A typology of social network interactions in sub-Saharan Africa: Evidence from a rural population in Senegal.

Social isolation/marginalization in sub-Saharan Africa is under-researched, despite increasing evidence of weakening traditional community-based social support. This paper aims to develop a typology of social networks capable of accounting for social marginalization in a rural community in Western Senegal and to describe the socio-demographic characteristics of network profiles. Building on prior qualitative work, we carry out a latent profile analysis using a unique and extensive social network data set, identifying four different network profiles: Locally integrated, Constrained relationships, Locally marginalized, and Local elites. This paper provides the first empirically supported classification of social integration and marginalization in social networks in rural sub-Saharan Africa. In doing so, it can serve as a reference for future research seeking to understand both the broader scope of social integration and marginalization and the consequences of differential access to social capital through social networks on access to health resources and well-being.

Does social integration really protect against loneliness? Gender determinants in a rural population in Senegal / L'intégration sociale protège-t-elle vraiment contre la solitude ? Déterminants genrés dans une population rurale du Sénégal

Introduction: This study aims to test a measure of loneliness and to document its determinants among rural men and women in Senegal. Methods: Data from the Niakhar Social Networks and Health Project were used. The analysis sample was composed of 1261 residents aged 16 years and older. Analyses were stratified by gender. Associations between loneliness and its determinants (socio-demographic characteristics and level of social integration) were examined with multivariate logistic regressions. Results: Loneliness affects almost one in three people. Its prevalence is more significant for women. Multivariate analyses indicate that for both men and women, older age intensifies loneliness and recent migration experience protects against loneliness. Other factors act differently according to gender. Widowhood or divorce for men, and residential isolation for women, worsen the experience of loneliness. Social integration protects men against loneliness, but this relationship is not found for women. Finally, the effect of the level of social integration on loneliness varies with age. Conclusions: This study, which documents a phenomenon which is often neglected by misconceptions about social solidarities in these societies, suggests that loneliness is not linked to the same issues for men and women. For men, being socially integrated and being in a union are protective, whereas for women, poor social integration does not appear to be a clear source of loneliness, unlike residential isolation.

Introduction: Cette étude vise à tester une mesure de la solitude et à documenter ses déterminants chez les hommes et les femmes en milieu rural au Sénégal. Méthodes: Les données du Niakhar Social Networks and Health Project sont utilisées. L'échantillon d'analyse est composé de 1 261 résidents âgés de 16 ans et plus. Les analyses sont stratifiées par sexe. Les associations entre la solitude et ses déterminants (caractéristiques socio-démographiques et niveau d'intégration sociale) sont examinées à l'aide de régressions logistiques multivariées. Résultats: La solitude touche près d'un individu sur trois et sa prévalence est plus grande chez les femmes. Les analyses multivariées indiquent que, pour les hommes et les femmes, l'âge avancé favorise la solitude, et l'expérience migratoire récente protège contre la solitude. D'autres facteurs agissent de manière différente selon le sexe. La situation de veuvage ou de divorce pour les hommes, et l'isolement résidentiel pour les femmes, entrainent l'expérience de solitude. L'intégration sociale protège les hommes contre la solitude, mais cette relation ne se retrouve pas pour les femmes. Enfin, l'effet du niveau d'intégration sociale sur la solitude varie selon l'âge. Conclusion: Cette étude suggère que la solitude ne répond pas aux mêmes enjeux pour les hommes et pour les femmes et documente ce phénomène souvent occulté par les idées reçues relatives aux solidarités sociales dans ces sociétés. Pour les hommes, être intégrés socialement et être en union sont des éléments protecteurs, alors que pour les femmes, une faible intégration sociale n'apparait pas clairement comme une source de solitude, contrairement à l'isolement résidentiel.

The psychosocial dimension of housing in Nunavik: does social support vary with household crowding?

OBJECTIVES: Studies show that living in overcrowded households can contribute to the erosion of social support, which is an important factor in health and well-being. In this study, we examine the relationship between household crowding and social support for Inuit living in Nunavik (hereafter referred to as Nunavimmiut), a region where housing shortages are considered a serious public health problem. We assess whether overcrowding is associated with lower levels of perceived social support and whether this association varies by gender and age group. METHODS: Cross-sectional data are from Qanuilirpitaa? the 2017 Nunavik Health Survey (N = 1306; aged 16 years and older). A perceived social support index was derived from answers to questions related to three different components of social support: positive interaction, emotional support, and love and affection. Associations between overcrowding (more than one person per room) and perceived social support were assessed using weighted linear and logistic regressions, adjusted for several factors. Sex- and age-stratified analyses were also conducted. RESULTS: Nunavimmiut report significantly lower levels of social support when living in overcrowded households, independently of other covariates. Analyses stratified by sex and age further show that the detrimental association between overcrowding and perceived social support is higher and stronger for men and older adults (both men and women 55 years and older). CONCLUSION: Overcrowding is associated with lower levels of perceived social support, which is a key component of health for the general population and for Nunavimmiut. Future research should examine the factors creating stronger associations between overcrowding and lower social support for men and older adults.

RéSUMé: OBJECTIFS: Des études montrent que le fait de vivre dans un ménage surpeuplé peut contribuer à l'érosion du soutien social, qui est un facteur important de santé et de bien-être. Dans cette étude, nous examinons la relation entre le surpeuplement des ménages et le soutien social chez les Inuits du Nunavik, une région où la pénurie de logements est considérée comme un grave problème de santé publique. Nous évaluons si le surpeuplement est associé à des niveaux plus faibles de soutien social perçu chez les Inuits vivant au Nunavik (ci-après appelés Nunavimmiut), et si cette association varie selon le sexe et le groupe d'âge. MéTHODES: Les données transversales proviennent de Qanuilirpitaa? l'enquête sur la santé au Nunavik de 2017 (N = 1 306; âgés de 16 ans et plus). Un indice de soutien social perçu a été dérivé des réponses aux questions relatives à trois composantes différentes du soutien social : interaction positive, soutien émotionnel, et amour et affection. Les associations entre le surpeuplement résidentiel (plus d'une personne par pièce) et le soutien social perçu ont été évaluées à l'aide de régressions linéaires et logistiques pondérées, ajustées pour plusieurs facteurs. Des analyses stratifiées par sexe et par âge ont également été réalisées. RéSULTATS: Les Nunavimmiut déclarent des niveaux de soutien social significativement plus faibles lorsqu'ils vivent dans des ménages surpeuplés, indépendamment d'autres covariables. Les analyses stratifiées par sexe et par âge montrent en outre que l'association néfaste entre le surpeuplement et le soutien social perçu est plus élevée et plus forte chez les hommes et les adultes plus âgés (hommes et femmes de 55 ans et plus). CONCLUSION: Le surpeuplement résidentiel est associé à des niveaux inférieurs de soutien social perçu, lequel est une composante clé de la santé pour la population générale et pour les Nunavimmiut. Les recherches futures devraient examiner les facteurs en cause derrière l'association entre le surpeuplement résidentiel et l'affaiblissement du soutien social chez les hommes et les adultes plus âgés.

Who Matters Most? Migrant Networks, Tie Strength, and First Rural-Urban Migration to Dakar.

Social networks' influence on migration has long been explored largely through the lenses of cumulative causation and social capital theory. This article aims to reconceptualize elements of these theories for the case of rural-urban migration and test their utility in explaining first-migration timing. We use a uniquely extensive social network survey linked to prospectively collected migration data in rural Senegal. We decompose migrant networks into return migrants, current migrants, and nonmigrant residents of the destination to capture heterogeneity in migration-relevant social capital. As expected, the number of nonmigrant alters living in the capital, Dakar, has an outsized association with the migration hazard, the number of current migrants from the village living in Dakar has a smaller association, and the number of return migrants has little association. Drawing on social capital theory, we test the influence of (1) subjectively assessed tie strength between the ego and their network alters and (2) structurally weak ties measured through second-order ("friend of a friend") connections. Weak and strong subjective ties to current migrants and nonmigrant Dakar residents are positively associated with the first-migration hazard. Structurally weak ties to current migrants are too, but only for individuals with no direct ties to current migrants.

Individual, Community, and Social Network Influences on Beliefs Concerning the Acceptability of Intimate Partner Violence in Rural Senegal.

Intimate partner violence (IPV) is a pressing international public health and human rights concern. Recent scholarship concerning causes of IPV has focused on the potentially critical influence of social learning and influence in interpersonal interaction through social norms. Using sociocentric network data from all individuals aged 16 years and above in a rural Senegalese village surveyed as part of the Niakhar Social Networks and Health Project (n = 1,274), we estimate a series of nested linear probability models to test the association between characteristics of respondents' social networks and residential compounds (including educational attainment, health ideation, socioeconomic status, and religion) and whether respondents are classified as finding IPV acceptable, controlling for individual characteristics. We also test for direct social learning effects, estimating the association between IPV acceptability among network members and co-residents and respondents' own, net of these factors. We find individual, social network, and residential compound factors are all associated with IPV acceptability. On the individual level, these include gender, traditional health ideation, and household agricultural investment. Residential compound-level associations are largely explained in the presence of the individual and network characteristics, except for that concerning educational attainment. We find that network alters' IPV acceptability is strongly positively associated with respondents' own, net of individual and compound-level characteristics. A 10% point higher probability of IPV acceptability in respondents' networks is estimated to be associated with a 4.5% point higher likelihood of respondents being classified as finding IPV acceptable. This research provides compelling evidence that social interaction through networks exerts an important, potentially normative, influence on whether individuals in this population perceive IPV as acceptable or not. It also suggests that interventions targeting individuals most likely to perceive IPV as acceptable may have a multiplier effect, influencing the normative context of others they interact with through their social networks.

A latent class analysis of attitudes concerning the acceptability of intimate partner violence in rural Senegal.

BACKGROUND: Research concerning the causes and consequences of intimate partner violence (IPV), particularly in less developed areas of the world, has become prominent in the last two decades. Although a number of potential causal factors have been investigated the current consensus is that attitudes toward IPV on the individual level, likely representing perceptions of normative behavior, and the normative acceptability of IPV on the aggregate level likely play key roles. Measurement of both is generally approached through either binary indicators of acceptability of any type of IPV or additive composite indexes of multiple indicators. Both strategies imply untested assumptions which potentially have important implications for both research into the causes and consequences of IPV as well as interventions aimed to reduce its prevalence. METHODS: Using survey data from rural Senegal collected in 2014, this analysis estimates latent class measurement models of attitudes concerning the acceptability of IPV. We investigate the dimensional structure of IPV ideation and test the parallel indicator assumption implicit in common measurement strategies, as well as structural and measurement invariance between men and women. RESULTS: We find that a two-class model of the acceptability of IPV in which the conditional probability of class membership is allowed to vary between the sexes is preferred for both men and women. Though the assumption of structural invariance between men and women is supported, measurement invariance and the assumption of parallel indicators (or equivalence of indicators used) are not. CONCLUSIONS: Measurement strategies conventionally used to operationalize the acceptability of IPV, key to modeling perceptions of norms around IPV, are a poor fit to the data used here. Research concerning the measurement characteristics of IPV acceptability is a precondition for adequate investigation of its causes and consequences, as well as for intervention efforts aimed at reducing or eliminating IPV.

The Niakhar Social Networks and Health Project.

This paper presents details of the design and implementation of the Niakhar Social Networks and Health Project (NSNHP), a large, mixed-methods project funded by the U.S. National Institute of General Medical Sciences (NIGMS). By redressing fundamental problems in conventional survey network data collection methods, the project is aimed at improving inferences concerning the association between social network structures and processes and health behaviors and outcomes. Fielded in collaboration with an ongoing demographic and health surveillance system in rural Senegal, the NSNHP includes qualitative data concerning the dimensions of social association and health ideologies and behaviors in the study zone, two panels of a new social network survey, and several supplementary and affiliated data sets. •Longitudinal social network survey linked to pre-existing surveillance data•Addresses fundamental methodological constraints in previous social network data•Enables social network analyses of health beliefs, behaviors, and outcomes.

Social learning, influence, and ethnomedicine: Individual, neighborhood and social network influences on attachment to an ethnomedical cultural model in rural Senegal.

The preference in many parts of the world for ethnomedical therapy over biomedical alternatives has long confounded scholars of medicine and public health. In the anthropological literature cultural and interactional contexts have been identified as fundamental mechanisms shaping adherence to ethnomedical beliefs and health seeking behaviors. In this paper, we examine the association between individual, neighborhood, and social network characteristics and the likelihood of attachment to an ethnomedical cultural model encompassing beliefs about etiology of disease, appropriate therapeutic and preventative measures, and more general beliefs about metaphysics and the efficacy of health systems in a rural population in Eastern Senegal. Using data from a unique social network survey, and supplemented by extensive qualitative research, we model attachment to the ethnomedical model at each of these levels as a function of demographic, economic and ideational characteristics, as well as perceived effectiveness of both biomedical and ethnomedical therapy. Individuals' attachment to the ethnomedical cultural model is found to be strongly associated with characteristics of their neighborhoods, and network alters. Experiences with ethnomedical care among neighbors, and both ethnomedical and biomedical care among network alters, are independently associated with attachment to the ethnomedical model, suggesting an important mechanism for cultural change. At the same time, we identify an independent association between network alters' cultural models and those of respondents, indicative of a direct cultural learning or influence mechanism, modified by the degree of global transitivity, or 'connectedness' of individuals' networks. This evidence supports the long held theoretical position that symbolic systems concerning illness and disease are shared, reproduced, and changed through mechanisms associated with social interaction. This has potentially important implications not only for public health programming, but for the understanding of the reproduction and evolution of cultural systems more generally.

The components of self-rated health among adults in Ouagadougou, Burkina Faso.

BACKGROUND: Although the relationship between self-rated health (SRH) and physical and mental health is well documented in developed countries, very few studies have analyzed this association in the developing world, particularly in Africa. In this study, we examine the associations of SRH with measures of physical and mental health (chronic diseases, functional limitations, and depression) among adults in Ouagadougou, Burkina Faso, and how these associations vary by sex, age, and education level. METHODS: This study was based on 2195 individuals aged 15 years or older who participated in a cross-sectional interviewer-administered health survey conducted in 2010 in areas of the Ouagadougou Health and Demographic Surveillance System. Logistic regression models were used to analyze the associations of poor SRH with chronic diseases, functional limitations, and depression, first in the whole sample and then stratified by sex, age, and education level. RESULTS: Poor SRH was strongly correlated with chronic diseases and functional limitations, but not with depression, suggesting that in this context, physical health probably makes up most of people's perceptions of their health status. The effect of functional limitations on poor SRH increased with age, probably because the ability to circumvent or compensate for a disability diminishes with age. The effect of functional limitations was also stronger among the least educated, probably because physical integrity is more important for people who depend on it for their livelihood. In contrast, the effect of chronic diseases appeared to decrease with age. No variation by sex was observed in the associations of SRH with chronic diseases, functional limitations, or depression. CONCLUSIONS: Our findings suggest that different subpopulations delineated by age and education level weight the components of health differently in their self-rated health in Ouagadougou, Burkina Faso. In-depth studies are needed to understand why and how these groups do so.

Why are virgin adolescents worried about contracting HIV/AIDS? Evidence from four sub-Saharan African countries.

Whether well founded or not, perceptions of one's own HIV risk have been shown by health behavior models to be an important factor in determining individuals' sexual behavior. Although empirical studies on the determinants of HIV risk perception exist, only a few have focused on adolescents who are not yet sexually active. Using data from nationally-representative surveys of adolescents, we assess the factors associated with HIV risk perception among sexually inactive adolescents in four sub-Saharan African countries at different stages of the HIV/AIDS epidemic (Burkina Faso, Ghana, Malawi and Uganda). The results show that there is no single influence on adolescents' HIV risk perception, but rather a range of individual, environmental and community factors such as schooling, knowledge about HIV, regional HIV prevalence and adolescents' social networks. These results can help better calibrate programs and policies addressing sexual and reproductive health issues among adolescents, a group that is disproportionately affected by new HIV infections.