Development and validation of the Social Capital Assessment Tool in pregnancy for Maternal Health in Low and middle income countries (LSCAT-MH)

What is it about?

Social capital indicates the state of social relationships of people and what they achieve through these relationships. It is rarely assessed in relation to maternal health in the world. A main reason for this is the unavailability of a specific tool to measure social capital in pregnancy. The objective of this study was to develop and validate an instrument to measure social capital among pregnant women. A systematic review was conducted to identify the best tools available to measure social capital in Low and Middle Income Countries (LMICs). Based on World Bank Social Capital Assessment Tool and its adaptations we developed and validated the tool according to standard guidelines. A strong qualitative study was performed for cultural adaptation. We conducted both cognitive and psychometric validation. The 24-item Social Capital Assessment Tool for Maternal Health (LSCAT-MH) demonstrated high internal consistency (Cronbach’s alpha; 0.94). Factor analytic methods suggested a 4 factor model of (i) neighborhood networks (structural bonding), (ii) domestic and neighborhood cohesion (cognitive bonding), (iii) social contribution and (iv) social participation (structural bridging). Concurrent validity with antenatal mental ill health was confirmed through a negative correlation with the EPDS. Test retest reliability was high with intra class correlation of 0.71 and a Pearson correlation of 0.83. The LSCAT-MH is a psychometrically valid and reliable tool to measure social capital in pregnancy. Predictive validity was not tested as the study was not a longitudinal follow up.

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