Village health volunteers' individual social capital and caretakers' health service utilization for febrile children in Malaria-endemic villages in Papua New Guinea.

Abstract

Little is known about the association between the social capital of village health volunteers (VHVs) and their performance in relation to malarial care. Data came from 337 children and 13 VHVs working in Dagua, Papua New Guinea. The outcome variable was whether caretakers brought their children to health care services on the incidence of a febrile episode. The social capital of VHVs was assessed by inquiring about relationships with people in 25 social positions/roles. Caretakers were more likely to bring their febrile children to health care services when they lived in a village whose VHVs frequently discussed their activities with people in positions/roles outside their village (prevalence ratio [PR]=1.47 [95% confidence interval {CI} 1.22 to 1.78]). On the other hand, caretakers were less likely to do so when their VHVs had known people in informal positions/roles inside their village (PR=0.85 [95% CI 0.77 to 0.93]) and when they discussed their activities with people in formal positions/roles inside their village (PR=0.76 [95% CI 0.61 to 0.95]). Our results suggest that the social interactions of VHVs with people in positions/roles outside the village may benefit residents while those with people in positions/roles inside the village might not necessarily benefit them.