Update from the field: Maternal healthcare experiences of Zimbabwean and South African women in Jo’burg

By Tackson Makandwa (Life in the City Doctoral Fellow, African Centre for Migration & Society, University of the Witwatersrand, Johannesburg, South Africa).

This blog gives an update on my PhD fieldwork and it is also part of a series of blog posts on the A to Z experiences during my fieldwork journey. This journey began with the process of seeking access to the research sites. However, in this post, I will simply give an introduction to what I am working on and an overall update of what I have achieved so far. My PhD research focuses on the maternal healthcare experiences and help-seeking behaviors of migrant women in urban spaces. This includes both internal and cross-border migrants relying on the public healthcare system and without medical aid (on the healthcare margins) in Johannesburg, South Africa. The research is qualitative in nature. Healthcare facilities were my entry point for accessing participants. I collected primary data from public healthcare facilities (clinics and hospital) in inner-city Johannesburg, South Africa, under the Mother, Child and Women’s Health Services section. I targeted both clinics and hospitals in region F, which is one of the 7 health regions in the City of Johannesburg. I got access to women attending their antenatal care (ANC) appointments, immunization schedules for their babies or postnatal care. I conducted interviews, observations and solicited for diaries over a period of 18 months from May 2016 to October 2017.

My participants were cross-border Zimbabwean migrants and South African women who have moved from South Africa’s other nine provinces into Gauteng province, particularly inner-city Johannesburg and key informants such as healthcare providers and department of health officials. The inclusion criteria for the women was that they had to be 18 years and above, self-identify as Zimbabwean or South African, be pregnant and attending ANC in public healthcare facilities or have delivered in the past 2 years having attended ANC in inner-city Johannesburg public healthcare facilities. I managed to conduct 70 interviews and 4 diaries – detailed in the table below, which includes repeated interviews with migrant mothers. The repeated interviews were done with pregnant mothers whom I followed until they gave birth. I conducted one detailed interview during pregnancy and one post-delivery, combined with informal discussions during their monthly ANC appointment dates.

I interviewed migrant women and key informants in inner-city Johannesburg Region F facilities, covering suburbs of Hillbrow, Yeoville, Beria, Jeppestown, Rosettenville, and Turfontein. These neighborhoods have a higher concentration of a heterogeneous migrant population who are ethnically and socioeconomically diverse. Since the study focuses on the maternal health care experiences and help-seeking behaviors of a particular population category, that is, internal and cross-border migrants, relying on the public healthcare system and without medical aid, it was fitting for this study to be conducted in a migrant dense area as this made it easier to identify participants.

The inner city was also convenient for several other reasons. First, this research builds on my Master’s thesis that I conducted in inner-city Johannesburg in 2013. Secondly I worked as a researcher in a project, which focused on the impact of migration on the South African public healthcare system, and the fieldwork was done in public healthcare facilities in Gauteng, including facilities in inner-city Johannesburg and the Limpopo province. Thirdly I am an active member of the Johannesburg Migrant Health Forum, which works to ensure that migrants’ rights to access health are realised. Hence it was relatively easier to obtain useful contacts to my study and to be accepted as a researcher around the facilities and migrant community. More so, being a migrant in the city and in South Africa, the inner-city that is home to a huge cohort of African migrants from within and beyond its borders made me feel at home within a broader context marred by imminent dangers of xenophobic violence and criminal activities.

Throughout this journey, I have managed to present part of the findings in two academic spaces. I presented in one of the works in progress presentations conducted at the Humanities PhD Resident Fellows Seminar Series and at the International Urban conference held in Cape Town in February 2018 (1 -3 February 2018). I also have some work in progress – a special issue paper under review (Special issue on Global Health Action), which is part of one of my PhD chapters. I am also looking forward to making a poster presentation at Africa in the World: Shifting Boundaries of Knowledge Production Conference this month (May 25 -29) in Johannesburg, South Africa. I will be constantly posting updates on the A to Z of my PhD fieldwork and writing process (I will call it writing “Johannesburg from within”).

 

Tackson table
Interviews conducted and diaries completed

This research is funded through MaHp, SeaM and a “Life in the City’ doctoral fellowship with the Wits School of Governance and hosted by The ACMS.