Abstract
BackgroundSocial capital is an important social determinant of women’s sexual and reproductive health and rights. Little research has been conducted to understand the role of social capital in women’s sexual and reproductive health and how this can be harnessed to improve health in humanitarian settings. We synthesised the evidence to examine the nexus of women’s sexual and reproductive health and rights and social capital in humanitarian contexts.MethodsWe undertook a systematic review of qualitative studies. The preferred reporting items for systematic review and meta-analysis guidelines were used to identify peer-reviewed, qualitative studies conducted in humanitarian settings published since 1999. We searched CINAHL, MEDLINE, ProQuest Health & Medicine, PubMed, Embase and Web of science core collection and assessed quality using the Critical Appraisal Skills Programme tool. We used a meta-ethnographic approach to synthesise and analyse the data.FindingsOf 6749 initially identified studies, we included 19 studies, of which 18 were in conflict-related humanitarian settings and one in a natural disaster setting. The analysis revealed that the main form of social capital available to women was bonding social capital or strong links between people within groups of similar characteristics. There was limited use of bridging social capital, consisting of weaker connections between people of approximately equal status and power but with different characteristics. The primary social capital mechanisms that played a role in women’s sexual and reproductive health and rights were social support, informal social control and collective action. Depending on the nature of the values, norms and traditions shared by network members, these social capital mechanisms had the potential to both facilitate and hinder positive health outcomes for women.ConclusionsThese findings demonstrate the importance of understanding social capital in planning sexual and reproductive health responses in humanitarian settings. The analysis highlights the need to investigate social capital from an individual perspective to expose the intra-network dynamics that shape women’s experiences. Insights could help inform community-based preparedness and response programs aimed at improving the demand for and access to quality sexual and reproductive health services in humanitarian settings.
Highlights
Social capital is an important social determinant of women’s sexual and reproductive health and rights
These findings demonstrate the importance of understanding social capital in planning sexual and reproductive health responses in humanitarian settings
Insights could help inform community-based preparedness and response programs aimed at improving the demand for and access to quality sexual and reproductive health services in humanitarian settings
Summary
Social capital is an important social determinant of women’s sexual and reproductive health and rights. Meeting the reproductive health needs of women and girls in these complex contexts requires the provision of and demand for quality services, and the recognition that sexual and reproductive rights—frequently violated in humanitarian settings—are human rights. A social cohesion approach, developed first by Coleman [4] and built on by Putnam [5], sees social capital as the resources (e.g., trust, norms, exercise of sanctions) which are available, collectively, to members of a social group [6] This is in contrast to a social network approach, first conceptualised by Bourdieu [7] and later developed by Lin [8] where social capital is understood as the resources, or mechanisms, (e.g. social support, information channels, social credentials, social control) that inhere within an individual’s social and interpersonal networks. Bridging social capital describes weaker links between people in groups of more or less equal status and power but with different identities and promotes some types of support, control and collective action [9, 10]
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