Nurturing networks: Connecting the dots between social capital and antenatal care in south Karnataka, India.

Abstract

Introduction: Antenatal care (ANC) is one of the pillars of primary healthcare in India. Timely and appropriate ANC can reduce complications from pregnancy and childbirth. Social capital-the collective benefit for an individual when part of a larger society-has the potential to improve the uptake of ANC services.

Objective: To assess social capital and its association with ANC utilization in a peri-urban area in south India.

Methodology: A cross-sectional study was conducted in two sub-center areas of Anekal Taluk in Bangalore Urban District, south India. A total of 350 women were interviewed on socio-demography, obstetric history, ANC utilization, and social capital. A composite index for quality ANC was constructed from various ANC services and social capital was measured using a validated 13-item instrument. Bivariate associations with socio-demographic variables, obstetric factors, and social capital were assessed. Logistic regression models were used to determine the association between quality ANC and social capital after controlling for covariates.

Results: Mean age was 24.19 ± 3.56 years and mean education was 9.03 ± 4.98 years. Of all the women, 85% were homemakers and 70% belonged to the lower and middle classes. Quality ANC was achieved by 42.8% of the women. Being from Handenahalli subcentre (OR: 2.21; 95% CI: 1.36-3.60), completing secondary (OR: 4.56; 95% CI: 1.86-11.17) or higher education (OR: 5.95; 95% CI: 2.28-15.51), being gainfully employed (OR: 2.18; 95% CI: 1.06-4.48), belonging to middle class (OR: 2.37; 95% CI: 1.24-4.53), and feeling like one belongs to the village (OR: 8.33; 95% CI: 1.73-40.11.53) were significant predictors of achieving quality ANC.

Conclusion: Even though individual services of the ANC were achieved by more than 80% of women, quality ANC was accomplished by less than half. Apart from factors like education, occupation, and geographic area; social capital factors, like social cohesion, proved to be a strong predictor of quality ANC. Social capital should be leveraged to empower society to further strengthen access to quality ANC services.