An analysis of health behaviour of children from child headed households in a selected health district in KwaZulu-Natal : an ethnographic study.

Ph. D. University of KwaZulu-Natal, Durban 2013.Introduction The loss of a parent predominantly as a result of HIV and AIDS disease has a negative effect on children, which can lead to increased number of orphans. Traditionally the extended family would take in orphaned children into their extended families and make one big family where culture of ‘’Ubuntu’’ still prevailed. The changes in the socio-economic systems and family structure leaves the children with very little choice but to make alternative living arrangements, where they find themselves in child headed household families. The eldest child becomes the head (caregiver) within a household. The aim of the study was to explore the health behavior, health seeking behavior and issues of access to health and social care services to children coming from child headed household families in a selected district in KwaZulu Natal. Methodology A qualitative approach using ethnographic method was conducted. Three households were purposefully chosen with a total of nine participants. Data collection processes included participant observation in their natural setting, individual interviews as well as focus group interviews in their own environment. Children participants were so heterogeneous that they could not be studied together in a focus group for three families, but the volunteers and professional group could be studied together in a focus group. The data analysis followed Spradley’s (1980) three levels of analysis called the domain, taxonomic and componential analysis as presented in chapter five. Findings The children’s health behavior is affected by the HIV and AIDS infection, poverty and lack of support from the extended family and communities. Their health seeking behavior is influenced by the previous history and attitudes towards the health professionals. The access to health and social care services is also surrounded with mistrust of the present health care system. Conclusions and study recommendations The discussions in the current study focuses mainly on the logistics of awarding the child headed status by the court of law as the lengthy and tedious process, but as the best practice because it eliminates the corruption and fraud in the system by expecting the children to be physically (identified) presented before the court of law before awarding of the status. The legislative ambiguity, shortage of volunteers, unaffordable transport and the attitude of the health care professionals impact negatively on the child headed household children’s health seeking behavior to an extent that children tend to avoid accessing health and social care services until they are very ill to be picked up by an ambulance which bypasses the administration section which subjects them to sad memories and embarrassing questions such as those related to HIV statuses of their late parents which could imply theirs too, within a limited space. The study recommended a longitudinal case study to be undertaken to follow up on the children who are 18 years and above as it appears that they tend to get lost in the thick vicious world and end up in the wrong side of the law. All participants echoed that the poor coordination of services made available for such children should be urgently attended to by government, the Faith Based Organizations (FBO) meaning the structures that represent the church and responsible Non-Governmental organizations (NGO’s). The greatest limitation of the study was that it was qualitative and used only nine participants in three families, hence cannot be generalized beyond the context of the study