Caregiver perspectives of risk and protective factors influencing early childhood development in low-income, urban settings: a social ecological perspective

South Africa is a diverse country characterised by stark inequalities that undermine early childhood development (ECD). Caregivers of young children play a critical role in providing nurturing care to mitigate against risks to ECD. The aim of this qualitative study was to explore caregivers’ perceptions of factors influencing ECD in a low-income, urban South African setting, from a social ecological perspective. Individual interviews were conducted with 15 caregivers of 3-5-year-old children from three low-income communities in Cape Town, and a reflexive thematic analysis approach was adopted. In the family and home context, caregivers spoke about their role in developing, nurturing, providing, protecting, and disciplining their children. Risks in this context included low socioeconomic status, dysfunctional relationships, and caregiver mental health; resources related to early learning and social support. In the preschool / school context, caregivers discussed the value of early learning, and priorities for selecting early childhood care and education settings. In the community context, risks included violence and crime, whereas resources mentioned were social support, community programmes, and infrastructure. Caregivers also shared perceptions of the community’s role in their child’s development. These findings should be considered in light of the structural violence experienced in low-income settings in South Africa in order to holistically address risks and amplify protective factors for promoting ECD and the provision of nurturing care in these settings.