Do village-level normative and network factors help explain spatial variability in adolescent childbearing in rural Honduras?

Holly B Shakya; John R Weeks; Nicholas A Christakis

doi:10.1016/j.ssmph.2019.100371

Do village-level normative and network factors help explain spatial variability in adolescent childbearing in rural Honduras?

SSM Popul Health. 2019 Feb 4:9:100371. doi: 10.1016/j.ssmph.2019.100371. eCollection 2019 Dec.

Authors

Holly B Shakya¹, John R Weeks², Nicholas A Christakis³

Affiliations

¹ Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla CA, USA.
² Department of Geography, San Diego State University, San Diego CA, USA.
³ Department of Sociology, Yale University, New Haven CT, USA.

Abstract

Adolescent childbearing rates are higher in Central America than almost anywhere else. However, in this research we discovered that adolescent childbearing exhibits variability from one village to another, and we might discover factors associated with this spatial variability that can help us understand key characteristics underlying the pattern of early childbearing. To do this, we assessed the village-level normative and network factors associated with adolescent birth (birth taking place before age 20 years) in rural Honduras and evaluated the geographic dispersion of these patterns. We used full population data from 24,937 people in 176 villages (81% of the eligible population) to assess prevalence and patterns of adolescent childbearing among women. We modeled the predictors of adolescent births among women younger than 21 years. After accounting for individual demographic characteristics, one of the strongest predictors of adolescent birth within the population was village-level collective norms about the acceptability of adolescent childbearing, based on aggregating normative measures from the entire population. The proportion of women in the village who had given birth as an adolescent was also strongly associated with an individual girl's likelihood of having given birth as an adolescent. We used full village-level network analyses to calculate social cohesion within the village. Normative pressure was strongly associated with the likelihood of an adolescent birth in villages with high cohesion (high network density) and was not associated or had a weak association in villages with low cohesion. On the other hand, the longer a girl had lived in the village, the stronger the association between the overall proportion of women in that village who gave birth as adolescents and the girl's own likelihood of having done so. Spatial analyses suggest that levels of adolescent births vary spatially across villages, as do the village-level normative factors associated with them.

Keywords: Adolescent fertility; Honduras; Social cohesion; Social networks; Social norms; Spatial analysis.