Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study

South African Family Practice

Field Value
Title Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study
Creator Profitt, Luke B. Bresick, Graham Rossouw, Liezel Van Stormbroek, Ben Ras, Tasleem Von Pressentin, Klaus
Subject Family medicine; general practice; primary care; primary health care; barriers; facilitators; healthcare access; children; low-income area
Description Background: In Cape Town, the under-5 mortality rate has plateaued to 20 per 1000 live births, with 60% of child deaths occurring out of hospital. The southern subdistrict has the largest paediatric population in Metro West and accounts for 31% of deaths. This study aimed to uncover the access barriers and facilitators underlying this high burden of out-of-hospital deaths.Methods: An exploratory mixed-methods case study design employed three data collection strategies: a quantitative survey with randomly sampled community members, semi-structured interviews with purposively sampled caregivers whose children presented critically ill or deceased (January 2017 – December 2020) and a nominal group technique (NGT) to build solution-oriented consensus among purposively sampled health workers, representing different levels of care in the local health system.Results: A total of 62 community members were surveyed, 11 semi-structured caregiver interviews were conducted, and 11 health workers participated in the NGT. Community members (74%) experienced barriers in accessing care. Knowledge of basic home care for common conditions was limited. Thematic analysis of interviews showed affordability, acceptability, and access, household and facility factor barriers. The NGT suggested improvement in community-based services, transport access and lengthening service hours would facilitate access.Conclusion: While multiple barriers to accessing care were identified, facilitators addressing these barriers were explored. Healthcare planners should examine the barriers within their geographic areas of responsibility to reduce child deaths.Contribution: This study uncovers community perspectives on childhood out-of-hospital deaths and makes consensus-based recommendations for improvement.
Publisher AOSIS
Contributor none
Date 2023-12-20
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — cross sectional, mixed methods
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/safp.v65i1.5754
Source South African Family Practice; Vol 65, No 1 (2023): Part 4; 12 pages 2078-6204 2078-6190
Language eng
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Coverage Africa; South africa; Western Cape; Cape Town Metropole; southern subdistrict 2017-2020 adults; caregivers; community based services
Rights Copyright (c) 2023 Luke B. Profitt, Graham Bresick, Liezel Rossouw, Ben van Stormbroek, Tasleem Ras, Klaus von Pressentin