On est ensemble: social capital and maternal health care use in rural Cameroon

BACKGROUND Every day approximately 1500 women worldwide die due to pregnancy or childbirth related complications. Maternal health care use is critical in reducing maternal mortality worldwide. Cameroon has one of the highest maternal mortality rates worldwide, but there is little knowledge about maternal health care use in Cameroon, particularly in more remote areas. The purpose of this study was to examine the importance of social networks and social capital in maternal health care use in the Far-North province of Cameroon. METHODS A sample of 110 Cameroonian women was recruited door-to-door in the urban town of Maroua and rural village of Moutourwa in the Far-North province in 2009. A maternal health questionnaire was administered to women between the ages of 18-45. The questionnaire assessed maternal health care history, social network, and social demographic characteristics. Social capital was measured in terms of the average educational level of women's networks. Bivariate and multivariable poisson regression analysis was used to assess the number of maternal health care visits as a function of social network characteristics, education, ethnicity, age, and urban and rural residence. RESULTS Among the 110 participants, 13 percent reported not having visited a health care provider during the last pregnancy - 19 percent of the women sampled in Moutourwa and 6 percent in Maroua. Findings showed that women with higher social capital had a greater tendency to use maternal health care services (IRR: 1.13; 95 % CI: 1.02-1.26). Social network size and social participation were not significant in full models. Ethnic characteristics were also shown associated with MHCU in the Far-North province. CONCLUSION Although the size of women's health-related networks were not shown significant, the resources to which women might have access through their social networks were associated with women's maternal health care use in remote areas of Cameroon. Although pregnancy may not be widely discussed in public, women's social networks may provide key social resources, e.g., information or financial capital, that facilitate MHCU. Leveraging women's social capital may provide a means to improve maternal health care use among women in low-income countries. ON EST ENSEMBLE Social capital and participation in the use of maternal health care services in remote areas of Cameroon.