Factors influencing primary health care services utilisation by children living in child-headed households in a rural community of Swaziland

Abstract

Background: Children living in child-headed households have health needs that require treatment and care. Matsanjeni is one of the poorest socio-economic areas of Swaziland with the high number of children orphaned by HIV and AIDS who are often living without adequate family and social supports. These conditions are known for increasing people vulnerability to diseases and hindering access and utilization of health services. However, children living in child-headed households in Matsajeni community do attend the primary health care (PHC) services on regular basis. What influence the utilization of the above services by children living in child-headed households in the Matsanjeni community is not clear and well documented. Aim of the study: To explore and describe the views of children living in child-headed households in a rural community of Swaziland regarding factors influencing their utilization of PHC services. Design: A qualitative descriptive design was used to guide the study. Purposive sampling was used to select the most senior child from child-headed households in a rural community. Semi-structured individual face-to-face interviews were used to generate data. Data saturation was reached after twenty interviews. Thematic content analysis was used to analyse data. The researcher used Andersen behavioural model was to identify and organised the emerged themes. Ethical clearance was obtained from the Ethics Committees of the University of South Africa and the Ministry of Health of Swaziland. Results: Fear to develop a deadly disease, perceived seriousness of the condition, desire for compliance to medical treatment, and community support emerged as enablers of primary health care services utilisation among children living in child-headed households. While lack of money, ignorance, shortage of healthcare personnel, negative behaviour and attitude of health professionals, long waiting hours, unreliable transportation system, and long distance emerged as inhibitors of primary health care services utilisation among children living in child-headed households. Conclusion and recommendation: The results of this study add to our understanding factors that positively and negatively influence the utilisation of primary health care services among children living in child-headed households in rural communities. The findings suggest that the utilisation of primary health care services among children living in child-headed households is influenced by need for care-enabling resources-experience of care triad. Behavioural and social welfare interventions are needed to enhance the utilisation of primary health care services among this vulnerable section of the community in Swaziland. Recommendation for further research is also articulated.