Social Capital and Related Factors among Village Health Volunteers in Samutprakarn Province

Abstract

            Village Health Volunteers (VHVs) are an important part of Thailand's primary health care. The World Health Organization recommends ‘social capital’ as one of the VHV selection criteria. This cross-sectional study aimed to study VHVs in Samutprakarn province’s social capital levels in three dimensions including 1) structural social capital; 2) civil engagement; and 3) cognitive social capital and their potentially associated factors. The developed questionnaire had 3 parts consisted of personal and working factors, VHV's performance evaluation and social capital assessment. The scores for each item fell within the permitted range of 0.67 to 1.00 when the content validity index was calculated using the questionnaire, then utilized to gauge the accuracy. Cronbach's alpha coefficient for the reliability analysis is greater than 0.70, and the confidence level is adequate.
                There were 778 VHVs in Samutprakarn province who participated in this study (79.47% response rate). Adjusted by other related variables, multiple logistic regression models reported that: 1) ‘structural social capital’ was positively associated with living outside municipality area OR 2.28 (95%CI 1.43 - 3.65), having adequate income and savings OR 2.50 (95%CI 1.54 - 4.06), age (years) OR 1.03 (95%CI 1.01 - 1.05), higher frequency of working/ meeting with public health officials at the level of ≥ 1 time per month OR 3.99 (95%CI 2.44 - 6.54), and length of being a VHV (years) OR 1.04 ( 95%CI 1.01 - 1.06); 2) ‘civil engagement’ was oppositely associated with living outside municipality area OR 0.49 (95%CI 0.30 - 0.79) and length of living in the current area OR 0.98 (95%CI 0.97 - 0.99); however, ‘civil engagement’ was positively associated with higher level of education at the level of a bachelor's degree or above OR 2.38 (95%CI 1.12 - 5.07); and 3) ‘cognitive social capital’ was positively associated with living outside municipality area OR 2.37 (95%CI 1.08 - 5.17) and having adequate income and savings OR 3.17 (95%CI 1.53 - 6.55). Good VHV's performance was also associated with good levels of social capital in all three dimensions. In summary, promoting factors positively related to good social capital, particularly economic status, higher educational level and frequent working and meeting with public health officials, should be considered at the policy level for supporting VHV’s performance.