Ireland Hannah, Tran Nguyen Toan, Dawson Angela
Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, PO Box 123, Sydney, NSW, 2007, Australia.
Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1206, Geneva, Switzerland.
Confl Health. 2021 Nov 24;15(1):87. doi: 10.1186/s13031-021-00421-1.
Social 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.
We 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.
Of 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.
These 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.
社会资本是女性性健康和生殖健康及权利的重要社会决定因素。目前针对社会资本在女性性健康和生殖健康中的作用以及如何利用社会资本改善人道主义环境下的健康状况的研究较少。我们综合了相关证据，以审视人道主义背景下女性性健康和生殖健康及权利与社会资本之间的联系。
我们对定性研究进行了系统综述。采用系统综述与荟萃分析优先报告项目指南来识别自1999年以来在人道主义环境中开展的经过同行评审的定性研究。我们检索了护理学与健康领域数据库（CINAHL）、医学期刊数据库（MEDLINE）、ProQuest健康与医学数据库、医学文献数据库（PubMed）、荷兰医学文摘数据库（Embase）以及科学引文索引核心合集（Web of science core collection），并使用批判性评估技能计划工具评估质量。我们采用元民族志方法来综合和分析数据。
在最初识别的6749项研究中，我们纳入了19项研究，其中18项是在与冲突相关的人道主义环境中开展的，1项是在自然灾害环境中开展的。分析表明，女性可利用的社会资本的主要形式是结合型社会资本，即具有相似特征的群体内部人与人之间的紧密联系。桥接型社会资本的使用有限，桥接型社会资本是指地位和权力大致平等但特征不同的人之间较薄弱的联系。在女性性健康和生殖健康及权利方面发挥作用的主要社会资本机制是社会支持、非正式社会控制和集体行动。根据网络成员共享的价值观、规范和传统的性质，这些社会资本机制有可能促进也有可能阻碍女性获得积极的健康结果。
这些发现表明在规划人道主义环境下的性健康和生殖健康应对措施时理解社会资本的重要性。分析强调需要从个体角度调查社会资本，以揭示塑造女性经历的网络内部动态。相关见解有助于为旨在改善人道主义环境下对优质性健康和生殖健康服务的需求及获取情况的社区备灾和应对计划提供参考。
