Social capital and access to primary health care in developing countries: Evidence from Sub-Saharan Africa

We test the causal role of social capital, as measured by self-reported trust, in determining access to basic health facilities in Sub-Saharan Africa. To skirt reverse-causality problems between social capital and basic health, we rely on instrumental variable (IV) estimates. The results show that a one standard deviation increase in the level of localized trust leads to a 0.221 standard deviation decrease in the predicted value of doctor absenteeism, a 0.307 standard deviation decreases in the predicted value of waiting time and a 0.301 standard deviation decreases in the predicted value of bribes. As a robustness check, we also use a different database regarding a different health issue, namely access to clean water. We find that a one standard deviation increase in the level of localized trust leads to a 0.330 standard deviation increase in the access on clean water. All in all, social capital is found to have an important causal effect on health, even stronger that the one found in western countries.