7.2 The Behaviors

Altogether we examine 19 behaviors in this framework, which we divide into three general categories:

  • Biomedically recommended
  • Biomedically not-recommended
  • Neutral

Table 7.1 defines each behavior, gives it a short-name to facilitate reference throughout the next two chapters, and explains any coding that may have been needed to convert it from a multi-option response to a binary yes/no response. Table 7.2 presents the counts of women answering in the affirmative in each sample, ASHAs and Mothers.

While there are a total of 19 behaviors that are associated with influencers and reasons, we also look at two additional dietary questions here, about increasing the diet during pregnancy and post-partum. These two questions are not associated with the same two followup questions about influencers and reasons. Individual foods added and avoided are treated in a separate analysis.

Table 7.1: The questions from the survey along with their abbreviations and codes, that are used in the Influencer Analaysis
Figure.Label Question.from.survey Response.explanation
Biomedically not recommended
Conceal_Preg Q212A During last pregnancy, for how long you hide the pregnancy to the outsiders? yes = hid to three months or longer than three months; No means did not hide, or hid 1 month or two months
FastWhilePreg Q213AC During last pregnancy, did you use to fast during religious occasions/days?_DID NOT FAST yes = yes did fast in some form, no is did not fast at all
WorkWhilePreg Q214A During last pregnancy, did you do heavy work such as fetching water, climbing stairs, lifting heavy things? yes = frequently or sometimes, no = never
Cordstump_Apply Q250AA After child birth did you (ever) apply anything to the cord stump after cord cutting?_NOTHING yes = yes applied something (but there are many options for what was applied); no means applied nothing.
Bath_24hpp Q254A When did you give bath to the child after birth? yes = gave bath within 24 hours; no = within 24 to 48 hrs, after 48, and not given
AvoidCereal Q256A Did you avoid cereal based regular meals for the first few days after delivery? yes = avoided cereals just after delivery
Biomedically recommended
ANC_TimelyReg Q204A In which month of your pregnancy, did you register for ANC? yes’ if registered within first 3 months of pregnancy
ANC_4checkups Q205A How many ANC check-ups did you receive during last pregnancy ? yes = had 4 or more checkups, no = 0 to 3
DietIncrease_Preg Q218 During your pregnancy, did you make any changes in the quantity of your diet because of pregnancy?   yes = yes I increased my diet (as opposed to decreased or made no change)
IFAtabs Q207A Did you consume 90 ifa tablets/3 bottle of syrup during your last pregnancy? yes’ = consumed the full recommended amount; ‘no’ = did not consume or consumed less than recommended
Hospital_del Q242A Was your last child born in the hospital ? yes = government or private hospital; no = home birth
FeedColostrum Q252A Did you feed colostrum to the child yes = yes I fed colostrum; no means no I didn’t
TIBF_onehr Q251A How long after birth did you first put the child to breast yes = breast fed within first hour; no = after first hour or never breastfed
DietIncrease_Postpartum Q263 After the child birth, did you make any changes to your diet? yes = yes I increased my diet (as opposed to decreased or made no change)
Abstain Q210AA During last pregnancy, did you abstain from having physical relations with husband?_ABSTAINED THROUGHOUT THE PREGNANCY yes = yes avoided sexual relations
Avoid_Market Q211A Did you avoid going to markets/relatives/other households in the village during last trimester of the pregnancy yes = yes avoided markets in last trimester
Consult_Priest Q217A During your last pregnancy, did you consult any priest/maulana? yes = once, frequently, or sometimes; no = never
DaiVisit_Preg Q208A During last pregnancy, did dai visit your household to provide health related services/advices yes = yes dai visited
DaiCall Q241A When your labor started, did you call dai? yes = yes called dai when labor started
DaiVisit_Deliv Q255A Did dai visit you after delivery? yes = yes Dai visited after delivery
Mom_NB_Isolation Q253A After delivery were you and the child kept separately in isolation. yes = yes we were kept separate;
Chhathi Q257A Did you celebrate chhathi? yes = yes I celebrated Chhathi

Table 7.2 gives the difference in the percent of woman doing the behavior for ASHAs and Mothers. The behaviors with largest gaps such that ASHAs did them at higher frequencies than their beneficiaries include: fasting while pregnant, applying a substance to the cordstump, bathing the newborn within 24 hours of birth, taking the full regimen of IFA tablets, and calling a Dai when labor started.

The behaviors that are done by higher frequencies among beneficiaries than ASHAs include: early ANC registration, institutional delivery, and abstaining from sexual relations while pregnant.

Recall that a number of factors could be responsible for differences between ASHAs and their beneficiaries with some likely candidates being age, relative exposure to traditional and biomedical recommendations, and the ASHA training itself. With this reminder in mind, we might still wonder why ASHAs reported higher compliance with taking IFA tables. It could just be desirability bias but there might also be rising resistance to taking IFA tablets as women report side effects related to digestive discomfort. The largest changes in behavioral uptake are institutional delivery followed by early ANC registration, which could indeed reflect success of the ASHA program and other health initiatives.

Table 7.2: Counts and percentages of each sample responding ‘yes’ to the behavioral questions
behavior count ASHA percent ASHA count Mother percent Mother difference in percent
Biomedically not recommended
WorkWhilePreg 135 33.8 411 35.1 1
Conceal_Preg 347 86.8 1014 86.5 0
AvoidCereal 149 37.2 354 30.2 -7
Bath_24hpp 166 41.5 376 32.1 -9
Cordstump_Apply 272 68.0 684 58.4 -10
FastWhilePreg 318 79.5 684 58.4 -21
Biomedically recommended
Hospital_del 151 37.8 965 82.3 44
ANC_TimelyReg 116 29.0 610 52.0 23
ANC_4checkups 149 37.2 563 48.0 11
FeedColostrum 315 78.8 966 82.4 4
TIBF_onehr 248 62.0 764 65.2 3
DietIncrease_Preg 104 26.0 176 15.0 -11
IFAtabs 180 45.0 402 34.3 -11
DietIncrease_Postpartum 263 65.8 588 50.2 -16
Abstain 37 9.2 269 23.0 14
Consult_Priest 29 7.2 175 14.9 8
DaiVisit_Preg 134 33.5 405 34.6 1
Chhathi 309 77.2 868 74.1 -3
Avoid_Market 263 65.8 724 61.8 -4
DaiVisit_Deliv 335 83.8 919 78.4 -5
Mom_NB_Isolation 342 85.5 945 80.6 -5
DaiCall 261 65.2 643 54.9 -10

7.2.1 Variation in the coded behaviors

Many of the behaviors in Table 7.1 represent questions with multiple possible responses that were recoded into a binary response of yes/no.

To include a summary description for the underlying variation in these behaviors, we look at each in fairly rapid-fire succession here.