Socio-cultural Foundations of Caregiver Institutions: Lineage and Community Networks in Zimbabwe’s Health Care System

This study sought to investigate factors that affect caregiver compliance to professional health advice with reference to children. An anthropological approach was used and clients were observed from mainstream health facilities to their homes to analyze the broader social structures, in familial settings, that influence decision making and final practices of the caregiver who visits the health centres. The study revealed a more complex pattern with a sophisticated cultural structure of caregivers who control and make decisions other than the person who visits the facility. Often this structure is unknown to mainstream health professionals with consequences on efficacy. In addition to the social structures is a powerful belief system that conditions the caregiver. This significantly compromises the advice by mainstream health professionals in a dual health care delivery system as Zimbabwe's. The study recommends that to improve on caregiver compliance mainstream health professionals need to know and engage this other invisible caregiver structure.