FACTORS IMPEDING EXCLUSIVE BREASTFEEDING IN A LOW-INCOME AREA OF THE WESTERN CAPE PROVINCE OF SOUTH AFRICA

The promotion of exclusive breastfeeding for the first six months of life is estimated to be the most effective measure to save infants from morbidity and mortality in low-income settings. South Africa is challenged by very poor exclusive breastfeeding practices (6.8–8.3%) during the first six months of life. In the low-income area investigated, the exclusive breastfeeding rate was 6% in 2011. The aim of this study was to describe the factors impeding exclusive breastfeeding practices in a low-income area of the Western Cape Province of South Africa in order to provide recommendations on tailored and generalisable intervention strategies for the promotion of exclusive breastfeeding practices. Focus group discussions were conducted with caregivers and health care workers. Several barriers to exclusive breastfeeding practices were reported and seven themes were identified during data analysis: 1) the perception that infants needed water, gripe water and Lennon’s Behoedmiddel; 2) the concern that milk alone does not satisfy an infant; 3) inadequate infant feeding education and support by the health system; 4) the lack of community-based postnatal support; 5) convention and family influence; 6) mothers separated from infants; and 7) local beliefs about maternal behaviour and breastfeeding. The barriers to exclusive breastfeeding practices proved to be multifaceted and interlinked. The influence of convention and community perceptions and beliefs combined with suboptimal infant feeding education by the health system and the lack of local postnatal breastfeeding support initiatives posed an intricate group of barriers to exclusive breastfeeding practices.

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Implementation of the HealthKick intervention in primary schools in low-income settings in the Western Cape Province, South Africa: a process evaluation

BMC Public Health ◽

10.1186/s12889-015-2157-8 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 10

Author(s):

Anniza de Villiers ◽

Nelia P. Steyn ◽

Catherine E. Draper ◽

Jillian Hill ◽

Lucinda Dalais ◽

...

Keyword(s):

South Africa ◽

Process Evaluation ◽

Low Income ◽

Primary Schools ◽

Western Cape ◽

Western Cape Province

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The impact of family physician supply on district health system performance, clinical processes and clinical outcomes in the Western Cape Province, South Africa (2011–2014)

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v10i1.1442 ◽

2018 ◽

Vol 10 (1) ◽

Author(s):

Rekai L. Chinhoyi ◽

Moleen Zunza ◽

Klaus B. Von Pressentin

Keyword(s):

South Africa ◽

Health System ◽

Family Physician ◽

System Performance ◽

Health System Performance ◽

Western Cape ◽

Western Cape Province ◽

District Health ◽

District Health System ◽

The Impact

Background: A revised family physician (FP) training programme was introduced in South Africa in 2007. A baseline assessment (2011) of the impact of FP supply on district health system performance was performed within the Western Cape Province, South Africa. The impact of an increased FP supply within this province required re-evaluation.Aim: To assess the impact of FP supply on indicators of district health system performance, clinical processes and clinical outcomes in the Western Cape Province. The objectives were to determine the impact of FPs, nurses, medical officers (MOs) and other specialists.Setting: The study sample included all five rural districts and eight urban subdistricts of the Western Cape Province.Methods: A secondary analysis was performed on routinely collected data from the Western Cape Department of Health from 01 March 2011 until 30 April 2014.Results: The FP supply did not significantly impact the indicators analysed. The supply of nurses and MOs had an impact on some of the indicators analysed.Conclusion: This study did not replicate the positive associations between an increase in FP supply and improved health indicators, as described previously for high-income country settings. The impact of FP supply on clinical processes, health system performance and outcome indicators in the Western Cape Province was not statistically significant. Future re-evaluation is recommended to allow for more time and an increase in FP supply.

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