Nutritional well-being of young children in Duncan Village, East London, South Africa: accessibility of primary health care clinics.

OBJECTIVE The aim was to contribute to the nutritional well-being of young children living in Duncan Village by investigating factors that influence clinic attendance of mothers and to formulate recommendations for optimisation of accessibility of primary health care (PHC) clinics in the area. DESIGN PHC clinic accessibility was evaluated by assessing the experiences of mothers who attended clinics in the area as well as the experiences of health care workers (HCWs) in these clinics of service delivery and its recipients (mothers/children), using the focus group technique. The ATLAS/ti program was used to analyse the data in the following steps: preparation and importing of the data, getting to know and coding the data, retrieval and examination of codes and quotations, creation of families and creation of networks. SETTING Duncan Village, a low socio-economic urban settlement in East London, South Africa. SUBJECTS Focus group discussions (four to seven participants per group) were conducted with four groups of mothers who do not attend PHC clinics, six with mothers who do attend the clinics (including pregnant women) and four groups of HCWs. RESULTS Four networks that provide a summary of all the major trends in the data were created. The results clearly indicate that mothers in Duncan Village perceive and/or experience serious problems that make it difficult for them to attend clinic and even prevent them from doing so. These problems include both the way they are treated at the clinics (especially the problem of verbal abuse) as well as the actual services delivered (no medicines, no help, disorganised, long waiting periods, being turned away). The main problem experienced by the HCWs with service delivery seems to be a heavy workload, as well as the fact that many mothers do not come for follow-up visits. CONCLUSION Efforts to increase the accessibility of PHC clinics in Duncan Village should focus on improving the relationship between mothers and HCWs and the heavy workload experienced by these workers.