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Barriers and facilitators to health care access for children in a low-income are in Cape Town

Background In Cape Town the under-5 mortality rate has plateaued to 20 per 1000 live births. The southern subdistrict has the largest paediatric population in Metro West and accounts for 31% of deaths in Metro West. Across the metropole 60% of child deaths are out of hospital. We investigated barrie...

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Main Author: Profitt, Luke
Other Authors: Ras, Tasleem
Format: Thesis
Language:English
Published: Department of Public Health and Family Medicine 2023
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access_status_str Open Access
author Profitt, Luke
author2 Ras, Tasleem
author_browse Profitt, Luke
Ras, Tasleem
author_facet Ras, Tasleem
Profitt, Luke
author_sort Profitt, Luke
collection Thesis
description Background In Cape Town the under-5 mortality rate has plateaued to 20 per 1000 live births. The southern subdistrict has the largest paediatric population in Metro West and accounts for 31% of deaths in Metro West. Across the metropole 60% of child deaths are out of hospital. We investigated barriers to accessing health care for children in the False Bay Hospital drainage area. Methods Quantitative and qualitative methods were used: community survey (n=62), qualitative interviews (n=11) with caregivers of children who presented critically ill or deceased (January 2017 - Dec 2020) and a modified nominal group meeting of community based and clinical services managers to identify and achieve consensus on solutions. Results Community members (74%) experienced barriers in accessing care and only 60% knew the correct emergency contact numbers. Knowledge of basic home care for common conditions was limited. Interview themes showed barriers of affordability, acceptability, access, as well as household and facility factors. The nominal group technique suggested that improvement in community-based services, transport access and lengthening service hours would alleviate some of the challenges in accessing care. Conclusions The barriers to accessing care seem insurmountable to those who encounter them, yet solutions and community assets do exist. The optimal utilization of services and community assets have the potential to improve access to care with resultant decreased out-of-hospital deaths and improvement of the under-5 mortality rate. A well-coordinated Community Orientated Primary Care (COPC) program with intersectoral collaboration and government commitment needs to be implemented.
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:34:25.395Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2023
publishDateRange 2023
publishDateSort 2023
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spelling oai:open.uct.ac.za:11427/38148 Barriers and facilitators to health care access for children in a low-income are in Cape Town Profitt, Luke Ras, Tasleem Medicine Background In Cape Town the under-5 mortality rate has plateaued to 20 per 1000 live births. The southern subdistrict has the largest paediatric population in Metro West and accounts for 31% of deaths in Metro West. Across the metropole 60% of child deaths are out of hospital. We investigated barriers to accessing health care for children in the False Bay Hospital drainage area. Methods Quantitative and qualitative methods were used: community survey (n=62), qualitative interviews (n=11) with caregivers of children who presented critically ill or deceased (January 2017 - Dec 2020) and a modified nominal group meeting of community based and clinical services managers to identify and achieve consensus on solutions. Results Community members (74%) experienced barriers in accessing care and only 60% knew the correct emergency contact numbers. Knowledge of basic home care for common conditions was limited. Interview themes showed barriers of affordability, acceptability, access, as well as household and facility factors. The nominal group technique suggested that improvement in community-based services, transport access and lengthening service hours would alleviate some of the challenges in accessing care. Conclusions The barriers to accessing care seem insurmountable to those who encounter them, yet solutions and community assets do exist. The optimal utilization of services and community assets have the potential to improve access to care with resultant decreased out-of-hospital deaths and improvement of the under-5 mortality rate. A well-coordinated Community Orientated Primary Care (COPC) program with intersectoral collaboration and government commitment needs to be implemented. 2023-07-21T10:02:39Z 2023-07-21T10:02:39Z 2023 2023-07-21T10:01:18Z Master Thesis Masters MMed http://hdl.handle.net/11427/38148 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences
spellingShingle Medicine
Profitt, Luke
Barriers and facilitators to health care access for children in a low-income are in Cape Town
thesis_degree_str Master's
title Barriers and facilitators to health care access for children in a low-income are in Cape Town
title_full Barriers and facilitators to health care access for children in a low-income are in Cape Town
title_fullStr Barriers and facilitators to health care access for children in a low-income are in Cape Town
title_full_unstemmed Barriers and facilitators to health care access for children in a low-income are in Cape Town
title_short Barriers and facilitators to health care access for children in a low-income are in Cape Town
title_sort barriers and facilitators to health care access for children in a low income are in cape town
topic Medicine
url http://hdl.handle.net/11427/38148
work_keys_str_mv AT profittluke barriersandfacilitatorstohealthcareaccessforchildreninalowincomeareincapetown