A new study by a researcher at the University of Arkansas shows that Internet kiosks providing information on prenatal and postnatal care for mother and baby have helped reduce infant, child and maternal mortality rates in rural India. Contrary to traditional assumptions about the positive effects of social networks, the study’s findings demonstrated that strong social ties in rural villages did not help women seek and obtain appropriate medical care.

“Based on our knowledge of religious beliefs and various customs within rural Indian culture, as well as the basic tendency of people to associate and bond with others similar to themselves, we hypothesized that strong network ties would be detrimental to women seeking good information about health care,” said Viswanath Venkatesh, professor in the Sam M. Walton College of Business. “The results of this study provided evidence that this was indeed the case. Women with strong network ties seemed to be influenced by strong pressure not to change traditional practices and customs.”

Although in recent years India has experienced a growing economy and burgeoning middle class in primarily urban centers, most people in rural areas live in extreme poverty.

For example, according to a recent study that used a multidimensional poverty index, eight Indian states are worse off than people in sub-Saharan Africa. As part of this problem, India has high infant mortality rates – approximately 55 per 1,000 live births – and child mortality rates – 78 per 1,000 live births. In response to this problem, several private organizations have installed Internet kiosks to provide valuable information about prenatal and postnatal care for mother and baby. The kiosks are public Internet stations, similar to those found in a library or café, where rural Indians can gain access to the World Wide Web.

In direct connection to a United Nations Millennium Development Goal to reduce infant, child and maternal mortality rates in underdeveloped areas, Venkatesh examined the impact of the Internet kiosks. He wanted to know if the kiosks had contributed to systematic benefits related to reducing infant, child and maternal deaths, and if so, who was most likely to benefit.

Venkatesh and former doctoral student Tracy Sykes, now assistant professor at the Australian National University, conducted a five-year study of women in 20 rural villages, 10 with Internet kiosks and 10 with no such intervention. They used surveys and health records from government archives to gather data. A general survey was taken at the deployment of each kiosk. In each village, approximately 300 women participated.

From 2004 to 2009, infant and child mortality rates in both groups decreased, but overall the intervention group – those villages with Internet kiosks – experienced a more rapid decline. In 2004, the year the Internet kiosks were installed, overall mortality rates were approximately the same number – 68 per 1,000 live births. Below are results from an equally weighted index of infant, child and maternal mortalities over the five-year period:
Control group Intervention group
2004 68.4 68.5
2005 66.2 65.1
2006 64.1 61.8
2007 61.8 56.4
2008 59.4 52.2
2009 57.3 49.1

The percentage of women using the kiosks was low, only 4.8 percent in 2004 and rising steadily each year to 8.8 percent in 2009. Venkatesh said this information was valuable because it showed that the transfer of information about health issues depended not only on the kiosk but also on women’s ties to other women who had used them.

Venkatesh and Sykes then tested the classic social network hypothesis, which argues that strong ties among community members result in positive social benefits. In this case, they found the opposite, that strong community ties among women in the villages were associated with negative effects on them seeking health information and medical care. They found positive effects – access to health information and medical care – for women with weak community ties.

“Mortality rates in rural India have shown a steady decline, which is great,” Venkatesh said. “But it’s important to dig a little deeper and find out why. We have empirical evidence of the positive impact of Internet kiosks and, perhaps counterintuitively, both the detrimental effects of a strong social network and positive effects of a weak network.”

Venkatesh presented these results to a United Nations panel of experts on gender, science and technology. At a conference in Paris, the group explored gender dimensions of science and technology and identified policies and programs to accelerate progress toward Millennium Development Goals.
Venkatesh holds the George and Boyce Billingsley Chair in Information Systems.

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Source: University of Arkansas, Fayetteville