acase@tulane.edu / BACKGROUND
Malawi is one of the least developed countries in the world, where the government’s investment in the health care system, including mental health services is very low. As a result, there is limited access to mental health services and general health workers lack training to address mental health issues. Low detection rates of common mental disorders (CMDs) in Malawi suggest that a large percentage of people with CMDs are going unrecognized and untreated. Social capital is important in this context because it may improve mental health for men and women in rural, sub-Saharan settings, such as rural Malawi, where there is little or no mental health care. This dissertation presents three papers related to the relationship between social capital and mental health in rural Malawi. The first paper explores the social determinants of social capital, the second paper examines the relationship between social capital and mental health, and the final paper looks at the role of gender as a moderator in this relationship.
METHODS
The analyses in this dissertation use a subset of data from the 2008 and 2010 Malawi Longitudinal Study of Families and Health” (MLSFH). The study sample included 1523 females and 994 males who had both 2008 and 2010 SF-12 mental health scores. The seven social capital measures were financial and non-financial transfers given and received, financial and non-financial reciprocity, and social participation. The six mental health measures were the 2010 SF-12 mental health composite score (MCS-12); the 4 components/scales of the 2010 MCS-12 which includes role/emotional functioning, social functioning, vitality, and mental health functioning; and overall satisfaction as perceived by the respondent. Paper #1 used seven ordinary least squared multiple regression and ordered logistic regression models to determine the determinants of social capital in 2008. Paper #2 used six ordinary least squared multiple regression and logistic regression models to determine the association between 2008 social capital measures and mental health outcomes in 2010 from 2008 and 2010 longitudinal data. Paper #3 used six ordinary least squared multiple regression and logistic regression models stratified by sex to determine the association between 2008 social capital measures, 2008 gender attitudes and gender power, and mental health outcomes in 2010 for males and females.
RESULTS
Paper #1 found that none of the predictor variables were statistically significant for all seven social capital measures, although being from the Central region of Malawi and attending Church in the last week were associated with five out of seven measures. Paper #2 found only one measure of social capital had a positive association with a measure of mental health, while three other measures of social capital had a negative association with a mental health measure. Paper #3 found clear differences between men and women when examining the role of gender on the relationship between social capital and mental health.
CONCLUSION
These results will inform future studies seeking to measure social capital in rural, sub-Saharan African settings and will provide insights when planning interventions to increase social capital in order to improve mental health for men and women in resource-poor settings. The measures of social capital used in this study should be further explored further and validated in other rural, sub-Saharan African settings. / 1 / Stacy Wallick
| Identifer | oai:union.ndltd.org:TULANE/oai:http://digitallibrary.tulane.edu/:tulane_78954 |
| Date | January 2018 |
| Contributors | Wallick, Stacy (author), Do, Mai (Thesis advisor), Andrinopoulos, Katherine (Thesis advisor), School of Public Health & Tropical Medicine Global Health Management and Policy (Degree granting institution) |
| Publisher | Tulane University |
| Source Sets | Tulane University |
| Language | English |
| Detected Language | English |
| Type | Text |
| Format | electronic |
| Rights | 12 months, Copyright is in accordance with U.S. Copyright law. |
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