Analysis of the influence of social capital on the utilization of maternal health services in Kibera Informal Settlements, Nairobi, Kenya.
Gitimu, Anne Muthoni
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Evidence linking social capital to lower levels of mortality exists. However, little is known about the relationship between social capital and utilization of maternal health services in resource-poor countries such as Kenya. The maternal health goal under the Millennium Development Goal showed slow progress. Maternal health indicators are largely informed by utilization of various services. This study sought to examine the association between structural social capital and the utilization of three types of maternal health services—antenatal care, skilled delivery, and family planning in informal settlements. The study’s objective was to examine the influence of bonding, bridging and linking social capital on the utilization of maternal health services in Kibera informal settlements, Nairobi, Kenya. This study interviewed 391 women who had given birth in the years 2015 and 2016. Questionnaires were administered to these women and interviews were conducted among leaders of community based organizations, Ministry of Health staff, Ministry of Social services staff, and local leaders using a Key Informant Interview guide. Independent variables ─ bonding, bridging and linking social capital were examined in relation to the dependent variables on utilization of the three types of maternal health services (antenatal care, skilled delivery and family planning). Data from the study was analyzed using descriptive and inferential statistics. The analysis indicated that bonding social capital was not significant in the utilization of the three types of maternal health services. Bridging social capital was significant in utilization of family planning services only. Linking social capital was significantly associated with utilization of antenatal care services and family planning with both positive and inverse relationships. None of the three types of social capital influenced skilled delivery. The findings of this study will be useful in informing maternal health strategies and programs as well as informing health policy on the important forms of social capital for availing maternal health services in informal settlements. Key words: Maternal health, Social Capital, Informal Settlements