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Ananga MK, Agbefu RK, Doku PN, Manu A, Alangea DO, Ganle JK. The influence of social capital in the utilisation of sexual reproductive health services among the youth in Ghana. A community-based cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001225. [PMID: 37796774 PMCID: PMC10553252 DOI: 10.1371/journal.pgph.0001225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 08/21/2023] [Indexed: 10/07/2023]
Abstract
Social capital, often seen as the resources accessed through social connections, is currently gaining much attention in public health. However, limited studies have focused on the relationship between social capital and reproductive health services. Besides, while the factors associated with the use of reproductive health services among the youth are well documented in the literature, most studies have focused on narrowed perspective failing to take cognisance of the role of social capital. Yet, it is known that these behaviours can be influenced by social factors, which may be beyond the individual's control partly because the youth are embedded in social organisations. Therefore, this study examined the relationship between social capital and the youth's utilisation of reproductive health services.The study population comprised adolescents and young adults aged 15-24 years who were both in and out of school at the time of the survey. The study used a cross-sectional quantitative design involving a community-based household survey method to sample 792 respondents through multi-stage cluster sampling. The chi-square test examined the relationship between sociodemographic, social capital variables and reproductive health services. To account for potential confounding factors, a multivariable logistic regression model included variables from the binary logistic regression analysis with a p-value less than 0.05. In general, access to higher social capital was observed among 493 (62.2%). Almost half, 385 (48.6%) of the respondents have ever used at least one of the reproductive services examined in this study. After controlling all other significant predictors, the following social capital variables remained associated with increased utilisation of SRH services: higher trust in neighbourhood (AOR = 1.8; CI = 1.22-2.66), higher trust in people/institutions (AOR = 2.66; CI = 1.82-3.99), higher social cohesion (AOR = 3.35; CI = 2.21-5.08), stronger network (AOR = 7.55; CI = 4.43-12.87).Access to some social capital dimensions is associated with increased use of reproductive health services. However, any intervention such as mentoring including peer support programs, meant to address social capital needs in sexual and reproductive health should consider the efficacy of each social capital dimension and the intervention's environment.
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Affiliation(s)
- Mark Kwame Ananga
- Department of Population and Behavioural Sciences, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Rosemary Kafui Agbefu
- Institute of Alternative and Traditional Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Paul Narh Doku
- Department of Mental Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Adom Manu
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Ghana
| | - Deda Ogum Alangea
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Ghana
| | - John Kumuori Ganle
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Ghana
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Nabi MNU, Zohora FT, Misbauddin S. Social media links with social capital to trust in healthcare facilities: empirical evidence from Bangladesh. LIBRARY HI TECH 2023. [DOI: 10.1108/lht-09-2022-0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
PurposeThe paper aims to investigate the most influential social media information sources to trust in healthcare facilities. The article shows a valuable point of reference for understanding how social media becomes the casting of social capital.Design/methodology/approachThis paper has taken 660 responses from the people who used social media for healthcare information in the mid of 2020 during the pandemic. The people were approached through different social media groups. The paper conducted structural equation modelling (SEM). The result has shown that with the instigating power of social capital where people put trust in social media information during pandemics.FindingsThe findings demonstrated that personal sources, government organisations and healthcare professionals are the most influential sources of social media. In order to effectively ensure the encompassing provision of COVID-19 health services, this article argues that social capital considerations establish trust between healthcare facilities seeking community to healthcare information providers.Research limitations/implicationsThis research has signified that social cohesion and concern for community welfare instigated people to engage in social media communication. The inherent social capital belongings influence people to trust the sources of health information from selected sources that appear on social media.Practical implicationsHealthcare policymakers may utilise this intense feeling of belongingness and cohesion of social capital and use social media platforms to spread health-related information.Originality/valueThe study shows social capital has the strength to entice people into healthcare-seeking behaviour. In this era, social capital is reformulated to digital social capital through social media and strongly affects people's trust.
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Yan N, Chen D, Pan R, Zhang L, Ma J, Zhang Z, Dang Y, Wang L, Ma X, Jia S. The Relationship Between Social Capital and Hypertension Among Type 2 Diabetes Mellitus Patients: The Moderating Effect of Depressive Symptoms. Patient Prefer Adherence 2023; 17:209-216. [PMID: 36713973 PMCID: PMC9875576 DOI: 10.2147/ppa.s396383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/07/2023] [Indexed: 01/21/2023] Open
Abstract
PURPOSE This study aimed to evaluate the relationship between social capital (SC) and hypertension among type 2 diabetes mellitus (T2DM) patients, considering the moderation effects of depressive symptoms. PATIENTS AND METHODS A total of 1761 Chinese T2DM patients completed measure scales of social capital and epidemiological survey depression scale (CES-D). The Bootstrap methods PROCESS program is employed to test the moderation model. RESULTS The prevalence of hypertension among T2DM patients was 39.3%. The SC was negatively correlated with the CES-D score (r=-0.18, P<0.01); the SC was also negatively correlated with diastolic blood pressure (r=-0.05, P<0.05); and the CES-D score was positively correlated with systolic blood pressure (r=0.05, P<0.05). Both logistic regression analysis and the Bootstrap method showed that depressive symptoms weakened the protective effect of SC on hypertension, there existed a moderating effect of depressive symptoms on the relationship between SC and hypertension among T2DM patients. CONCLUSION Depressive symptoms may be one crucial moderator of the relationship between SC and hypertension in a representative sample of Chinese diabetes patients. The findings indicate that improving SC and mental health may help manage hypertension among T2DM patients.
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Affiliation(s)
- Ning Yan
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Dapeng Chen
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Ruiping Pan
- Department of Chinese Medicine, The Second People’s Hospital of Shizuishan, Shizuishan, 753000, People’s Republic of China
| | - Li Zhang
- Department of Endocrinology, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Juan Ma
- Clinical Medical College, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Zhengjun Zhang
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Yuqi Dang
- Department of Endocrinology, Yinchuan Hospital of Traditional Chinese Medicine, Yinchuan, 750001, People’s Republic of China
| | - Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Xueping Ma
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Ningxia Key Laboratory of Vascular Injury and Repair Research, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Correspondence: Xueping Ma; Shaobin Jia, Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China, Tel +8613519290991; +8613995078969, Email ;
| | - Shaobin Jia
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Ningxia Key Laboratory of Vascular Injury and Repair Research, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
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Goodman ML, Elliott A, Melby PC, Gitari S. Water insecurity, food insecurity and social capital associated with a group-led microfinance programme in semi-rural Kenya. Glob Public Health 2022; 17:3399-3411. [PMID: 35787237 PMCID: PMC9810762 DOI: 10.1080/17441692.2022.2095656] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 06/26/2022] [Indexed: 02/06/2023]
Abstract
ABSTRACTSocial capital predicts many positive health outcomes, including food and water access and sufficiency. Hence, increasing social capital has emerged as one potential strategy to improve food and water security. In this study, we investigate whether social capital generated through participation in a community-based microlending programme based in semi-rural Kenya is associated with water and food insecurity, and explore the interconnectedness of water and food insecurity through mediation analysis. Randomly-selected women participants of the community-based programme (n = 400) were interviewed in June 2018 and again in June 2019. Survey measures included water insecurity, food insecurity and an index of social capital constructs, namely group cohesion, trust, expectations of mutual support, sense of belonging and frequency of attendance in the programme. Random effects linear regression showed that an increase the social capital index was associated with lower water and food insecurity. The mediation analysis indicated that the association between social capital and food insecurity was completely mediated by water insecurity. This study demonstrates the need for further investigation into how social capital-generating programmes can contribute to systems approaches for collaborative food and water security programmes, especially among rural communities in low- and middle-income countries.
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Yu ST, Houle B, Manderson L, Jennings EA, Tollman SM, Berkman LF, Harling G. The double-edged role of accessed status on health and well-being among middle- and older-age adults in rural South Africa: The HAALSI study. SSM Popul Health 2022; 19:101154. [PMID: 35855969 PMCID: PMC9287360 DOI: 10.1016/j.ssmph.2022.101154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 12/04/2022] Open
Abstract
Background Social capital theory conceptualizes accessed status (the socioeconomic status of social contacts) as interpersonal resources that generate positive health returns, while social cost theory suggests that accessed status can harm health due to the sociopsychological costs of generating and maintaining these relationships. Evidence for both hypotheses has been observed in higher-income countries, but not in more resource-constrained settings.We therefore investigated whether the dual functions of accessed status on health may be patterned by its interaction with network structure and functions among an older population in rural South Africa. Method We used baseline survey data from the HAALSI study ("Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa") among 4,379 adults aged 40 and older. We examined the direct effect of accessed status (measured as network members' literacy), as well as its interaction with network size and instrumental support, on life satisfaction and self-rated health. Results In models without interactions, accessed status was positively associated with life satisfaction but not self-rated health. Higher accessed status was positively associated with both outcomes for those with fewer personal contacts. Interaction effects were further patterned by gender, being most health-protective for women with a smaller network and most health-damaging for men with a larger network. Conclusions Supporting social capital theory, we find that having higher accessed status is associated with better health and well-being for older adults in a setting with limited formal support resources. However, the explanatory power of both theories appears to depending on other key factors, such as gender and network size, highlighting the importance of contextualizing theories in practice.
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Affiliation(s)
- Shao-Tzu Yu
- School of Demography, The Australian National University, Canberra, ACT, Australia
| | - Brian Houle
- School of Demography, The Australian National University, Canberra, ACT, Australia
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faulty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- CU Population Center, Institute of Behavioral Science, University of Colorado at Boulder, Boulder, CO, USA
| | - Lenore Manderson
- School of Public Health, Faulty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- School of Social Sciences, Monash University, Victoria, Australia
| | - Elyse A. Jennings
- Harvard Center for Population and Development Studies, Harvard University, USA
| | - Stephen M. Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faulty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- Center for Global Health Research, Umeå University, Umeå, Sweden
- INDEPTH Network, Accra, Ghana
| | - Lisa F. Berkman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faulty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- Harvard Center for Population and Development Studies, Harvard University, USA
- INDEPTH Network, Accra, Ghana
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, USA
| | - Guy Harling
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faulty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- Harvard Center for Population and Development Studies, Harvard University, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, USA
- Institute for Global Health, University College London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Sarriot E, Davis T, Morrow M, Kabore T, Perry H. Motivation and Performance of Community Health Workers: Nothing New Under the Sun, and Yet…. GLOBAL HEALTH, SCIENCE AND PRACTICE 2021; 9:716-724. [PMID: 34933969 PMCID: PMC8691878 DOI: 10.9745/ghsp-d-21-00627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/16/2021] [Indexed: 12/16/2022]
Abstract
We know that both financial and nonfinancial incentives matter if we want community health workers (CHWs) who are motivated and performing. What are the practical implications for CHWs themselves and for effective management of viable CHW programs?
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Affiliation(s)
- Eric Sarriot
- Gavi, The Vaccine Alliance, Geneva, Switzerland.
| | - Tom Davis
- World Vision International, Geneva, Switzerland
| | | | | | - Henry Perry
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Mengesha EW, Alene GD, Amare D, Assefa Y, Tessema GA. Social capital and maternal and child health services uptake in low- and middle-income countries: mixed methods systematic review. BMC Health Serv Res 2021; 21:1142. [PMID: 34686185 PMCID: PMC8539777 DOI: 10.1186/s12913-021-07129-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social capital has become an important concept in the field of public health, and is associated with improved health services uptake. This study aimed to systematically review the available literature on the role of social capital on the utilization of maternal and child health services in low- and middle-income countries (LMICs). METHODS Mixed-methods research review and synthesis using three databases PubMed, Scopus, and Science Direct for peer-reviewed literature and Google Scholar and Google search engines for gray literature were performed. Both quantitative and qualitative studies conducted in LMICs, published in English and in grey literature were considered. Prior to inclusion in the review methodological quality was assessed using a standardized critical appraisal instrument. RESULTS A total of 1,545 studies were identified, of which 13 records were included after exclusions of studies due to duplicates, reading titles, abstracts, and full-text reviews. Of these eligible studies, six studies were included for quantitative synthesis, and seven were included for qualitative synthesis. Of the six quantitative studies, five of them addressed the association between social capital and health facility delivery. Women who lived in communities with higher membership in groups that helps to form intergroup bridging ties had higher odds of using antenatal care services. Synthesized qualitative findings revealed that women received some form of emotional, informational, and instrumental support from their network members. Receiving health information from trusted people and socio-cultural factors influenced the use of maternal and child health services. CONCLUSIONS Social capital has a great contribution to improve maternal and child health services. Countries aiming at improving maternal and child health services can be benefited from adapting existing context-specific social networks in the community. This review identified limited available evidence examining the role of social capital on maternal and child health services uptake and future studies may be required for an in-depth understanding of how social capital could improve maternal and child health services. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021226923.
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Affiliation(s)
- Endalkachew Worku Mengesha
- Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Getu Degu Alene
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Desalegne Amare
- School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Australia
| | - Gizachew A Tessema
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
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Rosha BC, Suryaputri IY, Irawan IR, Arfines PP, Triwinarto A. Factors Affecting Public Non-compliance With Large-scale Social Restrictions to Control COVID-19 Transmission in Greater Jakarta, Indonesia. J Prev Med Public Health 2021; 54:221-229. [PMID: 34370934 PMCID: PMC8357540 DOI: 10.3961/jpmph.21.101] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/24/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The Indonesian government issued large-scale social restrictions (called Pembatasan Sosial Berskala Besar, or PSBB) at the beginning of the coronavirus disease 2019 (COVID-19) pandemic to control the spread of COVID-19 in Jakarta, Bogor, Depok, Tangerang, and Bekasi (Greater Jakarta). Public compliance poses a challenge when implementing large-scale social restrictions, and various factors have contributed to public non-compliance with the regulation. This study aimed to determine the degree of non-compliance and identify the factors that contributed to public non-compliance with the PSBB in Greater Jakarta, Indonesia. METHODS This was a quantitative study with a cross-sectional design. A total of 839 residents of Greater Jakarta participated in this study. Data were collected online using a Google Form, and convenience sampling was undertaken. Univariate and multivariate analyses were performed to explore the relationships between public non-compliance with the PSBB regulation and socio-demographic variables, respondents' opinion of the PSBB, and social capital. RESULTS A total of 22.6% of subjects reported participating in activities that did not comply with the PSBB. The variables that most affected non-compliance with the PSBB were age, gender, income, opinion of the PSBB, and social capital. CONCLUSIONS Strengthening social capital and providing information about COVID-19 prevention measures, such as washing one's hands with soap, wearing masks properly, and maintaining social distancing, is essential. Robust public understanding will foster trust and cooperation with regard to COVID-19 prevention efforts and provide a basis for mutual agreement regarding rules/penalties.
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Affiliation(s)
- Bunga Christitha Rosha
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Central Jakarta, Indonesia
| | - Indri Yunita Suryaputri
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Central Jakarta, Indonesia
| | - Irlina Raswanti Irawan
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Central Jakarta, Indonesia
| | - Prisca Petty Arfines
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Central Jakarta, Indonesia
| | - Agus Triwinarto
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Central Jakarta, Indonesia
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Higa C, Davidson EJ, Loos JR. Integrating family and friend support, information technology, and diabetes education in community-centric diabetes self-management. J Am Med Inform Assoc 2021; 28:261-275. [PMID: 33164074 DOI: 10.1093/jamia/ocaa223] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 09/01/2020] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Diabetes self-management (DSM) education, social support, and information technology interventions can improve patient engagement and health. A major challenge is animating, integrating, and accessing resources in under-resourced, rural communities. Set in an island community in Hawai'i, this study piloted a program that integrated friend-and-family support, community health services, telehealth-enabled DSM education, and mobile technologies by activating the community's social capital to support the program. MATERIALS AND METHODS An action research approach informed the design and implementation of a community-based DSM program that included: friends and family support, telehealth classes, personalized consultations, Bluetooth-enabled blood glucose monitors, and text messaging support. Outcomes were evaluated using biometric data, surveys, interviews, and participant observations. RESULTS The study spanned 9 months with 7 dyads, each with 1 individual with type 2 diabetes and a friend or family member. Six of the 7 participants with diabetes experienced reduced hemoglobin A1c percentages, with 3 reducing by more than 1%. The seventh participant maintained a hemoglobin A1c level within American Diabetes Association recommended ranges. DSM knowledge and self-care behaviors improved overall. Interviews and participant observations highlighted program strengths and social challenges associated with the interpersonal relationships between the members of the dyads. CONCLUSIONS A community-centric diabetes program can enhance understanding of diabetes etiology, DSM activities, and communication skills for effective disease management support in under-resourced rural communities. Social capital among community members, leveraged with health information technology, can catalyze and integrate limited health system resources for DSM and social support as a cost-effective strategy to develop community-centric chronic healthcare management initiatives.
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Affiliation(s)
- Christina Higa
- Social Science Research Institute, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Elizabeth J Davidson
- Shidler School of Business, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Joanne R Loos
- School of Nursing and Dental Hygiene, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
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Social Capital and Age at Sexual Debut: Race Differences in South Africa. SOCIAL SCIENCES-BASEL 2020. [DOI: 10.3390/socsci9110197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Literature on social capital has long considered whether and how social capital is protective against various risk behaviors, including age at sexual debut. However, much of this literature uses data from wealthy countries in the Global North and is often cross-sectional, dampening generalizability. In this paper, we employ longitudinal South African data from adolescents in the Cape Area Panel Study to examine the longitudinal link between social capital and age at sexual debut. We first examine the overall relationship between age at sexual debut and social capital and then examine how the relationship differs by race. Results suggest that, on average, each additional activity is associated with an approximate 2 month delay in age at sexual debut. However, we observed steep racial differences. For Africans, the link between social capital and age at sexual debut was not significant, while the results for Coloureds and Whites were. For Coloureds, each additional activity translated into a 3 month delay in sexual debut, while for Whites we found a 4 month delay. We found no evidence of sex differences. Taken together, these results suggest that social capital is not equally efficacious for all South African adolescents. For Africans, social capital does not appear to be linked to age at sexual debut. In contrast, more social capital activities appear to be linked to delayed sexual debut, most particularly for Whites.
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Choi M, Ki M, Yip PS, Park J, Song A, Lee WY, Paik JW, Lim J. Small but protective social capital against suicide ideation in poor communities: A community-based cross-sectional study. Medicine (Baltimore) 2020; 99:e22905. [PMID: 33126345 PMCID: PMC7598880 DOI: 10.1097/md.0000000000022905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/23/2020] [Accepted: 09/25/2020] [Indexed: 11/25/2022] Open
Abstract
Coupled with the lowest level of social connectedness, South Korea has the highest suicide rate among the Organization for Economic Co-operation and Development countries. A possible link between community and suicide is social capital imprinted in social connectedness. This study explores whether social capital is protective against suicide ideation in relation to the poverty level of communities, and whether the associations are specific to certain elements of social capital.A total of 908 participants were included to assess cross-sectional association of social capital at individual level with suicide ideation by comparing between poor (government-leased apartments) and non-poor communities (nongovernment-leased apartments). Logistic regression analyses were performed to examine various social capital dimensions in relation to suicide ideation.Suicide ideation was far higher among those living in the poor communities (poor communities 12%; non poor communities 6.3%) and the level of social capital was lower in the poor communities. Nevertheless, the protective effect of social capital, in particular, the cognitive dimension against suicide ideation was demonstrated only in the poor communities (eg, odds ratio = 0.27, 95% confidence interval: 0.12-0.58 for trust in the poor communities). Low income was significantly associated with suicide ideation only in the poor communities, but depression and resilience were associated with suicide ideation both in the poor and non-poor communities.To increase the reliability of the results, established measures based on relevant literature were utilized, but measures on bridging social capital and social network might have relatively low reliability.As to protection against suicide ideation, the extent of reliance on social capital was higher in poor communities than in non-poor communities, in particular, the cognitive dimension was likely to activate in this regard.
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Affiliation(s)
- Minjae Choi
- Department of Public Health, Korea University
| | - Myung Ki
- Department of Public Health, Korea University
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Paul S.F. Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Jungyoun Park
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Areum Song
- Department of Public Health, Korea University
| | - Weon Young Lee
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Dongjak-Gu
| | - Jong-Woo Paik
- Department of Psychiatry, College of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul
| | - Jiseun Lim
- Department of Preventive Medicine, Eulji University, Daejeon Jung-gu, Daejeon, Republic of Korea
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Sarriot E, Shaar AN. Community Ownership in Primary Health Care-Managing the Intangible. GLOBAL HEALTH: SCIENCE AND PRACTICE 2020; 8:327-331. [PMID: 33008849 PMCID: PMC7541110 DOI: 10.9745/ghsp-d-20-00427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 11/15/2022]
Abstract
Although enduringly intangible, community ownership is foundational to primary health care. This intangibility is a reminder of what programs can and should do (create space for dialogue, question their own choices, expand diversity in stakeholder voices making sense of program-induced changes, including through evaluation) and what they cannot do (manage someone else’s ownership).
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Affiliation(s)
| | - Ali Nashat Shaar
- Palestinian Child Institute, An-Najah National University, Nablus, Palestine
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Wong ASY, Kohler JC. Social capital and public health: responding to the COVID-19 pandemic. Global Health 2020; 16:88. [PMID: 32977805 PMCID: PMC7517063 DOI: 10.1186/s12992-020-00615-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As countries continue to respond to the COVID-19 pandemic, the importance of ensuring that fair and equal access to healthcare for all is more urgent than ever. Policies that promote social capital building along all levels of society may offer an important avenue for improved healthcare delivery and health systems strengthening in the COVID-19 response. MAIN BODY In reference to the established and emerging literature on social capital and health, we explore the role of social capital in the COVID-19 health policy response. We analyse current research with respect to mental health, public health policy compliance, and the provision of care for vulnerable populations, and highlight how considerations of bonding, bridging, and linking capital can contribute to health systems strengthening in the context of the COVID-19 response and recovery effort. CONCLUSIONS This article argues that considerations of social capital - including virtual community building, fostering solidarity between high-risk and low-risk groups, and trust building between decision-makers, healthcare workers, and the public - offer a powerful frame of reference for understanding how response and recovery programs can be best implemented to effectively ensure the inclusive provision of COVID-19 health services.
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Affiliation(s)
- Anna S. Y. Wong
- World Health Organization Collaborating Centre for Governance, Accountability, and Transparency in the Pharmaceutical Sector, 144 College St, Toronto, Ontario M5S 3M2 Canada
| | - Jillian C. Kohler
- World Health Organization Collaborating Centre for Governance, Accountability, and Transparency in the Pharmaceutical Sector, 144 College St, Toronto, Ontario M5S 3M2 Canada
- University of Toronto Leslie Dan Faculty of Pharmacy, 144 College St, Toronto, Ontario M5S 3M2 Canada
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Win T, Tun Sein T, Ikeda W, Morita A, Sokejima S. Does Father's Social Capital Matter to Child Undernutrition in Myanmar? Asia Pac J Public Health 2020; 32:418-425. [PMID: 32857618 DOI: 10.1177/1010539520951717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article examined the association between social capital of fathers and child undernutrition using a community-based survey in Myanmar in 2018. The anthropometric measurements of 1546 children aged 6 to 59 months and face-to-face interviews of 1546 respective biological fathers were performed. The three social capital indicators (institutional trust, social supports, and collective action) were included in 2-level logistic regression models for child wasting and child stunting. Social supports from fathers' social networks were protective measures for child wasting and child stunting at individual and community levels, respectively. The collective action of fathers was positively associated with child stunting at individual level. No association was found between institutional trust and both indicators of child undernutrition at all levels. The individual-level collective action on child stunting was conditional on the community-level social supports. Our findings suggest that existing nutritional strategies in Myanmar may be strengthened by targeting fathers to increase their support in child nutrition and by targeting the community to engage in the nutritional programs with their full support.
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Affiliation(s)
- Thida Win
- University of Medicine, Mandalay, Myanmar
| | | | | | | | - Shigeru Sokejima
- Mie University Hospital, Tsu, Mie, Japan.,Mie University, Tsu, Mie, Japan
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Oguttu JW, Ncayiyana JR. Social capital and self-rated health of residents of Gauteng province: Does area-level deprivation influence the relationship? SSM Popul Health 2020; 11:100607. [PMID: 32637552 PMCID: PMC7330610 DOI: 10.1016/j.ssmph.2020.100607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/13/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022] Open
Abstract
Although social capital has been linked to population health, there is a dearth of studies on the phenomenon especially in sub-Saharan Africa. We investigated the individual and contextual effects of social capital indicators (group membership, registered to vote, perception towards safety in community and generalised trust) on the self-rated health (SRH) of the residents of Gauteng province. We used data from the 2015 Quality of Life (QoL) survey, which included a random representative sample of 27476 residents (level 1) in 508 administrative wards (level 2). We employed a multilevel logistic regression to examine the association of social capital and SRH (good vs poor). After adjusting for individual and area-level factors, no main effect of group membership (Adjusted OR: 0.93: 95% CI: 0.85-1.02), generalised trust (Adjusted OR: 1.01: 95% CI: 0.89-1.49) and registered to vote (Adjusted OR: 0.95; 95% CI: 0.82-1.10) was observed. However, if respondents were positive in their perception towards safety in community, there was a positive association with good SRH (Adjusted OR: 1.15; 95% CI: 1.01-1.31); while if residents reported a negative perception towards safety in community, a strong negative association with good SRH (Adjusted OR: 0.70; 95% CI: 0.62-0.79) was observed. Both ward variance and median odds ratio (MOR) indicate significant differences in good SRH by wards. A strong positive joint effect on the multiplicative scale was observed between satisfied with safety and the ward-level South African Multiple Deprivation Poverty Index (SAMPI), while a strong negative joint effect was also observed on a multiplicative scale between dissatisfied with safety and the SAMPI. Perception of safety in community is the core domain of social capital that significantly impacts the SRH of residents of Gauteng. Although the effect of perception towards safety in community on good SRH is influenced by ward deprivation,the effect is not dependent on the level of deprivation. Contextual factors as evidenced by the persistent MOR, in addition to individual factors, explain variation in reporting good SRH in the study area.
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Affiliation(s)
- James W Oguttu
- Department of Agriculture and Animal Health, College of Agriculture & Environmental Sciences, University of South Africa, Pretoria, South Africa.,Division of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jabulani R Ncayiyana
- Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
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16
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Toivanen S, Tarantino AO, Emmelin M, Östergren PO. Diverting blame to stay sane - young people's strategies for dealing with the mental health effects of precarious employment: a grounded theory study. BMC Public Health 2020; 20:571. [PMID: 32345287 PMCID: PMC7189722 DOI: 10.1186/s12889-020-08626-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Precarious employment is a risk factor for poor mental health, particularly among young adults. Knowledge about how young people maintain their mental health while in a precarious employment situation is scarce. The aim of the study was to explore the meaning of precarious employment for young adults in Sweden and their strategies for maintaining good mental health. METHODS In-depth interviews were conducted with 15 individuals (9 men and 6 women) aged 20-39 years in a precarious employment situation. Contact persons at union offices and at specific job-coaching organizations collaborating with the Swedish public employment agency in the city of Malmö were gate openers to reach informants. Analysis was based on constructivist grounded theory, implying an emergent design where data collection and analysis go hand in hand. RESULTS All informants had completed secondary school in Sweden, and one third had studied at the university level. A majority currently had jobs; however, they were mostly employed on an hourly basis and only a few had temporary full-time jobs. The analysis resulted in a core category "Diverting blame to stay sane," which summarized an emergent coping process involving individual resources and resources represented by the individuals' social capital. The developed theoretical model contained four main categories, "Facing reality," "Losing control," "Adapting," and "Fighting back," related to the core category. CONCLUSIONS The results implied a process where the challenges created by loss of employment-based rights required a coping process where the individual's social capital plays an important role. However, social capital is to a large extent determined by contextual factors, underlining the strong health equity aspect of precarious employment.
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Affiliation(s)
- Susanna Toivanen
- School of Health, Care, and Social Welfare, Mälardalen University, 721 23, Västerås, SE, Sweden.
| | - Anna Olofsson Tarantino
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Lund University, 202 13, Malmö, SE, Sweden.,First Line Clinic, Paediatric Psychiatry (BUP), Skåne University Hospital (SUS), Davidshallsgatan 16, 252 02, Malmö, Sweden
| | - Maria Emmelin
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Lund University, 202 13, Malmö, SE, Sweden
| | - Per-Olof Östergren
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Lund University, 202 13, Malmö, SE, Sweden
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17
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Hung N, Lau LL. The relationship between social capital and self-rated health: a multilevel analysis based on a poverty alleviation program in the Philippines. BMC Public Health 2019; 19:1641. [PMID: 31806012 PMCID: PMC6896750 DOI: 10.1186/s12889-019-8013-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor health is both a cause and consequence of poverty, and there is a growing body of evidence suggesting that social capital is an important factor for improving health in resource-poor settings. International Care Ministries (ICM) is a non-governmental organization in the Philippines that provides a poverty alleviation program called Transform. A core aim of the program is to foster social connectedness and to create a network of support within each community, primarily through consistent community-led small group discussions. The purpose of this research was to investigate the relationship between social capital and self-rated health and how ICM's Transform program may have facilitated changes in those relationships. METHODS Three types of social capital were explored: bonding-structural, bridging-structural and cognitive. Using cross-sectional data collected before and after Transform, multilevel modelling was used to examine their effects on self-rated health between the two time points. RESULTS The analyses showed that while social capital had minimal effects on self-rated health before Transform, a series of associations were identified after the program. Evidence of interdependence between the different types of social capital was also observed: bonding social capital only had a beneficial effect on self-rated health in the presence of bridging social capital, but we found that there was a 17 percentage point increase in self-rated health when individuals possessed all possible bridging and bonding relationships. At the same time, our estimates showed that maximising all forms of social capital is not necessarily constructive, as the positive effect of cognitive social capital on self-rated health was weaker at higher levels of bridging social capital. CONCLUSIONS The results from this study has shown that building social capital can influence the way people perceive their own health, which can be facilitated by intervention programs which seek to create bonding and bridging relationships. Transform's intentional design to learn in community could be relevant to program planners as they develop and evaluate community-based programs, making adaptations as necessary to achieve organisation-specific goals while acknowledging the potential for varied effects when applied in different contexts or circumstances.
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Affiliation(s)
- Natalee Hung
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Lincoln Leehang Lau
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, Canada. .,International Care Ministries, Manila, Philippines.
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18
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Story WT, Glanville JL. Comparing the association between social capital and self-rated health in poor and affluent nations. SSM Popul Health 2019; 9:100508. [PMID: 31998830 PMCID: PMC6978489 DOI: 10.1016/j.ssmph.2019.100508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/25/2019] [Accepted: 10/27/2019] [Indexed: 10/25/2022] Open
Abstract
Country context has been shown to influence the association between social capital and health; however, few studies have examined how the level of societal affluence affects the relationship between social capital and health. Drawing on the study of individual-level socioeconomic variation in the returns to social capital by Uphoff and colleagues (2013), we examine two possible explanations about the differential impact of social capital on health based on country-level socioeconomic variation. The buffer hypothesis posits that social capital will have a greater benefit for poorer (versus more affluent) nations, whereas the dependency hypothesis suggests that social capital will be more beneficial in more affluent (versus poorer) nations. Using Waves 5 and 6 of the World Values Survey, we employed multilevel ordered logistic regression to examine whether national wealth moderates the association between social capital-as measured by particularized and generalized trust-and self-rated health across 72 countries. We also assessed five potential explanations for the moderating role of economic context based on the buffer and dependency hypotheses: institutional effectiveness, economic inequality, coverage of health services, human capital, and access to clean water and sanitation services. In support of the dependency hypothesis, we found that both particularized and generalized trust were associated with self-rated health to a greater extent in more affluent countries than in poorer countries; however, none of the potential explanations that we tested accounted for this pattern. Further, we found that particularized trust was more strongly associated with self-rated health compared to generalized trust across all countries. Future research should focus on the mechanisms by which economic context modifies the relationship between social capital and self-rated health.
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Affiliation(s)
- William T Story
- Department of Community and Behavioral Health, University of Iowa, Iowa City, IA, 52242, USA
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19
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Noguchi T, Kondo K, Saito M, Nakagawa-Senda H, Suzuki S. Community social capital and the onset of functional disability among older adults in Japan: a multilevel longitudinal study using Japan Gerontological Evaluation Study (JAGES) data. BMJ Open 2019; 9:e029279. [PMID: 31597648 PMCID: PMC6797418 DOI: 10.1136/bmjopen-2019-029279] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The present study examined the association between community social capital and the onset of functional disability among older Japanese people by using validated indicators of social capital and a prospective multilevel design. DESIGN Prospective cohort study SETTING: We used data from the Japan Gerontological Evaluation Study, established from August 2010 to January 2012 in 323 districts. PARTICIPANTS The target population was restricted to non-institutionalised people aged 65 years or older who were independent in activities of daily living. Participants included 73 021 people (34 051 men and 38 970 women) who were followed up over a 3-year period. PRIMARY OUTCOME MEASURE The primary outcome measure was the onset of functional disability, defined as a new registration in public long-term care insurance system records with a care-needs level of two or above, analysed with multilevel Cox proportional hazards regression models by community social capital (civic participation, social cohesion and reciprocity). RESULTS The mean age of participants was 73.3 years (SD=6.0) for men and 73.8 years (SD=6.2) for women. During the study period, the onset of functional disability occurred in 1465 (4.3%) men and 1519 (3.9%) women. Of three community social capital variables, social cohesion significantly reduced the risk of onset of functional disability (HR 0.910; 95% CI 0.830 to 0.998) among men, after adjusting for individual social and behavioural variables. There was no significant effect among women. CONCLUSIONS Living in a community with rich social cohesion is associated with a lower incidence of onset of functional disability among older Japanese men.
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Affiliation(s)
- Taiji Noguchi
- Department of Public Health, Nagoya City University, Nagoya, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Katsunori Kondo
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Center for Preventive Medical Science, Chiba University, Chiba, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
| | | | - Sadao Suzuki
- Department of Public Health, Nagoya City University, Nagoya, Japan
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20
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Ir P, Jacobs B, Asante AD, Liverani M, Jan S, Chhim S, Wiseman V. Exploring the determinants of distress health financing in Cambodia. Health Policy Plan 2019; 34:i26-i37. [PMID: 31644799 PMCID: PMC6807511 DOI: 10.1093/heapol/czz006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2019] [Indexed: 11/14/2022] Open
Abstract
Borrowing is a common coping strategy for households to meet healthcare costs in countries where social health protection is limited or non-existent. Borrowing with interest, hereinafter termed distress health financing or distress financing, can push households into heavy indebtedness and exacerbate the financial consequences of healthcare costs. We investigated distress health financing practices and associated factors among Cambodian households, using primary data from a nationally representative household survey of 5000 households. Multivariate logistic regression was used to determine factors associated with distress health financing. Results showed that 28.1% of households consuming healthcare borrowed to pay for that healthcare with 55% of these subjected to distress financing. The median loan was US$125 (US$200 for loans with interest and US$75 for loans without interest). Approximately 50.6% of healthcare-related loans were to pay for the costs of outpatient care in the past month, 45.8% for inpatient care and 3.6% for preventive care in the past 12 months. While the average period to pay off the loan was 8 months, 78% of households were still indebted from loans taken over 12 months before the survey. Distress financing is strongly associated with household poverty-the poorer the household the more likely it is to borrow, fall into debt and unable to pay off the debt-even for members of the health equity funds, a national scheme designed to improve financial access to health services for the poor. Other determinants of distress financing were household size, use of inpatient care and outpatient consultations with private providers or with both private and public providers. In order to ensure effective financial risk protection, Cambodia should establish a more comprehensive and effective social health protection scheme that provides maximum population coverage and prioritizes services for populations at risk of distress financing, especially poorer and larger households.
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Affiliation(s)
- Por Ir
- National Institute of Public Health, Lot No. 80, Street 289, Phnom Penh, Cambodia
| | - Bart Jacobs
- Social Health Protection Programme, Deutsche Gesellschaft für Internationale Zusammenarbeit (GiZ), Lot No. 80, Street 289, Phnom Penh, Cambodia
| | - Augustine D Asante
- School of Public Health & Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Marco Liverani
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Pl, Kings Cross, London, UK
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, 1 King St Newtown, New South Wales, Australia
| | - Srean Chhim
- National Institute of Public Health, Lot No. 80, Street 289, Phnom Penh, Cambodia
| | - Virginia Wiseman
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Pl, Kings Cross, London, UK
- Kirby Institute, University of New South Wales, Wallace Wurth Building, High St, Kensington NSW, Australia
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21
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Karhina K, Eriksson M, Ghazinour M, Ng N. What determines gender inequalities in social capital in Ukraine? SSM Popul Health 2019; 8:100383. [PMID: 31193722 PMCID: PMC6539423 DOI: 10.1016/j.ssmph.2019.100383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/14/2019] [Accepted: 03/05/2019] [Indexed: 11/24/2022] Open
Abstract
Background Social capital is a social determinant of health that has an impact on equity and well-being. It may be unequally distributed among any population. The aims of this study are to investigate the distribution of different forms of social capital between men and women in Ukraine and analyse how potential gender inequalities in social capital might be explained and understood in the Ukrainian context. Method The national representative cross-sectional data from the European Social Survey (wave 6) was used with a sample of 1377 women and 797 men. Seven outcomes that represent cognitive and structural social capital were constructed i.e. institutional trust, generalised trust, reciprocity, safety, as well as bonding, bridging and linking forms. Multivariate logistic regression and post-regression Fairlies decompositions were used for the analyses. Results There are several findings that resulted from the analyses i), access to institutional trust, linking and bridging social capital is very limited; ii), the odds for almost all forms of social capital (besides safety) are lower for men; iii), feeling about income and age explain most of the gender differences and act positively, as well as offsetting the differences. Conclusion Social capital is unequally distributed between different population groups. Some forms of social capital have a stronger buffering effect on women than on men in Ukraine. Reducing gender and income inequalities would probably influence the distribution of social capital within the society. There is a limited access to institutional trust, linking and bridging social capital. The odds for almost all forms of social capital are lower for men (besides safety). Feeling about income and age explain most of the gender differences. Feeling about income and age offset most of the gender differences.
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Affiliation(s)
- K Karhina
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Sweden.,Center for Demographic and Ageing Research, Umeå University, Sweden
| | - M Eriksson
- Department of Social Work, Umeå University, Sweden
| | - M Ghazinour
- Police Education Unit, Umeå University, Sweden
| | - N Ng
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Sweden.,Center for Demographic and Ageing Research, Umeå University, Sweden
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Nandha B, Meenakshy V, Abdul Khader N, Vijayakumar KN, Jambulingam P. Bridging the gap in outreach and compliance with mass drug administration for lymphatic filariasis elimination in an endemic district in Kerala, India: an intervention research approach. HEALTH EDUCATION RESEARCH 2019; 34:300-309. [PMID: 30805648 DOI: 10.1093/her/cyz005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/15/2019] [Indexed: 06/09/2023]
Abstract
Lymphatic filariasis (LF), a neglected tropical disease is targeted for elimination globally by 2020. National Health Policy of India set the goal by 2017 and annual single-dose mass drug administration (MDA) with anti-filarial drugs is in operation in endemic districts since 2004. Performance and effectiveness of MDA was diverse across the nation and prevalence of infection continues above threshold level in 50% of endemic districts which requires alternative strategies. National programme aims at achieving >65% consumption for transmission control. Post 10 rounds of MDA in an endemic district of Kerala state, a three-arm study identified determinants in gap in outreach and consumption, based on which context-dependent intervention using social group work and networking (SGWN) was implemented and impact assessed. A spill over effect with overall increase in coverage and consumption rates irrespective of arms apparently is due to inclusive improvement in MDA programme whereas, significant relative improvement in intervention arm reflects effectiveness of SGWN strategy. Though reduction in microfilaria prevalence in all arms was observed, it was significant between intervention and comparison arm. This study highlights need for context-dependent communication strategy to improve MDA for accelerating LF elimination by the targeted 2020.
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Affiliation(s)
- B Nandha
- Vector Control Research Centre, (Indian Council of Medical Research), Medical Complex, Indira Nagar, Pondicherry, India
| | - V Meenakshy
- Office of the Directorate of Health Services, Tiruvananthapuram, Kerala, India
| | | | - K N Vijayakumar
- Vector Control Research Centre, (Indian Council of Medical Research), Medical Complex, Indira Nagar, Pondicherry, India
| | - P Jambulingam
- Vector Control Research Centre, (Indian Council of Medical Research), Medical Complex, Indira Nagar, Pondicherry, India
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Effects of Subjective Memory Complaints (SMCs) and Social Capital on Self-Rated Health (SRH) in a Semirural Malaysian Population. J Aging Res 2019; 2019:9151802. [PMID: 31093373 PMCID: PMC6481032 DOI: 10.1155/2019/9151802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 02/27/2019] [Accepted: 03/17/2019] [Indexed: 12/18/2022] Open
Abstract
Subjective memory complaints (SMCs) and social capital were known to be related to self-rated health (SRH). Despite this, no studies have examined the potential interaction of SMC and social capital on SRH. Using data from a cross-sectional health survey of men and women aged 56 years and above (n = 6,421), we examined how SMCs and social capital explained SRH in a population of community-dwelling older adults in a semirural area in Malaysia. We also evaluated whether SRH's relationship with SMCs is moderated by social capital. The association of SMC and social capital with poor SRH was investigated using multivariable logistic regression. Social capital (OR = 0.86, 95% CI = 0.82–0.89), mild SMC (OR = 1.70, 95% CI = 1.50–1.94), and moderate SMC (OR = 1.90, 95% CI = 1.63–2.20) were found to be associated with poor SRH after adjustment for sociodemographic factors and depression in the initial regression model. SMC was found to have partial interaction effects with social capital which was included in the subsequent regression model. Unlike individuals with no SMC and mild SMC, those who reported moderate SMC did not show decreasing probabilities of poor SRH despite increasing levels of social capital. Nevertheless, this analysis suggests that social capital and SMC are independent predictors of poor SRH. Further research needs to be targeted at improving the understanding on how social capital and SMC moderate and interact with the perception of health in older adults.
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Amoah PA. Local patterns of social capital and sustenance of the Community-Based Health Planning Services (CHPS) policy: a qualitative comparative study in Ghana. BMJ Open 2019; 9:e023376. [PMID: 30826790 PMCID: PMC6398647 DOI: 10.1136/bmjopen-2018-023376] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Social capital-the resources embedded in social relationships-has been associated with health severally. Notwithstanding, only a handful of studies have empirically examined how it shapes health policies. This paper extends the discourse by comparatively examining how variations in local patterns of structural and cognitive social capital underpin the successes and challenges in managing and sustaining the Community-Based Health Planning Services (CHPS) policy in Ghana. The CHPS is an intervention to address health inequalities. DESIGN Qualitative study involving individual in-depth interviews and focus group discussions using a semi-structured interview guide. Thematic analysis approach, inspired by McConnell's typology of policy success (or failure) was adopted. SETTING Two rural communities in two districts in Ashanti region in Ghana. PARTICIPANTS Thirty-two primary participants as well as four health personnel and four traditional and political leaders. RESULTS Both structural and cognitive components of social capital underpinned efficient functioning of the CHPS initiative regarding funding, patronage and effective information transmission. Sufficient level of social capital in a community enhanced understanding of the nature and purpose of the CHPS policy as well as complementary ones such as the referral policy. Contrary to popular conclusions, it was discovered that the influence of social capital was not necessarily embedded in its quantity but the extent of conscious activation and application. Furthermore, the findings contravened the assertion that social capital may be less potent in small-sized communities. However, elevated levels of cognitive social capital encouraged people to access the CHPS on credit or even for free, which was injurious to its sustenance. CONCLUSION The CHPS initiative, and pro-poor policies alike, are more likely to thrive in localities with sufficient structural and cognitive social capital. Lack of it may render the CHPS susceptible to recurrent, yet preventable challenges.
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Affiliation(s)
- Padmore Adusei Amoah
- Division of Graduate Studies; Asia Pacific Institute of Ageing Studies; Centre for Social Policy and Social Change, Lingnan University, Tuen Mun, Hong Kong
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25
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Reyes S, Giovannoni G, Thomson A. Social capital: Implications for neurology. Brain Behav 2019; 9:e01169. [PMID: 30536750 PMCID: PMC6346418 DOI: 10.1002/brb3.1169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 09/16/2018] [Accepted: 10/25/2018] [Indexed: 01/26/2023] Open
Abstract
Social capital (SC) is a broad term that encompasses the many resources derived from social connections. The contemporary study of SC in public health has deep roots in the related fields of sociology, economics, and politics. Its multidisciplinary nature and the varying potential ways it could affect individuals have resulted in different but overlapping models to approach SC in the health field. There are currently no standardized measures of SC, and even more challenging its impact on health outcomes seems to vary according to the level of analysis. Despite the accumulating evidence that supports a protective effect of SC on mental and physical health, and mortality, not enough attention has been paid to the potential drawbacks of SC. The role of SC in neurological disease is just beginning to be explored. Concerted efforts are needed to ensure that empirical evidence on SC could be properly translated into interventions for health-promoting purposes. In this paper, we review the current state of scientific knowledge on the subject of SC, with a focus on its application in the field of neurology.
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Affiliation(s)
- Saúl Reyes
- Queen Mary University of London, Blizard Institute, London, UK
| | - Gavin Giovannoni
- Queen Mary University of London, Blizard Institute, London, UK.,Barts and The London School of Medicine and Dentistry, London, UK
| | - Alison Thomson
- Queen Mary University of London, Blizard Institute, London, UK
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Joe W, Perkins JM, Subramanian SV. Community involvement, trust, and health-related outcomes among older adults in India: a population-based, multilevel, cross-sectional study. Age Ageing 2019; 48:87-93. [PMID: 30379981 PMCID: PMC6322503 DOI: 10.1093/ageing/afy154] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/30/2018] [Indexed: 11/14/2022] Open
Abstract
Objectives this study examined whether individual and contextual measures of structural and cognitive social capital were associated with six health-related outcomes across older adults in India. Methods data were collected from a representative sample of adults aged 60 and above across India in 2011-12 (n = 9,174). Personal community involvement and having someone to trust represented individual measures of structural and cognitive social capital. These measures were then aggregated to represent contextual measures of social capital, that is, the mean village level of community involvement and the village proportion having someone to trust. To examine associations between all four social capital indicators and six outcomes including self-rated health, psychological well-being, subjective well-being, memory, activities of daily living (ADL), and instrumental activities of daily living, we fit pooled, sex-stratified, and place-stratified multilevel regression models and adjusted for demographic and socio-economic factors. Results personal community involvement was positively associated with all outcomes among the full sample. Adjusted odds ratios ranged from 1.05 (95% CI 1.02; 1.08) for good self-rated health to 1.42 (95% CI 1.33; 1.53) for high-ADL function. Personally having someone to trust was associated with four outcomes. Village-level social capital measures were less frequently associated with outcomes than personal social capital measures. Association strength between six health-related outcomes and individual and contextual measures of structural and cognitive social capital varied, however, among older people in India by sex, place and outcome. Discussion interventions to promote healthy ageing by increasing community involvement and trust may need to be tailored to population subgroups.
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Affiliation(s)
- William Joe
- Population Research Centre, Institute of Economic Growth, Delhi, India; Department of Social and Behavioral Science, Harvard School of Public Health, Boston, MA, USA
| | - Jessica M Perkins
- Department of Human and Organizational Development, Peabody College of Education and Human Development, Vanderbilt University, Nashville, TN, USA; Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - S V Subramanian
- Department of Social and Behavioral Science, Harvard School of Public Health, Boston, MA, USA; Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Berhane HY, Ekström EC, Jirström M, Berhane Y, Turner C, Alsanius BW, Trenholm J. Mixed blessings: A qualitative exploration of mothers' experience of child care and feeding in the rapidly urbanizing city of Addis Ababa, Ethiopia. PLoS One 2018; 13:e0207685. [PMID: 30458024 PMCID: PMC6245682 DOI: 10.1371/journal.pone.0207685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 11/05/2018] [Indexed: 12/02/2022] Open
Abstract
Many studies have drawn attention to the vital role mothers have in safeguarding the health and nutritional wellbeing of their children. However, little is known about mothers’ experiences and the challenges they face in fulfilling this role in rapidly urbanizing cities in Africa. This study aims to explore child care and feeding practices of mothers with children under five years of age in Addis Ababa, Ethiopia. This qualitative study was conducted using a semi-structured interview guide. A total of thirty-six interviews were conducted with purposively selected participants. All interviews were audio recorded, transcribed verbatim and translated for analysis. We used a thematic analysis approach, which was guided by a resilience framework. The findings are presented as three major themes. 1) ‘Mixed blessings-balancing motherhood’s expectations’. While mothers identified positively with the social recognition and sense of fulfillment of being a ‘good mother’, they were ambivalent/torn about earning the necessary income from outside work and fulfilling their duties at home. 2) ‘Instabilities due to rampant urban sprawl’. While women expressed a keen desire to balance work and motherhood, the disintegrating social capital, due to large in-migration, market fluctuations and abrupt/forced resettlements to new housing units had left mothers without support for childcare, stressed and exhausted. 3) ‘Anchored by faith: a source of resilience to cope with adversities’. In the face of the multiple adversities, mothers cited their strong faith as their most reliable foundation for their resilience. In summary, the societal and environmental changes accompanying the rapid urbanization in low income settings makes combining child care and working outside the home very challenging for mothers. As a result they suffer from fatigue and feelings of isolation. Efforts to improve child feeding and care in urban low-income settings need to consider context appropriate strategies that support mothers with small children.
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Affiliation(s)
- Hanna Y. Berhane
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- * E-mail:
| | - Eva-Charlotte Ekström
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
| | - Magnus Jirström
- Department of Human Geography, Lund University, Lund, Sweden
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Christopher Turner
- Department of Human Geography, Lund University, Lund, Sweden
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Beatrix W. Alsanius
- Department of Biosystems and Technology, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - Jill Trenholm
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
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Social capital insights from Healthy Settings needs assessment in Malawi. PLoS One 2018; 13:e0206156. [PMID: 30339678 PMCID: PMC6195280 DOI: 10.1371/journal.pone.0206156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/07/2018] [Indexed: 11/19/2022] Open
Abstract
Despite global health improvements, substantial challenges in social determinants of health and poverty remain in rural communities in low-income countries. Public health theorists suggest that communities with high social capital are less vulnerable to such challenges and more likely to participate in community development. This research examines levels of social capital amongst rural communities in southern Malawi through data gathered as part of a participatory needs assessment for a Healthy Settings project, and discusses the potential benefits of having access to such data before project implementation. Social capital data was collected during 108 focus group discussions in 18 communities (split by gender, age, status) by adapting an existing mixed methods measurement tool, the Schutte tool. Five indicators were measured: sense of belonging, friendship, reliance, ability to work together and influence. Mean results showed all 18 communities had medium-high levels of social capital. Means from each group in the 18 communities highlighted the lowest social capital among the youth groups and the highest with the leaders. A more detailed breakdown highlighted that all groups had a strong sense of belonging to the community, while youth and women had lower social capital levels in terms of influence over local decisions and ability to rely on other community members. Incorporating social capital tools into community health needs assessments in low-income settings provides a valuable overview of community dynamics before project implementation, and Monitoring & Evaluation indicators which allow changes in social capital to be measured at different stages of the project.
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Amoah PA, Koduah AO, Gyasi RM. "Who'll do all these if I'm not around?": Bonding social capital and health and well-being of inpatients. Int J Qual Stud Health Well-being 2018; 13:1435108. [PMID: 29447613 PMCID: PMC5827639 DOI: 10.1080/17482631.2018.1435108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: Although social capital influences health-related decisions and behavioural patterns in many developing countries, minimal attention has been paid to the nuances of its effect on healthcare. This paper examines how bonding social capital affects healthcare delivery for inpatients in Ghana. Methods: Semi-structured in-depth interviews were used and thematic analysis method employed to analyse the data. Interviews were conducted with health professionals and relatives and close friends of inpatients in three public health facilities in Ashanti region. Results: Relatives and close friends of inpatients were a critical source of instrumental support such as provision of meals, laundry services, running errands and financial assistance as well as emotional support. These functions—that were both ‘expected’ and ‘encouraged’— reduced the burden on the health facilities, which apparently had limited resources to offer adequate care. However, the relatives of inpatients sometimes inadvertently obstructed efficient healthcare delivery through actions such as extending ‘unapproved’ alternative care to patients. Moreover, the process of contributing towards health and well-being of the sick exposed the relatives to health risks due to poor living conditions. Conclusion: A well-defined and befitting role must be devised for at least an immediate social relation of inpatients to improve the positive effects of bonding social capital on healthcare delivery.
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Affiliation(s)
- Padmore Adusei Amoah
- a Division of Graduate Studies and Asia Pacific Institute of Aging Studies , Lingnan University , Tuen Mun , Hong Kong (SAR)
| | | | - Razak Mohammed Gyasi
- c Department of Sociology and Social Policy , Lingnan University , Tuen Mun , Hong Kong (SAR)
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Djellouli N, Mann S, Nambiar B, Meireles P, Miranda D, Barros H, Bocoum FY, Yaméogo WME, Yaméogo C, Belemkoabga S, Tougri H, Coulibaly A, Kouanda S, Mochache V, Mwakusema OK, Irungu E, Gichangi P, Dembo Z, Kadzakumanja A, Makwenda CV, Timóteo J, Cossa MG, de Melo M, Griffin S, Osman NB, Foia S, Ogbe E, Duysburgh E, Colbourn T. Improving postpartum care delivery and uptake by implementing context-specific interventions in four countries in Africa: a realist evaluation of the Missed Opportunities in Maternal and Infant Health (MOMI) project. BMJ Glob Health 2017; 2:e000408. [PMID: 29225949 PMCID: PMC5717926 DOI: 10.1136/bmjgh-2017-000408] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 10/13/2017] [Accepted: 10/18/2017] [Indexed: 11/11/2022] Open
Abstract
Postpartum care (PPC) has remained relatively neglected in many interventions designed to improve maternal and neonatal health in sub-Saharan Africa. The Missed Opportunities in Maternal and Infant Health project developed and implemented a context-specific package of health system strengthening and demand generation in four African countries, aiming to improve access and quality of PPC. A realist evaluation was conducted to enable nuanced understanding of the influence of different contextual factors on both the implementation and impacts of the interventions. Mixed methods were used to collect data and test hypothesised context–mechanism–outcome configurations: 16 case studies (including interviews, observations, monitoring data on key healthcare processes and outcomes), monitoring data for all study health facilities and communities, document analysis and participatory evaluation workshops. After evaluation in individual countries, a cross-country analysis was conducted that led to the development of four middle-range theories. Community health workers (CHWs) were key assets in shifting demand for PPC by ‘bridging’ communities and facilities. Because they were chosen from the community they served, they gained trust from the community and an intrinsic sense of responsibility. Furthermore, if a critical mass of women seek postpartum healthcare as a result of the CHWs bridging function, a ‘buzz’ for change is created, leading eventually to the acceptability and perceived value of attending for PPC that outweighs the costs of attending the health facility. On the supply side, rigid vertical hierarchies and defined roles for health facility workers (HFWs) impede integration of maternal and infant health services. Additionally, HFWs fear being judged negatively which overrides the self-efficacy that could potentially be gained from PPC training. Instead the main driver of HFWs’ motivation to provide comprehensive PPC is dependent on accountability systems for delivering PPC created by other programmes. The realist evaluation offers insights into some of the contextual factors that can be pivotal in enabling the community-level and service-level interventions to be effective.
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Affiliation(s)
| | - Sue Mann
- UCL Institute for Global Health, London, UK
| | | | - Paula Meireles
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Diana Miranda
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Henrique Barros
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Fadima Y Bocoum
- Institutde Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - W Maurice E Yaméogo
- Institutde Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Clarisse Yaméogo
- Institutde Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Sylvie Belemkoabga
- Institutde Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Halima Tougri
- Institutde Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Abou Coulibaly
- Institutde Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Seni Kouanda
- Institutde Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Vernon Mochache
- International Centre for Reproductive Health-Kenya (ICRHK), Mombasa, Kenya
| | - Omar K Mwakusema
- International Centre for Reproductive Health-Kenya (ICRHK), Mombasa, Kenya
| | - Eunice Irungu
- International Centre for Reproductive Health-Kenya (ICRHK), Mombasa, Kenya
| | - Peter Gichangi
- International Centre for Reproductive Health-Kenya (ICRHK), Mombasa, Kenya
| | - Zione Dembo
- Parent and Child Health Initiative (PACHI), Lilongwe, Malawi
| | | | | | - Judite Timóteo
- International Centre for Reproductive Health-Mozambique (ICRHM), Maputo, Mozambique
| | - Misete G Cossa
- International Centre for Reproductive Health-Mozambique (ICRHM), Maputo, Mozambique
| | - Malica de Melo
- International Centre for Reproductive Health-Mozambique (ICRHM), Maputo, Mozambique
| | - Sally Griffin
- International Centre for Reproductive Health-Mozambique (ICRHM), Maputo, Mozambique
| | - Nafissa B Osman
- Faculdade de Medicina, Universidade Eduardo Mondlane (UEM), Maputo, Mozambique
| | - Severiano Foia
- Faculdade de Medicina, Universidade Eduardo Mondlane (UEM), Maputo, Mozambique.,Chiúta District Health Department, Tete, Mozambique
| | - Emilomo Ogbe
- International Centre for Reproductive Health of the Ghent University (UG-ICRH), Ghent, Belgium
| | - Els Duysburgh
- International Centre for Reproductive Health of the Ghent University (UG-ICRH), Ghent, Belgium
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Sacks E, Swanson RC, Schensul JJ, Gleave A, Shelley KD, Were MK, Chowdhury AM, LeBan K, Perry HB. Community Involvement in Health Systems Strengthening to Improve Global Health Outcomes: A Review of Guidelines and Potential Roles. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2017; 37:139-149. [PMID: 29086630 DOI: 10.1177/0272684x17738089] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Definitions of health systems strengthening (HSS) have been limited in their inclusion of communities, despite evidence that community involvement improves program effectiveness for many health interventions. We review 15 frameworks for HSS, highlighting how communities are represented and find few delineated roles for community members or organizations. This review raises the need for a cohesive definition of community involvement in HSS and well-described activities that communities can play in the process. We discuss how communities can engage with HSS in four different areas-planning and priority-setting; program implementation; monitoring, evaluation, and quality improvement; and advocacy-and how these activities could be better incorporated into key HSS frameworks. We argue for more carefully designed interactions between health systems policies and structures, planned health systems improvements, and local communities. These interactions should consider local community inputs, strengths, cultural and social assets, as well as limitations in and opportunities for increasing capacity for better health outcomes.
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Affiliation(s)
- Emma Sacks
- 1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Anna Gleave
- 4 15851 School of Nursing, Johns Hopkins University , Baltimore, MD, USA
| | - Katharine D Shelley
- 1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Karen LeBan
- 7 USAID's Maternal and Child Survival Program (MCSP), 10822 CORE Group , Washington, DC, USA
| | - Henry B Perry
- 1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Agampodi TC, Rheinländer T, Agampodi SB, Glozier N, Siribaddana S. Social capital and health during pregnancy; an in-depth exploration from rural Sri Lanka. Reprod Health 2017; 14:89. [PMID: 28750663 PMCID: PMC5531101 DOI: 10.1186/s12978-017-0349-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 07/07/2017] [Indexed: 12/05/2022] Open
Abstract
Background Dimensions of social capital relevant to health in pregnancy are sparsely described in the literature. This study explores dimensions of social capital and the mechanisms in which they could affect the health of rural Sri Lankan pregnant women. Methods An exploratory qualitative study of solicited diaries written by pregnant women on their social relationships, diary interviews and in-depth interviews with key informants was conducted. A framework approach for qualitative data analysis was used. Results Pregnant women (41), from eight different communities completed diaries and 38 post-diary interviews. Sixteen key informant interviews were conducted with public health midwives and senior community dwellers. We identified ten cognitive and five structural constructs of social capital relevant to health in pregnancy. Domestic and neighborhood cohesion were the most commonly expressed constructs. Social support was limited to support from close family, friends and public health midwives. A high density of structural social capital was observed in the micro-communities. Membership in local community groups was not common. Four different pathways by which social capital could influence health in pregnancy were identified. These include micro-level cognitive social capital by promoting mental wellbeing; micro-level structural social capital by reducing minor ailments in pregnancy; micro-level social support mechanisms promoting physical and mental wellbeing through psychosocial resources and health systems at each level providing focused maternal care. Conclusion Current tools available may not contain the relevant constructs to capture the unique dimensions of social capital in pregnancy. Social capital can influence health during pregnancy, mainly through improved psychosocial resources generated by social cohesion in micro-communities and by the embedded neighborhood public health services.
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Affiliation(s)
- Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka. .,Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
| | - Thilde Rheinländer
- Department Of Public Health, Global Health Section, University of Copenhagen, København, Denmark
| | - Suneth Buddhika Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Nicholas Glozier
- Brain and Mind Research Institute & Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
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Kang Y, Kim J, Seo E. Association between maternal social capital and infant complementary feeding practices in rural Ethiopia. MATERNAL AND CHILD NUTRITION 2017; 14. [PMID: 28714283 DOI: 10.1111/mcn.12484] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 05/08/2017] [Accepted: 06/07/2017] [Indexed: 11/29/2022]
Abstract
Few studies have explored the potential of social capital in improving child nutritional status; however, most components of pathways between social capital and nutritional status have remained unexplained. Complementary feeding practice is a strong mediator of child nutritional status. This study examined the association between complementary feeding practice and maternal social capital in rural Ethiopia, using cross-sectional data of infant aged 6-12 months and their mother pairs (n = 870). The Short Social Capital Assessment Tool was used to assess maternal structural (i.e., community group membership, having emotional/economic support from individuals, and citizenship activities) and cognitive social capital (i.e., trust, social harmony, and sense of belonging) in the past 12 months. Infant's dietary diversity score (DDS, range: 0-7), minimum dietary diversity (MDD), and minimum meal frequency (MMF) were assessed using a 24-hr dietary recall. Multivariable ordinal/binary logistic regression analyses were conducted. Having support from two or more individuals was associated with higher DDS (OR = 1.84) and meeting a minimum level of dietary diversity (MDD: OR = 5.20) but not with MMF, compared to those having no support. Having two or more group memberships was associated with higher DDS (OR = 2.2) but not with MDD or MMF, compared to those without group membership. Citizenship activities showed mixed associations with MMF and no association with DDS or MDD. Cognitive social capital showed no association with DDS or MDD and lower odds of meeting MMF (OR = 0.56). These mixed results call for further studies to examine other potential pathways (e.g., hygiene and caring behaviours) in which social capital could improve child nutritional status.
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Affiliation(s)
- Yunhee Kang
- Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jane Kim
- Independent Consultant, Baltimore, Maryland, USA
| | - Eunkyo Seo
- International Ministry Division, World Vision Korea, Seoul, South Korea
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Schröders J, Wall S, Hakimi M, Dewi FST, Weinehall L, Nichter M, Nilsson M, Kusnanto H, Rahajeng E, Ng N. How is Indonesia coping with its epidemic of chronic noncommunicable diseases? A systematic review with meta-analysis. PLoS One 2017; 12:e0179186. [PMID: 28632767 PMCID: PMC5478110 DOI: 10.1371/journal.pone.0179186] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 05/07/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Chronic noncommunicable diseases (NCDs) have emerged as a huge global health problem in low- and middle-income countries. The magnitude of the rise of NCDs is particularly visible in Southeast Asia where limited resources have been used to address this rising epidemic, as in the case of Indonesia. Robust evidence to measure growing NCD-related burdens at national and local levels and to aid national discussion on social determinants of health and intra-country inequalities is needed. The aim of this review is (i) to illustrate the burden of risk factors, morbidity, disability, and mortality related to NCDs; (ii) to identify existing policy and community interventions, including disease prevention and management strategies; and (iii) to investigate how and why an inequitable distribution of this burden can be explained in terms of the social determinants of health. METHODS Our review followed the PRISMA guidelines for identifying, screening, and checking the eligibility and quality of relevant literature. We systematically searched electronic databases and gray literature for English- and Indonesian-language studies published between Jan 1, 2000 and October 1, 2015. We synthesized included studies in the form of a narrative synthesis and where possible meta-analyzed their data. RESULTS On the basis of deductive qualitative content analysis, 130 included citations were grouped into seven topic areas: risk factors; morbidity; disability; mortality; disease management; interventions and prevention; and social determinants of health. A quantitative synthesis meta-analyzed a subset of studies related to the risk factors smoking, obesity, and hypertension. CONCLUSIONS Our findings echo the urgent need to expand routine risk factor surveillance and outcome monitoring and to integrate these into one national health information system. There is a stringent necessity to reorient and enhance health system responses to offer effective, realistic, and affordable ways to prevent and control NCDs through cost-effective interventions and a more structured approach to the delivery of high-quality primary care and equitable prevention and treatment strategies. Research on social determinants of health and policy-relevant research need to be expanded and strengthened to the extent that a reduction of the total NCD burden and inequalities therein should be treated as related and mutually reinforcing priorities.
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Affiliation(s)
- Julia Schröders
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Stig Wall
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mohammad Hakimi
- Centre for Reproductive Health, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fatwa Sari Tetra Dewi
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lars Weinehall
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
| | - Mark Nichter
- School of Anthropology, College of Social and Behavioral Sciences, The University of Arizona, Tucson, United States of America
| | - Maria Nilsson
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Hari Kusnanto
- Department of Family Medicine, Community Medicine and Bioethics, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ekowati Rahajeng
- Center for Public Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta, Republic of Indonesia
| | - Nawi Ng
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
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Story WT, Carpiano RM. Household social capital and socioeconomic inequalities in child undernutrition in rural India. Soc Sci Med 2017; 181:112-121. [DOI: 10.1016/j.socscimed.2017.03.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 03/16/2017] [Accepted: 03/19/2017] [Indexed: 11/29/2022]
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Saito M, Kondo N, Aida J, Kawachi I, Koyama S, Ojima T, Kondo K. Development of an instrument for community-level health related social capital among Japanese older people: The JAGES Project. J Epidemiol 2017; 27:221-227. [PMID: 28169107 PMCID: PMC5394224 DOI: 10.1016/j.je.2016.06.005] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 06/17/2016] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND We developed and validated an instrument to measure community-level social capital based on data derived from older community dwellers in Japan. METHODS We used cross-sectional data from the Japan Gerontological Evaluation Study, a nationwide survey involving 123,760 functionally independent older people nested within 702 communities (i.e., school districts). We conducted exploratory and confirmatory factor analyses on survey items to determine the items in a multi-dimensional scale to measure community social capital. Internal consistency was checked with Cronbach's alpha. Convergent construct validity was assessed via correlating the scale with health outcomes. RESULTS From 53 candidate variables, 11 community-level variables were extracted: participation in volunteer groups, sports groups, hobby activities, study or cultural groups, and activities for teaching specific skills; trust, norms of reciprocity, and attachment to one's community; received emotional support; provided emotional support; and received instrumental support. Using factor analysis, these variables were determined to belong to three sub-scales: civic participation (eigenvalue = 3.317, α = 0.797), social cohesion (eigenvalue = 2.633, α = 0.853), and reciprocity (eigenvalue = 1.424, α = 0.732). Confirmatory factor analysis indicated the goodness of fit of this model. Multilevel Poisson regression analysis revealed that civic participation score was robustly associated with individual subjective health (Self-Rated Health: prevalence ratio [PR] 0.96; 95% confidence interval [CI], 0.94-0.98; Geriatric Depression Scale [GDS]: PR 0.95; 95% CI, 0.93-0.97). Reciprocity score was also associated with individual GDS (PR 0.98; 95% CI, 0.96-1.00). Social cohesion score was not consistently associated with individual health indicators. CONCLUSIONS Our scale for measuring social capital at the community level might be useful for future studies of older community dwellers.
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Affiliation(s)
- Masashige Saito
- Department of Social Welfare, Nihon Fukushi University, Aichi, Japan; Center for Well-being and Society, Nihon Fukushi University, Nagoya, Japan.
| | - Naoki Kondo
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Shihoko Koyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Katsunori Kondo
- Center for Well-being and Society, Nihon Fukushi University, Nagoya, Japan; Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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Myroniuk TW, Vanneman R, Desai S. Getting a Child Through Secondary School and To College in India: The Role of Household Social Capital. SOCIOLOGY OF DEVELOPMENT (OAKLAND, CALIF.) 2017; 3:24-46. [PMID: 28393109 PMCID: PMC5381932 DOI: 10.1525/sod.2017.3.1.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In the classic formulations of social capital theory, families employ their social capital resources to enhance other capitals, in particular their human capital investments. Social capital would seem to be especially important in the case of India where, in recent years, higher education has been under considerable stress with rising educational demand, inadequate supply, and little parental experience to guide their children's transition through the education system. We use the 2005 and 2012 waves of the nationally representative India Human Development Survey (IHDS) to show how relatively high status connections advantage some families' chances of their children reaching educational milestones such as secondary school completion and college entry. The 2005 IHDS survey measure of a household's formal sector contacts in education, government, and health predicts their children's educational achievements by the second wave, seven years later, controlling for households' and children's initial backgrounds.
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Affiliation(s)
- Tyler W Myroniuk
- Population Studies & Training Center, Brown University, 68 Waterman Street, Providence, RI, USA, 02912
| | - Reeve Vanneman
- Department of Sociology, University of Maryland, 2112 Art-Sociology Building, College Park, MD, USA, 20742
| | - Sonalde Desai
- Department of Sociology, University of Maryland, 2112 Art-Sociology Building, College Park, MD, USA, 20742
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Kim J, Kim JH, Sychareun V, Kang M. Recovering disrupted social capital: insights from Lao DPR rural villagers' perceptions of local leadership. BMC Public Health 2016; 16:1189. [PMID: 27884133 PMCID: PMC5123331 DOI: 10.1186/s12889-016-3858-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 11/18/2016] [Indexed: 11/29/2022] Open
Abstract
Background Social capital is often believed to be one of the key prerequisites for successful implementation of community-based health programs. In less-developed countries, local leaders are positioned as major players in broad community health strategies and interventions, and their capacities and roles are expected to increase in prominence in future community-health-care promotions. In this study, we examined how local leaders’ capacities could be related to social capital in rural villages in Lao PDR, and thus to villagers’ willingness to participate in community-based health efforts. Methods We adopted a qualitative approach, conducting semi-structured interviews for both individuals and focus groups. In 2012, 103 people from six villages in the Khoun and Phoukoud districts participated in the interviews. For the individual interviews, we interviewed 22 mothers who had given birth in the past 5 years. For the focus groups, we interviewed 30 women (six groups), 30 men (six groups), and 21 senior villagers (five groups). Results First, we noted large variations in the levels of community social capital across villages: four out of six study villages showed a high level of social capital, while two villages suffered greatly from a low level of social capital. In search of the reasons for the disrupted social capital in the latter two villages, interviews revealed that failed leadership, especially in regard to local resource allocations—lack of transparency and corrupt practices—were commonly cited reasons for disrupted social capital. The data also showed that the villagers’ mistrust of these failed local leaders critically reduced their willingness to participate in community-based health efforts, and especially in those that involved resource mobilization and risk-sharing for healthcare. Finally, we found that good communication skills and participatory decision-making styles were attributes that rural villagers in Lao PDR expected of their local leaders. Conclusion This study suggests that failed local leadership is detrimental to community participation, resource mobilization, and building communities’ social capital. To achieve intended health care goals through community-based interventions, there is a need to first support local leadership at all levels through capacity-building and improved communication within communities.
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Affiliation(s)
- Jinho Kim
- Department of Sociology, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI, 53706, USA
| | - Ji-Hye Kim
- Department of Curriculum and Instruction, University of Wisconsin-Madison, 210 Teacher Education Building 225 North Mills Street, Madison, WI, 53706, USA
| | - Vanphanom Sychareun
- Faculty of Postgraduate Study, University of Health Sciences, Vientiane, Laos
| | - Minah Kang
- Department of Public Administration, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemun-Gu, Seoul, 120-750, Korea.
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George AS, Scott K, Mehra V, Sriram V. Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review. BMC Health Serv Res 2016; 16:623. [PMID: 28185589 PMCID: PMC5123247 DOI: 10.1186/s12913-016-1860-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Community capability is the combined influence of a community’s social systems and collective resources that can address community problems and broaden community opportunities. We frame it as consisting of three domains that together support community empowerment: what communities have; how communities act; and for whom communities act. We sought to further understand these domains through a secondary analysis of a previous systematic review on community participation in health systems interventions in low and middle income countries (LMICs). Methods We searched for journal articles published between 2000 and 2012 related to the concepts of “community”, “capability/participation”, “health systems research” and “LMIC.” We identified 64 with rich accounts of community participation involving service delivery and governance in health systems research for thematic analysis following the three domains framing community capability. Results When considering what communities have, articles reported external linkages as the most frequently gained resource, especially when partnerships resulted in more community power over the intervention. In contrast, financial assets were the least mentioned, despite their importance for sustainability. With how communities act, articles discussed challenges of ensuring inclusive participation and detailed strategies to improve inclusiveness. Very little was reported about strengthening community cohesiveness and collective efficacy despite their importance in community initiatives. When reviewing for whom communities act, the importance of strong local leadership was mentioned frequently, while conflict resolution strategies and skills were rarely discussed. Synergies were found across these elements of community capability, with tangible success in one area leading to positive changes in another. Access to information and opportunities to develop skills were crucial to community participation, critical thinking, problem solving and ownership. Although there are many quantitative scales measuring community capability, health systems research engaged with community participation has rarely made use of these tools or the concepts informing them. Overall, the amount of information related to elements of community capability reported by these articles was low and often of poor quality. Conclusions Strengthening community capability is critical to ensuring that community participation leads to genuine empowerment. Our simpler framework to define community capability may help researchers better recognize, support and assess it.
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Affiliation(s)
- Asha S George
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. .,South African Research Chair in Health Systems, Complexity and Social Change, School of Public Health, University of Western Cape, Cape Town, South Africa.
| | - Kerry Scott
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Global health consultant, Bangalore, India
| | - Vrinda Mehra
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Veena Sriram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Asadi-Lari M, Hassanzadeh J, Torabinia M, Vaez-Mahdavi MR, Montazeri A, Ghaem H, Menati R, Niazi M, Kassani A. Identifying associated factors with social capital using path analysis: A population-based survey in Tehran, Iran (Urban HEART-2). Med J Islam Repub Iran 2016; 30:414. [PMID: 28210579 PMCID: PMC5307624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 01/18/2016] [Indexed: 11/28/2022] Open
Abstract
Background: Social capital has been defined as norms, networks, and social links that facilitate collective actions. Social capital is related to a number of main social and public health variables. Therefore, the present study aimed to determine the factors associated with social capital among the residents of Tehran, Iran. Methods: In this large cross-sectional population-based study, 31531 residents aged 20 years and above were selected through multi-stage sampling method from 22 districts of Tehran in 2011. The social capital questionnaire, 28-item General Health Questionnaire (GHQ-28), and Short-Form Health Survey (SF-12) were used. Hypothetical causal models were designed to identify the pathways through which different variables influenced the components of social capital. Then, path analysis was conducted for identifying the determinants of social capital. Results: The most influential variables in 'individual trust' were job status (β=0.37, p=0.02), marital status (β=0.32, p=0.01), Physical Component Summary (PCS) (β=0.37, p=0.02), and age (β=0.34, p=0.03). On the other hand, education level (β=0.34, p=0.01), age (β=0.33, p=0.02), marital status (β=0.33, p=0.01), and job status (β=0.32, p=0.01) were effective in 'cohesion and social support'. Additionally, age (β=0.18, p=0.02), PCS (β=0.36, p=0.01), house ownership (β=0.23, p=0.03), and mental health (β=0.26, p=0.01) were influential in 'social trust/collective relations'. Conclusion: Social capital can be improved in communities by planning to improve education and occupation status, paying more attention to strengthening family bonds, and provision of local facilities and neighborhood bonds to reduce migration within the city.
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Affiliation(s)
- Mohsen Asadi-Lari
- Associate Professor of Epidemiology, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Jafar Hassanzadeh
- Professor of Epidemiology, Research Center for Health Sciences, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mansour Torabinia
- Assistant Professor of Psychiatry, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran.
| | | | - Ali Montazeri
- Professor, Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
| | - Haleh Ghaem
- Assistant Professor of Epidemiology, Research Center for Health Sciences, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Rostam Menati
- PhD Student of Sociology, Prevention of Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.
| | - Mohsen Niazi
- Professor of Sociology, Department of Sociology, Faculty of Social Sciences, University of Kashan, Kashan, Iran.
| | - Aziz Kassani
- Assistant Professor of Epidemiology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran.
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Social capital and health in Kenya: A multilevel analysis. Soc Sci Med 2016; 167:11-9. [PMID: 27597538 DOI: 10.1016/j.socscimed.2016.08.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 08/23/2016] [Accepted: 08/27/2016] [Indexed: 11/20/2022]
Abstract
Despite the acknowledgment that social capital is an important predictor of good health and overall well being in wealthy countries, little empirical research has been conducted in developing countries, particularly in Africa, to examine this relationship. This study examines the association between cognitive (trust) and structural (membership in organization) social capital on health at both the individual and contextual levels. Health was measured using answers to a subjective question on physical health and anxiety/worry suffered by individuals within the last 30 days. This study utilized Afrobarometer data collected in Kenya in 2005 to examine this relationship using multilevel logistic statistical modeling. Upon controlling for socioeconomic and demographic factors, social capital was found to be significantly associated with anxiety/worry and physical health in Kenya. Membership in organizations was associated with increased odds (OR = 1.34, 95%CI: 1.02-1.76) of physical health problems, while individual trust was associated with a 6% (OR = 0.94, 95%CI: 0.90-0.99) reduction in the likelihood of physical health problems. Conversely, generalized trust was associated with a 37% reduction in the odds (OR = 0.63, 95%CI: 0.40-0.99) of anxiety/worry, while individual trust was associated with a 5% reduction (OR = 0.95, 95%CI: 0.90-1.00) of anxiety/worry. With the exception of membership in an organization that exacerbates physical health, both individual level trust and generalized trust were associated with better health outcomes in Kenya. The availability of social organizations at the contextual level was associated with worsening anxiety/worry although the effect size was small. These results show that social capital, particularly trust, is a concept that can apply to different social and cultural contexts and can potentially be harnessed to improve health in settings that suffer from resource poverty.
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Brasington A, Abdelmegeid A, Dwivedi V, Kols A, Kim YM, Khadka N, Rawlins B, Gibson A. Promoting Healthy Behaviors among Egyptian Mothers: A Quasi-Experimental Study of a Health Communication Package Delivered by Community Organizations. PLoS One 2016; 11:e0151783. [PMID: 26989898 PMCID: PMC4798575 DOI: 10.1371/journal.pone.0151783] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 03/03/2016] [Indexed: 11/18/2022] Open
Abstract
Decisions made at the household level, for example, to seek antenatal care or breastfeed, can have a direct impact on the health of mothers and newborns. The SMART Community-based Initiatives program in Egypt worked with community development associations to encourage better household decision-making by training community health workers to disseminate information and encourage healthy practices during home visits, group sessions, and community activities with pregnant women, mothers of young children, and their families. A quasi-experimental design was used to evaluate the program, with household surveys conducted before and after the intervention in intervention and comparison areas. Survey questions asked about women's knowledge and behaviors related to maternal and newborn care and child nutrition and, at the endline, exposure to SMART activities. Exposure to program activities was high in intervention areas of Upper Egypt: 91% of respondents reported receiving home visits and 84% attended group sessions. In Lower Egypt, these figures were 58% and 48%, respectively. Knowledge of danger signs related to pregnancy, delivery, and newborn illness increased significantly more in intervention than comparison areas in both regions (with one exception in Lower Egypt), after controlling for child's age and woman's education; this pattern also occurred for two of five behaviors (antenatal care visits and consumption of iron-folate tablets). Findings suggest that there may have been a significant dose-response relationship between exposure to SMART activities and certain knowledge and behavioral indicators, especially in Upper Egypt. The findings demonstrate the ability of civil society organizations with minimal health programming experience to increase knowledge and promote healthy behaviors among pregnant women and new mothers. The SMART approach offers a promising strategy to fill gaps in health education and counseling and strengthen community support for behavior change.
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Affiliation(s)
- Angela Brasington
- Maternal and Child Survival Program, Save the Children, Washington, DC, United States of America
| | - Ali Abdelmegeid
- Maternal and Child Survival Program, Jhpiego, Washington, DC, United States of America
| | - Vikas Dwivedi
- Maternal and Child Survival Program, John Snow, Inc., Boston, Massachusetts, United States of America
| | - Adrienne Kols
- Jhpiego, Baltimore, Maryland, United States of America
| | - Young-Mi Kim
- Jhpiego, Baltimore, Maryland, United States of America
| | - Neena Khadka
- Maternal and Child Survival Program, Save the Children, Washington, DC, United States of America
| | - Barbara Rawlins
- Maternal and Child Survival Program, Jhpiego, Washington, DC, United States of America
| | - Anita Gibson
- Maternal and Child Survival Program, Save the Children, Washington, DC, United States of America
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Hu F, Niu L, Chen R, Ma Y, Qin X, Hu Z. The association between social capital and quality of life among type 2 diabetes patients in Anhui province, China: a cross-sectional study. BMC Public Health 2015; 15:786. [PMID: 26276271 PMCID: PMC4542125 DOI: 10.1186/s12889-015-2138-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 08/11/2015] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To investigate the association between social capital and quality of life among type 2 diabetes patients in Anhui province, China. METHODS In a cross-sectional study, 436 adults with type 2 diabetes were interviewed. The two domains of Quality of life, physical component summary (PCS) and mental component summary (MCS), were measured using the Short-Form Health Survey (SF-36). A modified instrument scale was used to measure cognitive and structural social capital. Multiple logistic regression models were used to assess the associations between social capital and quality of life, adjusting for social economic status and risk factors for health. RESULTS 24.3 % of participants (106) were in poor PCS and 25.0 % (109) in poor MCS. The proportions of participants who had low cognitive and structural social capital were 47.0 % (205) and 64.4 % (281), respectively. Results of logistic regression models showed that cognitive social capital was positively associated with PCS (OR = 1.84; 95 % CI: 1.12, 3.02) and MCS (OR = 1.65; 95 % CI: 1.03, 2.66). However, the associations between structural social capital and PCS (OR = 0.80, 95 % CI: 0.48, 1.34) and MCS (OR = 0.62; 95 % CI: 0.38, 1.01) were not statistically significant. CONCLUSIONS It is the first study in China to investigate associations between quality of life and social capital in type 2 diabetes. Findings document that cognitive social capital is associated with the quality of life of type 2 diabetes patients. Our study suggests that the social capital theory may provide a new approach to increase physical resources in diabetes prevention and control, especially in Low and Middle Income countries (LMICs).
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Affiliation(s)
- Fuyong Hu
- Hefei Second People's Hospital, Hefei, China. .,School of Health Services Management, Anhui Medical University, No. 81, Meishan Road, Hefei, 230032, Anhui, China.
| | - Li Niu
- The First Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Ren Chen
- School of Health Services Management, Anhui Medical University, No. 81, Meishan Road, Hefei, 230032, Anhui, China.
| | - Ying Ma
- School of Health Services Management, Anhui Medical University, No. 81, Meishan Road, Hefei, 230032, Anhui, China.
| | - Xia Qin
- School of Health Services Management, Anhui Medical University, No. 81, Meishan Road, Hefei, 230032, Anhui, China.
| | - Zhi Hu
- School of Health Services Management, Anhui Medical University, No. 81, Meishan Road, Hefei, 230032, Anhui, China.
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Agampodi TC, Agampodi SB, Glozier N, Siribaddana S. Measurement of social capital in relation to health in low and middle income countries (LMIC): a systematic review. Soc Sci Med 2015; 128:95-104. [PMID: 25596373 DOI: 10.1016/j.socscimed.2015.01.005] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Social capital is a neglected determinant of health in low and middle income countries. To date, majority of evidence syntheses on social capital and health are based upon high income countries. We conducted this systematic review to identify the methods used to measure social capital in low and middle-income countries and to evaluate their relative strengths and weaknesses. An electronic search was conducted using Pubmed, Science citation index expanded, Social science citation index expanded, Web of knowledge, Cochrane, Trip, Google scholar and selected grey literature sources. We aimed to include all studies conducted in low and middle-income countries, published in English that have measured any aspect of social capital in relation to health in the study, from 1980 to January 2013. We extracted data using a data extraction form and performed narrative synthesis as the measures were heterogeneous. Of the 472 articles retrieved, 46 articles were selected for the review. The review included 32 studies from middle income countries and seven studies from low income countries. Seven were cross national studies. Most studies were descriptive cross sectional in design (n = 39). Only two randomized controlled trials were included. Among the studies conducted using primary data (n = 32), we identified18 purposely built tools that measured various dimensions of social capital. Validity (n = 11) and reliability (n = 8) of the tools were assessed only in very few studies. Cognitive constructs of social capital, namely trust, social cohesion and sense of belonging had a positive association towards measured health outcome in majority of the studies. While most studies measured social capital at individual/micro level (n = 32), group level measurements were obtained by aggregation of individual measures. As many tools originate in high income contexts, cultural adaptation, validation and reliability assessment is mandatory in adapting the tool to the study setting. Evidence on causality and assessing predictive validity is a problem due to the scarcity of prospective study designs. We recommend Harpham et al. s' Adapted Social Capital Assessment Tool (A-SCAT), Hurtado et al. s' six item tool and Elgar et al. s' World Value Survey Social Capital Scale for assessment of social capital in low and middle income countries.
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Affiliation(s)
- Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
| | - Suneth Buddhika Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Nicholas Glozier
- Brain and Mind Research Institute/CCS Sydney Medical School, University of Sydney, Australia
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
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Sarriot EG, Kouletio M, Jahan DS, Rasul I, Musha AKM. Advancing the application of systems thinking in health: sustainability evaluation as learning and sense-making in a complex urban health system in Northern Bangladesh. Health Res Policy Syst 2014; 12:45. [PMID: 25159873 PMCID: PMC4245801 DOI: 10.1186/1478-4505-12-45] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 07/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Starting in 1999, Concern Worldwide Inc. (Concern) worked with two Bangladeshi municipal health departments to support delivery of maternal and child health preventive services. A mid-term evaluation identified sustainability challenges. Concern relied on systems thinking implicitly to re-prioritize sustainability, but stakeholders also required a method, an explicit set of processes, to guide their decisions and choices during and after the project. METHODS Concern chose the Sustainability Framework method to generate creative thinking from stakeholders, create a common vision, and monitor progress. The Framework is based on participatory and iterative steps: defining (mapping) the local system and articulating a long-term vision, describing scenarios for achieving the vision, defining the elements of the model, and selecting corresponding indicators, setting and executing an assessment plan,, and repeated stakeholder engagement in analysis and decisions . Formal assessments took place up to 5 years post-project (2009). RESULTS Strategic choices for the project were guided by articulating a collective vision for sustainable health, mapping the system of actors required to effect and sustain change, and defining different components of analysis. Municipal authorities oriented health teams toward equity-oriented service delivery efforts, strengthening of the functionality of Ward Health Committees, resource leveraging between municipalities and the Ministry of Health, and mitigation of contextual risks. Regular reference to a vision (and set of metrics (population health, organizational and community capacity) mitigated political factors. Key structures and processes were maintained following elections and political changes. Post-project achievements included the maintenance or improvement 5 years post-project (2009) in 9 of the 11 health indicator gains realized during the project (1999-2004). Some elements of performance and capacity weakened, but reductions in the equity gap achieved during the project were largely maintained post-project. CONCLUSIONS Sustainability is dynamic and results from local systems processes, which can be strengthened through both implicit and explicit systems thinking steps applied with constancy of purpose.
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Affiliation(s)
- Eric G Sarriot
- />Director, ICF International Center for Design and Research in Sustainable Health and Human Development (CEDARS), 530 Gaither Road Suite 500, Rockville, MD 20850 USA
| | - Michelle Kouletio
- />Health Consultant, US Embassy, 01 BP 2012, Cotonou, Republic of Benin
| | - Dr Shamim Jahan
- />Country Director, University of Chicago Research, House 4 Road 2B, Sector 4, Uttara, Dhaka 123 Bangladesh
| | - Izaz Rasul
- />Director of Health Programs, Concern Worldwide, House 15 SW(D), Road 7, Gulshan 1, Dhaka Bangladesh
| | - AKM Musha
- />Country Director, Concern Worldwide, House 15 SW(D), Road 7, Gulshan 1, Dhaka Bangladesh
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