Health beliefs and health seeking behaviour among families of children with a respiratory illness in Cape Town, South Africa: lessons learnt from the COVID-19 pandemic

Globally, acute respiratory infections(ARIs)are one of the leading causes of mortality and morbidity in children and the most common causes of visits of children to health facilities. Pandemics can unintentionally negatively impact on health beliefs and health-seeking behaviour, irrespective of health problem. In this study we describe the health beliefs, knowledge and health-seeking behaviour of families of children with respiratory symptoms, in the context of the COVID-19 pandemic. Focusing on lessons learnt. A cross-sectional study within a prospective COVID-Kids cohort study in Cape Town, South Africa. Quantitative data on health beliefs, knowledge and health-seeking behavious were collected using an adapted Coronavirus Rapid Mobile survey(CRAM)measure. Qualitative data collected through semi-structured interviews. We used comparative thematic analysis and descriptive statistics. Caregivers of 62 children completed surveys; of which 15 households had a child tested positive for COVID-19. Qualitative data was collected from 21 caregivers of children. The main source of knowledge during the COVID-19 pandemic were media outlets e.g.: radio, television and newspaper. Overall, most caregivers reported a distrust in the government. Basic infection control information was well understood, but responses to more complex infection control were suboptimal. Health beliefs influenced health-seeking behavior, with some evidence suggesting the presence of problematic health beliefs. Data presented in this paper offers valuable information to improve preparedness for future pandemics. Investing in collaboration with communities is crucial for co-developing relevant informational materials, improving symptom recognition, and enhancing service delivery for caregivers. These efforts can strengthen trust between governments and communities, fostering more appropriate health behavior responses.