Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study
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 barri...
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| Format: | Article |
| Language: | English |
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AOSIS
2023-12-01
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| Series: | South African Family Practice |
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| Online Access: | https://safpj.co.za/index.php/safpj/article/view/5754 |
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| author | Luke B. Profitt Graham Bresick Liezel Rossouw Ben Van Stormbroek Tasleem Ras Klaus Von Pressentin |
| author_facet | Luke B. Profitt Graham Bresick Liezel Rossouw Ben Van Stormbroek Tasleem Ras Klaus Von Pressentin |
| author_sort | Luke B. Profitt |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-dbb8bacd0eb14097922328d306e80d1b |
| institution | Kabale University |
| issn | 2078-6190 2078-6204 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Family Practice |
| spelling | doaj-art-dbb8bacd0eb14097922328d306e80d1b2025-08-20T04:03:12ZengAOSISSouth African Family Practice2078-61902078-62042023-12-01651e1e1210.4102/safp.v65i1.57544365Healthcare access for children in a low-income area in Cape Town: A mixed-methods case studyLuke B. Profitt0Graham Bresick1Liezel Rossouw2Ben Van Stormbroek3Tasleem Ras4Klaus Von Pressentin5Department of Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town; and Western Cape Government Health and Wellness, Cape TownDepartment of Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape TownWestern Cape Government Health and Wellness, False Bay Hospital, Cape TownWestern Cape Government Health and Wellness, Victoria Hospital, Wynberg, Cape Town; and Department of Paediatrics, Faculty of Health Sciences, University of Cape Town, Cape TownDepartment of Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape TownDepartment of Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape TownBackground: 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.https://safpj.co.za/index.php/safpj/article/view/5754barriersfacilitatorshealthcare accesschildrenlow-income area |
| spellingShingle | Luke B. Profitt Graham Bresick Liezel Rossouw Ben Van Stormbroek Tasleem Ras Klaus Von Pressentin Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study South African Family Practice barriers facilitators healthcare access children low-income area |
| title | Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study |
| title_full | Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study |
| title_fullStr | Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study |
| title_full_unstemmed | Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study |
| title_short | Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study |
| title_sort | healthcare access for children in a low income area in cape town a mixed methods case study |
| topic | barriers facilitators healthcare access children low-income area |
| url | https://safpj.co.za/index.php/safpj/article/view/5754 |
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