Abstract:
Neonatal and pediatric health outcomes in peri-urban informal settlements are shaped by complex, interrelated ecological factors. This study examines how economic hardship, early pregnancies, and survival-driven transactional sex influence child health outcomes in Epworth, Zimbabwe, using Bronfenbrenner’s ecological systems theory as an analytical framework (Bronfenbrenner, 1979). A qualitative case study design involving 10 participants was employed to capture lived experiences of young mothers and caregivers. At the microsystem level, poverty and limited parental support contribute to early pregnancies and reduced capacity to access healthcare. At the mesosystem level, weak linkages between families, schools, and health services hinder effective health education and service utilisation. Exosystem influences include high unemployment rates and limited access to adolescent-friendly reproductive health services, increasing vulnerability to risky behaviours (WHO, 2020). At the macrosystem level, entrenched socio-cultural norms, gender inequalities, and economic instability perpetuate cycles of poverty, affecting maternal and child health outcomes (UNICEF, 2021). Findings indicate increased risks of low birth weight, preterm births, and childhood malnutrition, compounded by inconsistent antenatal care attendance. Despite these challenges, community-based interventions and informal support networks demonstrate potential for improving outcomes. The study concludes that addressing neonatal and pediatric health disparities in Epworth requires integrated, multi-level interventions that address both structural inequalities and healthcare access. An ecological approach provides a comprehensive framework for designing contextually relevant and sustainable health interventions in marginalized urban settings.
Keywords: Neonatal health; pediatric care; ecological systems theory; poverty; early pregnancy; transactional sex; Zimbabwe; urban health; social determinants of health.
