Infant mortality is internationally recognized as one of the most important indicators of health and development. Yet alarmingly high infant mortality rates continue to plague many countries, particularly within poor communities with inadequate infrastructure and high exposure to disease. In South Africa, the legacy of Apartheid's maldistribution of resources remains apparent in peri-urban townships and rural areas where the mortality rate among black infants is up to 15 times higher than the rate among white South African infants. In these settings, little is known about caregivers' perceptions regarding the processes and events leading up to and surrounding the death of their infants. To date, no study has endeavored to let families in resource- poor settings of South Africa tell their own stories directly, an approach that is likely to provide additional insights into the supports received and problems and barriers encountered during their child's illness, as well as insights into how the health system can more effectively respond to the needs of these families. This study aims to identify the behavioral, structural, and systemic factors that play a role in the deaths of infants in resource-poor settings of South Africa. Research objectives are: 1) to document caregivers' attitudes toward and perceptions about the events leading up to the infant's death, the accessibility and desirability of available health services, and information about their social supports and recommendations for improving health care in the community; and 2) to document the perceptions of local community leaders and providers regarding the accessibility and desirability of available health services, the behavioral, structural, and systemic factors associated with infant death, and their recommendations for improving health care in the community. In-depth interviews will be conducted with caregivers to assess their interpretations of the forces and influences relating to their infants' deaths. Key informant interviews will be conducted with local leaders and health providers in order to better understand the system of health care available for families. By using an innovative research method, this study will provide new information regarding social, economic, cultural, and health factors associated with infant mortality. It also will provide client-based information that will enable the development of targeted interventions and policies to address these factors and improve service systems and community resources. ? ? ?
| Sharkey, Alyssa B; Chopra, Mickey; Jackson, Debra et al. (2012) Pathways of care-seeking during fatal infant illnesses in under-resourced South African settings. Trans R Soc Trop Med Hyg 106:110-6 |
| Sharkey, Alyssa; Chopra, Mickey; Jackson, Debra et al. (2011) Influences on healthcare-seeking during final illnesses of infants in under-resourced South African settings. J Health Popul Nutr 29:379-87 |
