Social capital and utilization of HIV/ AIDS-related healthcare in rural Matabeleland South Province, Zimbabwe
Doctoral Thesis
2016
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University of Cape Town
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This study examined the relationship between social capital and utilization of HIV/AIDSrelated healthcare amongst people living with HIV in rural Matabeleland South province of Zimbabwe. It also explored barriers to optimal HIV/AIDS-related healthcare utilization among this rural population. Grounded on the Andersen and Newman model of healthcare utilization and social capital theory, the study employed a mixed method research design. Using time-location sampling procedure, a total of 399 people living with HIV were interviewed using a survey questionnaire. Semi-structured in-depth interviews were also conducted with 40 purposively selected key informants that included healthcare workers, HIV/AIDS service providers and community leaders. A statistically significant association was found between social capital and healthcare utilization. The binary logistic regression model was statistically significant, χ² (11) =129.362, (p < .005), it correctly classified 80.20% of cases and explained 59.3% of the variance in healthcare utilization (Nagelkerke R-Square =59.30%). The 16 items of the social capital scale were subjected to principal compoments analysis (PCA). Kaiser-Meyer-Olkin (KMO) value of sampling adequacy was 0.645 and Bartletts's Test of Spehericity reached statistical significance (χ² (120) = 128, p < .001), supporting the factorability of the correlation matrix. Social capital was a significant predictor of HIV/AIDS-related healthcare utilization (p<0.001). The results indicated that for a unit increase in social capital the odds of utilization of HIV/AIDS-related healthcare increased by a factor of 59.84. Other significant predictors of HIV/AID-related healthcare utilization amongst the study participants were gender (p<.05, odds ratio=3.4), discrimination (p<.05, odds ratio = 7.7) and household headship (p<.001, odds ratio = 4.3). Enabling factors such as membership in health insurance schemes and household income had no significant effect on HIV/AIDS-related healthcare utilization. Major barriers to HIV/AIDS-related healthcare utilization were food insecurity and reliance on informal sources of medication. This study contributed to understanding of the influences of social capital on the utilization of HIV/AIDS-related health care and underscored the need to integrate social capital in designing interventions to improve HIV/AIDS-related healthcare utilization in rural contexts.
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Mucheri, T. 2016. Social capital and utilization of HIV/ AIDS-related healthcare in rural Matabeleland South Province, Zimbabwe. University of Cape Town.