relations, but approximations to it may not be so rare. In studying a single population, two actors who are approximately structurally equivalent are facing pretty much the same sets of constraints and opportunities. Commonly we would say that two actors who are approximately structural equivalent are in approximately the same position in a structure.Regular equivalence deserves special attention because it gets at the idea of the "role" that an actor plays with respect to occupants of other "roles" in a structure. The idea of a social role, which is "institutionalized" by normative and sanctioned relationships to other roles
Open floor for discussion
Harnessing the Potential of Social Networks: The ABCs of using social network approaches to design & evaluate familly planning programs
Harnessing the Potential of Social NetworksThe ABCs of usingsocial networkapproaches todesign andevaluate familyplanning programs
Panel Overview 1. What is social network analysis (SNA)? 2. SNA and intervention design 3. SNA and monitoring & evaluation 4. SNA-based planning interventions
Social network analysis: What is it?A theoretical perspective applied to research andprograms• Recognizes that individuals interact with, learn from, and get information from other people• Focuses on relationships, not individuals “Who delivers the message, and in what interpersonal context, may be just as, if no more important, than the message itself, and may result in better, more relevant, and perhaps more effective programs.” - Valente & Fosados, 2006
Why a social network focus?• Women and men make decisions not as individuals but as actors in a social system.• Social structures are resources to diffuse and support SOCIETY innovations COMMUNITY RELATIONSHIPS INDIVIDUAL
How do networks support FP diffusion?Single FP User Social Support More FP Users Social Learning Social Influence
Social networks influence diffusion through….Social learning Social influenceNetwork members Network membersexchange ideas and follow norms of gatekeepers to gaininformation; and approval and avoidevaluate the relative conflict.benefits of innovation 6
Networks and FP UpdateFP uptake higher when an individual is:- Highly interconnected- Centrally located in their network- In a network with others who support and use FP
What network research tells us Women who were ambivalent about FP supplement information with experiences of women whose bodies and circumstances they perceive to be similar to their own. Women weigh reproductive decisions, not as individuals, but as actors in a traditional social system in which the needs of the extended family outweigh the significance of individual preferences. 8
Malawi: Differences between men and women in social learning about FPMen… Women…“Know” what network “Know” what networkmembers do from members do fromobservation conversationDiscuss pros and cons of FP Discuss details of FP methods, sources, sideHear about FP from radio or effectshealth-drama groups Hear about FP at hospital
10 Key results: SN-based program review • Combine elements of SN theory (i.e. social learning and social influence) to give legitimacy to new ideas (social influence) while allowing individuals to adopt a behavior change through social learning. • When working with informal groups, such as grins or tontines, involve group members in identifying the “natural” leader of the group. • Use radio to complement SN focused interventions and create a supportive environment that encourages dialogue between friends, family members and peers. • Involve stakeholders in developing messages and encourage sharing these ideas with their discussion networks to relay the message to a larger network.
Using social networks for learning andinfluence 1. Opinion Leaders / Leaders Influents 2. Strategically Targeted Groups / Groupes Stratégiquement Ciblé 3. Leaders of Established Groups / Leaders des groupes établis 4. Snowball Approach / Chacun invite trois 5. Bridges and Connectors / Liaison & connecteurs 6. Rewiring linkages, ties / Reconfiguration de liens
1. Engaging Opinion LeadersWhat it is:• Working with individuals who have formal power (religious leaders, clan leaders, elected officials)• Work with supporters or transform negative opinions into positive onesConsiderations:• Legitimizes innovation• Role models• Addressing norms leads to sustainable change
2. Strategically Targeted GroupsWhat it is:• Designing an intervention to be implemented by or within the group• Example: Field workers lead FP discussions during water and sanitation committee meetingsConsiderations:• Information travels easily throughout group• Builds on existing connections• Reinforce/support new behaviors• Changing group norms reduces individual risk
3. Leaders of Established GroupsWhat it is:• Work with leader of group, who in turn, coordinates/leads the group intervention• Example: Leaders of women’s savings and loans associations trained in FP and asked to discuss during group meetingsConsiderations:• Depends on leader’s persuasiveness• Leader may not wish to be “positive deviant”
4. Snowball ApproachWhat it is:• One individual informs/influences/invites two friends. Those two individuals reach their friends and so on.• Example: Chacun invite trois , peer educatorsConsiderations:• Effective in reaching “hard-to-reach” groups• Participants “own” intervention• Model positive “deviant” behavior
5. Activating & Supporting Bridgesand ConnectorsWhat it is:• Intervene through individuals who interact with two or more unconnected groups• Create or break bridge ties to strengthen or weaken information diffusion• Example: CBD workers bridges clinics and clients, mothers-in-law bridge FP information to daughter-in-lawConsiderations:• Can diffuse information between groups• Bridge persons can be bottlenecks
6. Rewiring Linkages or TiesWhat it is:• Purposely connecting individuals who would otherwise not interact with each other• Example: creating elder learning groups to connect women elders; connecting MOH staff in different technical areas by rearranging office spaceConsiderations:• Strengthens communication flow• Difficult to purposively change current network
How do SN interventions differ from conventional outreach approaches?• Focused on changing flow of information and social influence, rather than on individual behavior• Address social norms rather than practices• Work through informal as well as formal leaders to diffuse change through networks• Use influencers/connectors to inform, facilitate comparison, filter conflicting information and model attitudes/behaviors
Project TJ Example:Process for designing SN interventions How will the community be different as a result of this program?1. Formative research identifies structure of What will you see and hear social networks and FP as you walk through the community in five years? attitudes of network members2. Visioning exercise3. Define intervention goals and objectives
Design Process (cont.)4. Develop criteria for selecting SN intervention • Example: scalable, build on existing networks, gender perspective, potential for sustained change5. Brainstorm interventions (using resources such asresearch results, selection criteria, taxonomy of SNapproaches) • Identify problem to address (e.g. male opposition) • Brainstorm SN intervention approaches • Prioritize/select intervention(s)6. Obtain input from broader group of stakeholders
Tool: Social Network Design Grid Problem: FP use among newly married couples considered unacceptable Who will Who will be What activities? SN influence? influenced? approach(es)Mothers-in- • Daughters-in- Teas with mothers-in-laws Snowballlaw law • Sons Activity-based discussions facilitated by animators MILs talk with othersGrin • Grin Animators catalyze reflective Informal leadersmembers via members dialogs with grin leaders of groupssocial leader • Their wives • Other male Request to talk with others Snowball friendsMOH • Male social CHWs visit grins and give Reconfiguringsupervisors groups clinic tour networksand CHWs
Monitoring and evaluation of social network-based approaches
28 Theoretical considerations for measuring innovation diffusion • Need to monitor implementation and change at multiple levels • Theory of change draws from: • Individual behavior change models (Health Belief Model, Trans- theoretical) • Ecological models
29 Social network approaches to monitoring and evaluation Monitoring Methods Include process • Ego-centric mapping indicators related to conducted with a networks representative sample generalizable to entire population • Measure changes in network structure and member attitudes
Socio-centric network mappingMOST APPROPRIATE FORFORMATIVE RESEARCH1. Explains how information and influence diffuse through entire network2. Guides development of interventions to harness social learning and influence
Ego-centered network mappingMOST APPROPRIATEFOR EVALUATION1. Measures the effect of interventions on individual knowledge, attitudes and practices2. Identifies changes in the way information and influence diffuse3. representative sample generalizable to entire population
Illustrative Outcome Indicators Community Network Individual Social factors catalyzingproperties changes capacity Flow of Perception that Ownership/ fertility/FP info husband and participation Use of FP through network network partners among members services partners support FP to interventions Couple % of members Mean/% of Men/women with communication with favorable network unmet need (index score) attitudes Size and Cohesive social Proportion of Woman/couple composition of network segments p/year efficacy for FP women’s supporting FP with met need use network use for effective FP % who report Methodnetwork partners continuation use FP
Potential benefits of social networkapproachesDoes the application of network approaches…• Transform family planning programs?• Focus attention on the social factors influencing unmet need and FP?• Increase the efficiency and effectiveness of community mobilization efforts?
Scale up Indicators • Level of seed team functioning • Degree of stakeholder involvement Process • Pace of scale up • Cost of implementation • Feasibility • Use of LQAS or sentinel sites toOutcomes measure unmet need
How do we apply TJ social network approach at scale?• Identify connectors/influencers through PLA, RRA and key informant interviews• Apply intervention in communities with similar social network structures• Identify people who are “equivalent” in the networks (similar social roles or positions in relation to others such as mothers-in-law and daughters-in- law, co-wives)• SNA considers similarities in relationship patterns
For our interpreters: Social network types in English1. Working with/through opinion leaders or key players2. Working with/through groups located within the network3. Working with/through leaders within groups4. Snowball approach: Working with/ through individuals to reach/ connect with others in their social networks5. Bridges and Connectors6. Rewiring linkages, ties
For our interpreters: Social Network types in French1. Travail avec ou via les leaders d’opinions ou les acteurs clés2. Travail avec / via des groupes situés au sein du réseau3. Travail avec / via des dirigeants dans des groupes, ou combiner les dirigeants / les apprenants au sein des groupes4. Approche « boule de neige » : Travail avec / via des personnes pour atteindre / se connecter avec d’autres dans leurs réseaux sociaux5. Liaison & connecteurs6. Reconfiguration de liens