Community health worker's perspective of mother–infant bonding within the the first 1000 days of life in Khayelitsha, South Africa

Abstract

While community health workers possess valuable insight into health care delivery in South Africa, their voices and experiences are seldom sought in the acquisition of knowledge surrounding relevant social concerns. This research aimed to explore community health workers’ perspectives of mother–infant bonding within the first 1000 days of life. The first 1000 days of a child’s life are a delicate yet highly consequential period affecting future physical, cognitive, and socio-emotional growth. The bond between mother and infant within the first 1000 days is especially critical as it is within the bounds of this relationship that a child is fed, cared for, and kept safe. Furthermore, mother–infant bonding lays an essential foundation for future development. However, there is a paucity of contextualized literature, particularly regarding mother–infant bonding in the first 1000 days. In practice, mother–infant interventions are often delivered by community health workers. Through their work, community health workers gain a wealth of knowledge and information about the experiences and practices of bonding within their community. Their insights are a potentially untapped resource which could be used to supplement research and interventions with local, contextualized wisdom. The aim of this research was to explore community health workers’ perspectives of mother–infant bonding within the first 1000 days in Khayelitsha, South Africa. The study utilized a qualitative methodological framework and an exploratory research design. Semi-structured individual interviews were conducted with 15 experienced community health workers, who were purposively selected from a non-governmental organization located in Khayelitsha, South Africa. Data were thematically analysed, and five primary themes emerged from the analysis, namely: (1) the importance of the first 1000 days; (2) the centrality of mother–infant bonding within the first 1000 days; (3) effective approaches to bonding are simple, natural, and free; (4) the inhibitors of mother–infant bonding; and (5) the need for support. Trustworthiness and researcher reflexivity practices were integrated throughout the research process. Ethics considerations were prioritized, and included providing informed consent, ensuring confidentiality and anonymity, and informing participants of their rights as stipulated by the University of the Western Cape Biomedical Research Ethics Committee.