Social capital and formal health-seeking behavior in Tongi, a peri-urban municipality in Dhaka - Bangladesh
Abstract
Background Industrial development is rapidly urbanizing the periphery of Bangladesh’s major cities. Attracted by employment in the garment and pharmaceutical industries, large numbers of migrants have contributed to a... [ view full abstract ]
Background
Industrial development is rapidly urbanizing the periphery of Bangladesh’s major cities. Attracted by employment in the garment and pharmaceutical industries, large numbers of migrants have contributed to a mushrooming of low-income settlements. When migrants constitute a significant portion of the population, growing heterogeneity leads to lower social cohesion and trust [1]. Weak social capital - both structural and cognitive – may have negative implications on individual and population health.
This study aims to assess the influence of social capital on the use of formal healthcare for acute and chronic illnesses among low-income residents in Tongi, a peri-urban municipality in the shadow of Dhaka City.
Method
Respondents were interviewed during February-July 2014. Social capital was measured using the short Adapted Social Capital Assessment Tool, whereas health-seeking behavior was assessed using structured questionnaires. Descriptive analysis explored respondent characteristics, perceived community social capital, and patterns of health seeking behavior. Multivariate analysis examined the association between social capital and the use of formal healthcare, adjusted for other confounders.
Result
In total 690 respondents were interviewed, of which 387 and 303 suffered acute and chronic illnesses respectively. Respondents' structural social capital (group membership, citizenship participation and group support) were low with the exception of individual support; whereas the cognitive social capital (trust, harmony, and sense of belonging) were relatively higher. In adjusted analysis, individual emotional support was significantly associated with the use of formal healthcare among respondents with acute illness, while affluence and group-level emotional support influenced health-seeking in formal facilities among respondents with chronic illness.
Conclusion
Structural social capital was low among low-income residents in Tongi. Emotional support appeared to be an important component of social capital that affected health-seeking behavior. Investments in community-building may be useful in efforts to promote use of formal healthcare, and ultimately in improving health outcomes.
Authors
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Herfina Nababan
(International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b))
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Alayne Adams
(In)
Topic Areas
V. Healthcare Service 5.1 Accessibility of healthcare services and its optimization 5.2 He , II. Urban Health at the intersection of urban environment, social determinants and places
Session
PS-3 » POSTER SESSION 3 (12:15 - Sunday, 3rd April, TBA)
Paper
Abstract_IUCH_2016_Herfina_Nababan.docx
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