Peer-reviewed article
Awareness and Perceptions of Health Promotion Strategies Among Caregivers to Reduce Child Mortality in Mount Fletcher, Eastern Cape, South Africa
Lulama Lathitha Faku, Mirabel Kah-Keh Nanjoh, Luviwe Lutotswana, Monwabisi Faleni, Mbuyiselo Douglas et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This study looked at how caregivers of young children in a rural part of South Africa understand and feel about health programs meant to reduce child deaths. Researchers interviewed 20 mothers and caregivers at a clinic in Mount Fletcher, Eastern Cape. Most caregivers knew about key child-survival practices like vaccination, breastfeeding, nutrition, and hygiene, and had positive views of health workers. However, they faced real obstacles to using these services, such as poverty, transport costs, long clinic waits, and traditional beliefs. The study suggests that simply knowing about health advice is not enough; economic and social barriers also need to be addressed.
Key points
- Caregivers showed good awareness of core child-survival interventions including immunisation, breastfeeding, nutrition, hygiene, and clinic attendance
- Participants generally held positive attitudes toward health promotion services and healthcare workers
- Barriers included poverty, transport costs, distance to facilities, long clinic waiting times, and staff shortages
- Traditional and cultural beliefs continued to influence health-seeking behaviour
- Study recommends strengthening community health worker outreach and engaging traditional leaders alongside biomedical education
Limitations
The study used a small purposive sample of 20 caregivers in one clinic, so findings cannot be generalised beyond similar rural settings, and it explores perceptions rather than measuring actual health or mortality outcomes.
Abstract
Background Child mortality remains a major public health challenge in low- and middle-income countries, with Sub-Saharan Africa carrying a disproportionate share of the global burden. In South Africa, rural and under-resourced areas such as Mount Fletcher in the Eastern Cape continue to record high rates of preventable under-five deaths. The effectiveness of national and provincial health promotion strategies depends heavily on local awareness, acceptance, and participation, yet little is known about how caregivers in rural communities such as Mount Fletcher understand and experience these interventions. Objective To explore the awareness and perceptions of health promotion strategies among caregivers to reduce child mortality in Mount Fletcher, and to identify the barriers and facilitators influencing their uptake. Methods A qualitative descriptive study was conducted among 20 mothers and primary caregivers of children under five years attending Taylor Bequest Clinic in Mount Fletcher, Elundini Local Municipality. Participants were selected through purposive sampling and took part in semi-structured, audio-recorded interviews conducted in isiXhosa or English. Data were transcribed verbatim and analysed thematically using ATLAS.ti (version 8), guided by the Health Belief Model. Results Participants demonstrated good awareness of core child-survival interventions, including immunisation, exclusive breastfeeding, nutrition, hygiene, and clinic attendance, and generally held positive attitudes toward health promotion services and healthcare workers. However, participants identified substantial barriers to the uptake of these strategies, including poverty, transport costs and distance to health facilities, long clinic waiting times and staff shortages, and the continued influence of traditional and cultural beliefs on health-seeking behaviour. Conclusion Caregivers in Mount Fletcher are broadly aware of, and hold favourable attitudes toward, child health promotion strategies, but structural, economic, and cultural barriers continue to limit their consistent use. Strengthening community health worker outreach, addressing health system constraints, and engaging traditional and community leaders alongside biomedical health education may help translate existing awareness into more consistent uptake of child mortality reduction interventions in similar rural South African settings.