Social Capital & Pregnancy

Dr. Thilini Agampodi

Social Capital in Pregnancy

Background

Social capital is defined as “features of social organization, such as trust, norms and networks that can improve the efficiency of society by facilitating coordinated actions”. Social capital is scarcely mentioned in addressing global maternal mortality in low and middle-income countries. The objective of this study was to systematically review methods used to measure social capital in LMICs, to explore social capital of pregnant women in Sri Lanka and to develop and validate an instrument to measure social capital related to maternal health. 

Methods

This study consisted of three components. An electronic search was conducted using a number of databases and selected grey literature sources. All studies conducted in low and middle-income countries, that have measured social capital in relation to health during 1980 to January 2013 were included. In the second component, 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. Bubble plots were used to visualize the community differences of social capital. In the third component,tool development was done following the COnsenses-based Standards for the selection of health Measurement INstruments (COSMIN) approach. 

Results

The systematic review identified the best tools to measure social capital and their strengths and limitations. The qualitative study identified ten cognitive and five structural constructs of social capital relevant to health in pregnancy and concluded that current tools might not capture the unique dimensions of social capital in pregnancy. A new 24-item Social Capital Assessment Tool related to Maternal Health in low and middle-income countries (LSCAT-MH) was developed. The tool demonstrated high internal consistency (Cronbach’s alpha; 0.94). Factor analytic methods suggested a 4-factor model of underlying constructs. Concurrent validity with the mental health status in pregnancy was confirmed through a negative correlation with the Edinburgh Postpartum Depression Scale (EPDS). Test retest reliability was high with an intra class correlation of 0.71 and a Pearson correlation of 0.83.

Conclusion

LSCAT-MH is a valid tool to measure social capital in pregnant women in low and middle-income countries.

Output from the thesis

Social Capital Assessment Tool for Pregnant mothers in Low and middle income countries (LSCAT_MH)

Awards received for thesis related work
  1. Outstanding Oral Presentation Award “Development and Validation of a Tool to Measure Social Capital in Pregnancy”. 49thAsia Pacific Academic Consortium for Public health conference, Korea
  2. Presidents award for scientific publications 2015
  3. NRC merit award for scientific publications 2017
List of journal articles from the PhD

Agampodi, T. C., Agampodi, S. B., Glozier, N., & Siribaddana, S. (2015). Measurement of social capital in relation to health in low and middle income countries (LMIC): a systematic review. Social Science & Medicine, 128, 95-104.

Agampodi, T. C., Agampodi, S. B., Glozier, N., & Siribaddana, S. (2016). Exploring beyond norms: social capital of pregnant women in Sri Lanka as a factor influencing health. SpringerPlus, 5(1), 411.

 Agampodi, T. C., Rheinländer, T., Agampodi, S. B., Glozier, N., & Siribaddana, S. (2017). Social capital and health during pregnancy; an in-depth exploration from rural Sri Lanka. Reproductive health, 14(1), 89.

 Agampodi TC, Agampodi SB, Glozier N, et al. Development and validation of the Social Capital Assessment Tool in pregnancy for Maternal Health in Low and middle income countries (LSCAT-MH)BMJ Open 2019;9:e027781. doi: 10.1136/bmjopen-2018-027781

Agampodi, Thilini, et al. “How context matters: Demonstrating microgeographical differences in social capital and its implications for mental wellbeing in pregnancy with a novel bubble diagram technique.” Health & Place 60 (2019): 102231.

List of conference presentations
  1. Agampodi, T.C., Lelwala, T.A., Sirisena, P., Agampodi, S.B., Glozier, N., & Siribaddana, S. (2017) Development And Validation of A Tool To Measure Social Capital In Pregnancy. The 49th Asia Pacific Consortium of Public Health Conference, Incheon, South Korea. (Appendix 1)
  2. Agampodi, T.C., Malika, E.N., Agampodi, S.B., Glozier, N., & Siribaddana, S. (2017) Going beyond routine care; how does Public Health Midwife promote maternal well-being; a qualitative study. Annual Scientific sessions, Anuradhapura Clinical Society. Anuradhapura, Sri Lanka (Appendix 2)
  3. Agampodi, T.C., Warnasekara, J.N., Agampodi, S.B., Glozier, N., Siribaddana, S. (2016). Poor social capital as a risk factor for maternal self-harm in Rural Sri Lanka and the role of public health system as a buffer. The 48th Asia-Pacific Academic Consortium for Public Health Conference. Tokyo, Japan. (Appendix 3)
  4. Agampodi, T.C., Husna, F., Agampodi, S.B., Glozier, N., Siribaddana, S.(2015) Social capital ; A link towards health and wellbeing among minority pregnant women ? Annual Scientific sessions, Anuradhapura Clinical Society. Anuradhapura, Sri Lanka. (Appendix 4)
  5. Agampodi, T. C., Agampodi, S. B., Glozier, N., & Siribaddana, S.Unexplored social dimensions of health of pregnant women; a qualitative study on social capital and health in Sri Lanka. (2015). The 47th Asia Pacific Consortium of Public Health Conference, Kuala Lumpur, Malaysia. (Appendix 5)
  6. Agampodi, T.C. (2015) Exploring domestic cohesion as a social determinant of health during pregnancy; the husbands’ role. Conference on Rethinking Marriage and Kinship in Sri Lanka. Gender, Intimacy, and Change. American Institute for Sri Lankan Studies, Kandy, Sri Lanka.  

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