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Open Access Research article

Determinants of better health: a cross-sectional assessment of positive deviants among women in West Bengal

Katelyn NG Long1*, Lisa H Gren1, Chris A Rees1, Joshua H West2, Parley Cougar Hall2, Bobbi Gray3 and Benjamin T Crookston2

Author Affiliations

1 Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA

2 Department of Health Science, Brigham Young University, Provo, UT, USA

3 Freedom from Hunger, Davis, CA, USA

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BMC Public Health 2013, 13:372  doi:10.1186/1471-2458-13-372

Published: 20 April 2013

Abstract

Background

Rural women in West Bengal have been found to have low rates of formal education, poor health knowledge, high rates of malnutrition and anemia, and low levels of empowerment. Despite these difficult circumstances, some women have positive health outcomes compared to women with similarly disadvantaged backgrounds. The purpose of this study is to identify factors associated with positive health outcomes among women with primary education or less.

Methods

Multivariable regression models were built for outcomes of positive deviance to better characterize the factors in a woman’s life that most impact her ability to deviate from the status quo.

Results

Positive deviants in this context are shown to be women who are able to earn an income, who have access to information through media sources, and who, despite little schooling, have marginally higher levels of formal education that lead to improved health outcomes.

Conclusions

Study findings indicate that positive deviant women in disadvantaged circumstances can achieve positive outcomes amidst a host of contextual barriers that would predict poor health outcomes. Focusing on areas such as enhancing access to media sources, facilitating self-help groups for married women, and promoting prolonged education and delayed marriage for girls may improve health knowledge and behavior among married women with low levels of education.

Keywords:
India; Women; West Bengal; Positive deviance; Health; Education