An Original Investigation into the Mechanisms of Social Capital and Health Outcomes in Rural Nigerian Communities

Social capital has been theorised as a determinant of health outcomes in communities through its effects on health information sharing, collective action for environmental health, social support for health behaviour, and access to social networks for health resource mobilisation. However, the specific mechanisms through which social capital operates on health outcomes in Nigerian rural community contexts have not been rigorously investigated. This study conducted an original theoretical and empirical investigation into social capital mechanisms and health outcomes in rural Nigeria. A mixed-methods study design combining social network analysis, in-depth interviews, and a cross-sectional health outcomes survey was employed across eight rural communities in Benue, Katsina, Akwa Ibom, and Sokoto States representing different ethnic and ecological contexts. Social network analysis was conducted in each community using ego-network surveys to characterise bonding, bridging, and linking social capital dimensions and structures. In-depth interviews with 48 community members explored social capital health mechanisms. A cross-sectional health outcomes survey of 480 households assessed immunisation coverage, antenatal care utilisation, acute illness care-seeking, and dietary diversity as health outcome measures. Structural equation modelling with social capital latent constructs tested mechanism pathways. Results showed that bridging social capital (connections across different social groups) was the most health-outcome-relevant dimension, significantly associated with immunisation coverage (beta = 0.41; p < 0.001) and care-seeking (beta = 0.38; p < 0.001). Linking social capital (connections to formal institutions) showed strong effects on antenatal care utilisation.