Peer-reviewed article
Social capital and uptake of primary healthcare during protracted displacement: Evidence from four refugee settlements in northern Uganda.
Nancy Vollmer, Robert Anguyo, Anjali Sharma, Joseph J Valadez ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how social capital influences the use of maternal, newborn, and child health services in four refugee settlements in northern Uganda. Researchers surveyed 570 caregivers of young children and measured social capital through three dimensions: social support, social action, and community cohesion. The findings show that different forms of social capital are linked to better use of health services, including antenatal care, vaccination, breastfeeding, and child nutrition.
Key points
- Social support was associated with children receiving minimum dietary diversity (35% higher odds)
- Social action was strongly associated with first-trimester antenatal care (nearly 4 times higher odds) and tetanus vaccination in pregnancy
- Community cohesion was linked to early breastfeeding initiation and Vitamin A supplementation (3-4 times higher odds)
- Three distinct social capital dimensions were identified through factor analysis
- Social capital appears to be an important asset for displaced populations to access health services
Limitations
The cross-sectional design cannot establish causation, only associations. The study cannot explain the mechanisms through which social capital influences health service use or whether the findings apply to other refugee or displaced populations in different contexts.
Abstract
The world's refugee populations primarily reside in low- and middle-income countries, where they face protracted displacement and limited financial and human capital. Social capital is among the few assets they can leverage for resilience. Despite its importance, few studies have examined how social capital influences the uptake of healthcare services during protracted displacement. This study examines the associations of refugee with access to maternal, newborn and child health (MNCH) services in northern Uganda's long-term settlements. We conducted cross-sectional probability household surveys across four refugee settlements with independent samples of caregivers of children 0-5, 12-23, and 0-59 months (n = 570). Caregivers' demographic characteristics and responses to 57 items from the Shortened Adapted Social Capital Assessment Tool were analyzed as independent variables. Dependent variables were MNCH service coverage and young child feeding practices. Factor analysis revealed three distinct social capital dimensions: Social Support (Ω = 0.73), Social Action (Ω = 0.72), and Community Cohesion (Ω = 0.48 indicating lower reliability). In adjusted multiple regression analyses, Social Support was positively associated with minimum dietary diversity (aOR = 1.35, 95 %CI = 1.04-1.74). Social Action was positively associated with antenatal care during the first trimester (aOR = 3.93, 95 %CI = 1.47-10.50), Tetanus Toxoid vaccination during pregnancy (aOR = 4.00, 95 %CI = 1.33-12.04) and postnatal care (aOR = 2.48, 95 %CI = 1.02-6.05). Community Cohesion showed positive associations with early initiation of breastfeeding (aOR = 3.47, 95 %CI = 1.00-12.06) and Vitamin A supplementation (aOR = 3.51, 95 %CI = 1.15-10.68). These findings suggest that social capital is linked to the uptake of essential MNCH services, with distinct dimensions showing positive associations with key health behaviors. Understanding these dynamics is important for designing effective, community-based health interventions in refugee settings.