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Review Article
Home visits for preterm/low birthweight infants in South Africa: Qualitative evidence synthesis
Submitted: 31 July 2024 | Published: 20 November 2024
About the author(s)
Sara Cooper, Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; and, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; and, Department of Global Health, Stellenbosch University, Cape Town, South AfricaIdriss I. Kallon, Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Denny Mabetha, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
Amanda S. Brand, Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Tamara Kredo, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; and, Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, School of Family Medicine and Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Shakti Pillay, Division of Neonatology, Groote Schuur Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Gugu Kali, Division of Neonatology, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
Willem Odendaal, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; and, HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa; and, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Abstract
Background: Prematurity and low birth weight (LBW) are the main causes of neonatal mortality in South Africa (SA). Home visits by lay health workers (LHWs) may be effective in addressing this.
Aim: To inform a national guideline on LHW home visits as part of the Global Evidence, Local Adaptation (GELA) project, we conducted a rapid qualitative evidence synthesis exploring the acceptability, feasibility and equitability of this intervention for preterm and LBW babies.
Setting: We included studies conducted in SA.
Methods: We searched PubMed and Embase until 15 September 2023 and identified eligible studies independently and in duplicate. We synthesised evidence using thematic analysis, assessed study quality using an adaptation of the Critical Appraisal Skills Programme tool and assessed confidence in the review findings using GRADE-CERQual.
Results: The 16 eligible studies included diverse settings and populations in SA. Factors facilitating mothers’ acceptance included the knowledge and skills gained, the psychosocial support offered and improved healthcare access and relationships with facility staff. Distrust in LHWs and stigma associated with home visits were barriers to acceptance. Lay health workers’ acceptance was facilitated by them feeling empowered. The emotional burden of home visits for LHWs, coupled with insufficient training and support, undermined the feasibility of home visits.
Conclusion: A complex range of interacting contextual factors may impact on the implementation of home visit programmes for preterm and LBW infants in SA.
Contribution: This country profile provides insights into how home visits for preterm and LBW infants in SA might be contextually tailored to increase local relevance and in turn effectiveness, with potential relevance for other African countries.
Keywords
Sustainable Development Goal
Metrics
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