Factors contributing to home deaths for children under 5 years old in Okavango district for the year 2021-2022: An Exploratory study
1
Public Health, Unicaf University, Lusaka, Zambia
2
Medicine, University Of The West Indies, Montego Bay, Jamaica
3
Health Education, Boitekanelo, Gaborone, Botswana
4
Agricultural Education, Uninersity Of Botswana, Gaborone, Botswana
5
Medicine, University Hospital Of Kinshansa, Kinshasa, Congo, Democratic Republic of the
6
Social Sciences, University Of Botswana, Gaborone, Botswana
Popul. Med. 2026;8(Supplement Supplement 1):A1156
ABSTRACT
INTRODUCTION:
Globally under five mortality has declined over the past two decades, yet in 2017 alone, 6.3 million under five children died largely from preventable causes. Sub Saharan Africa carries the highest burden of deaths occurring at home. In Botswana, under five mortality rate is around 22 per 1,000 live births. In Okavango District, 26% of under five deaths over three years occurred at home, with a rising trend in 2022—underscoring an urgent need to investigate underlying causes.
METHODS:
This qualitative study focused on children died outside health facilities who reside and mortality occurred in Okavango district. Semi structured, in depth interviews were conducted, analyzed using both descriptive statistics and thematic analysis. Sample size determined by data saturation.
RESULTS:
Seven mothers meeting inclusion criteria were interviewed. Most were single, unemployed and had completed junior secondary education. Identified themes: Caregivers often turned to traditional healers/ religious remedies as alternative medical care, Witchcraft, cultural taboos and beliefs, Health system gaps—weak referrals, inadequate assessments and staffing shortages. Moreover, child negligence led to delayed care-seeking or mismanagement while extended family influence further discouraged formal healthcare
DISCUSSION:
This study addresses a critical issue in line with the Sustainable Development Goals particularly in the Sub-Saharan African context. Its qualitative approach offers insight into sociocultural, health system, and household-level factors that quantitative data might overlook. Themes identified especially reliance on alternative medicine and perceptions of illness rooted in tradition and witchcraft strongly influence care-seeking behaviors. Service delivery challenges exacerbate delays in accessing appropriate care. Poor parenting practices, neglect and harmful family dynamics also play a crucial role in child health outcomes.
CONCLUSIONS:
These insights underline the need for culturally sensitive health education, improved healthcare access and delivery, performance of Post mortem to all non-institutional mortalities and strengthened community and family support systems to reduce preventable child deaths.
Globally under five mortality has declined over the past two decades, yet in 2017 alone, 6.3 million under five children died largely from preventable causes. Sub Saharan Africa carries the highest burden of deaths occurring at home. In Botswana, under five mortality rate is around 22 per 1,000 live births. In Okavango District, 26% of under five deaths over three years occurred at home, with a rising trend in 2022—underscoring an urgent need to investigate underlying causes.
METHODS:
This qualitative study focused on children died outside health facilities who reside and mortality occurred in Okavango district. Semi structured, in depth interviews were conducted, analyzed using both descriptive statistics and thematic analysis. Sample size determined by data saturation.
RESULTS:
Seven mothers meeting inclusion criteria were interviewed. Most were single, unemployed and had completed junior secondary education. Identified themes: Caregivers often turned to traditional healers/ religious remedies as alternative medical care, Witchcraft, cultural taboos and beliefs, Health system gaps—weak referrals, inadequate assessments and staffing shortages. Moreover, child negligence led to delayed care-seeking or mismanagement while extended family influence further discouraged formal healthcare
DISCUSSION:
This study addresses a critical issue in line with the Sustainable Development Goals particularly in the Sub-Saharan African context. Its qualitative approach offers insight into sociocultural, health system, and household-level factors that quantitative data might overlook. Themes identified especially reliance on alternative medicine and perceptions of illness rooted in tradition and witchcraft strongly influence care-seeking behaviors. Service delivery challenges exacerbate delays in accessing appropriate care. Poor parenting practices, neglect and harmful family dynamics also play a crucial role in child health outcomes.
CONCLUSIONS:
These insights underline the need for culturally sensitive health education, improved healthcare access and delivery, performance of Post mortem to all non-institutional mortalities and strengthened community and family support systems to reduce preventable child deaths.
| eISSN: | 2654-1459 |
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