Exploring beyond norms: social capital of pregnant women in Sri Lanka as a factor influencing health

BACKGROUND: Social capital during pregnancy in low and middle-income countries is hardly discussed in scientific literature. In Sri Lanka, even though the maternal health indicators are exemplary, addressing social determinants in pregnancy to improve the quality of care remains at minimal levels. While social capital is found to be context dependent, a comprehensive approach on identification of its dimensions within the context will unravel its relationships to health. The present qualitative study protocol was developed to explore social capital related to health among pregnant women in Anuradhapura district Sri Lanka. METHODS: The study will be conducted in two phases. In the phase one, we will select different communities from Anuradhapura district. Five to seven pregnant women will be selected from each community to complete a two week solicited diary on their social relationships. After completion of the diaries they will be interviewed for further clarification of social capital based on their diary documentation. In the second phase, we will conduct in-depth interviews with Public Health Midwives and senior community dwellers from each community to discuss social capital of pregnant women in the respective communities in order to triangulate the information obtained from the diaries. A framework analysis will be conducted for each community and formulate a final framework for social capital among pregnant women and there possible effects on health. DISCUSSION: This study will focus on filling a research gap of social determinants pertaining to maternal health in Sri Lanka. The findings will be helpful in generating hypotheses on unidentified social risk factors and their pathways to maternal health. The results of this in-depth exploration will be utilized to formulate a culturally sensitive study instrument to assess social capital during pregnancy.