Abstract

BackgroundAppropriate health-seeking practices may have a positive influence on child survival, particularly when practiced by kin caregivers of children who are below the age of 5 years. While literature has shown that children who are raised in kinship care often present with poor health outcomes and often have unmet healthcare needs, the health-seeking behaviours and practices of the children’s kin caregivers that ultimately influence these health outcomes remain largely unknown. In this paper, we explored the healthcare beliefs and practices of kin caregivers in South Africa on child survival.MethodsOverall, 12 structured interviews were conducted with all the participants. Six [6] interviews were conducted in the Eastern Cape province and 6 were conducted in the KwaZulu-Natal province. The sample of participants was obtained by seeking permission from the child welfare authorities in the KwaZulu-Natal and Eastern Cape Department of Social Development (DSD) to assist in identifying a sample of the kin-caregivers who have provided primary care to children below the age of 5. The structured interviews were transcribed and analysed using thematic content analysis. After thematic content analysis was carried out, transcripts were given case numbers and then imported into NViVo version 11 for analysis and interpretation of the findings.ResultsThe healthcare seeking behaviours and poor use of healthcare services of the caregivers were largely influenced by their notions and perceptions of health and illness. The notions and perceptions that the caregivers hold about the health statuses of the children placed under their care and illness were found to be largely culturally determined and largely influenced by preconceptions and certain healthcare beliefs. Increased reliance on traditional herbs, Notion of witchcraft and Faith healing emerged as key factors that influence health-seeking practices and beliefs of kin caregivers, thus influencing under-five mortality.ConclusionKin caregivers should be equipped with the necessary guidance, resources and training that facilitate the successful fulfilment of the caregiving role, given the number of unmet needs and challenges that they face. This will in turn translate into positive child health outcomes.

Highlights

  • Appropriate health-seeking practices may have a positive influence on child survival, when practiced by kin caregivers of children who are below the age of 5 years

  • While literature has shown that children who are raised in kinship care often present with poor health outcomes and often have unmet healthcare needs, the health-seeking behaviours and practices of the children’s kin caregivers that influence these health outcomes remain largely unknown

  • Literature has shown that appropriate health-seeking practices may have a positive influence on child survival, when practiced by kin caregivers of children who are below the age of 5 years [98]

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Summary

Introduction

Appropriate health-seeking practices may have a positive influence on child survival, when practiced by kin caregivers of children who are below the age of 5 years. The practice of kinship care, which is the placement of children with other extended kin (other than the biological parents) is a phenomenon that is gradually receiving much attention and focus from child welfare systems, despite its existence in societies for decades [11,12,13,14]. It is the largest alternative care option for children who cannot be raised by their biological parents [15,16,17], and increasingly growing at an accelerated rate compared to traditional foster care [18,19,20,21,22,23]. A comparative study of countries that examined the structure and composition of families indicated that despite the marked increases in family changes on a global level, over the last years, children are most likely to be raised in nuclear families except in South Africa [34]

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