Dr Christiane Horwood


I am UK trained family physician, who has been working in South Africa for over 20 years. I am a senior researcher with extensive research experience in the field of maternal and child health and nutrition, with a focus on infant feeding, skills development, community health and implementation research.

I have experience of working in several African countries including Malawi and the Democratic Republic of Congo (DRC).  I have been the principal investigator for a number of large programme evaluations and randomized controlled trials (RCTs), including for newborn care, and breastfeeding support and

I have long-standing partnerships with both WHO and UNICEF. I have published over 40 peer-reviewed publications. Current projects include a qualitative longitudinal study with mothers working in the informal work environment to prospectively explore these women’s experiences and practices in regards to pregnancy, infant feeding and childcare. This is a WHO-funded project and project work is being carried out in South Africa and in India.

I am also PI for an upcoming RCT to evaluate the effectiveness of an electronic decision-making tool based on the Integrated Management of Childhood Illness (IMCI), known as eIMCI. I am currently completing a six-year in a partnership with colleagues in the DRC and in Norway to support the development and implementation of a post-graduate programme in nutritional epidemiology at the Kinshasa School of Public Health. I have extensive experience in teaching and supervising students at Masters Level.

Contact Details


Horwood C., Surie A., Haskins L., Luthuli S., Hinton R., Chowdhury A., Rollins N. 2020.  ‘She must cover up whilst the baby is feeding’: Experiences and attitudes about breastfeeding among female and male informal workers in India and South Africa.

Haskins L., Chiliza J., Barker P., Connolly C., Phakathi S., Feeley A., Horwood C.  2020.  Evaluation of the effectiveness of a quality improvement intervention to support integration of maternal, child and HIV care in primary health care facilities in South Africa. BMC Public Health (2020) 20:318. https://doi.org/10.1186/s12889-020-8397-2

Horwood C., Haskins L., Luthuli S., McKerrow N. Communication between mothers and health workers is important for quality of newborn care: a qualitative study in neonatal units in district hospitals in South Africa. BMC Pediatrics (2019) 19:496. https://doi.org/10.1186/s12887-019-1874-z

Horwood C, Haskins L, Engebretsen IM, Connolly C, Coutsoudis A, Spies L.  Are we doing enough? Improved breastfeeding practices at 14weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa. BMC Public Health

Horwood C., Haskins L., Goga A., Doherty T., John V., Engebretsen IMA., Feucht U., Rollins N., Kroon M., Sanders D., Tylleskar T.  2019. An educational intervention to update health workers about HIV and infant feeding. Maternal & child nutrition 2019:e12922. https://doi.org/10.1111/mcn.12922

Horwood C., Haskins L., Alfers L., Masango-Muzindutsi Z., Dobson R and Rollins N. 2019. A descriptive study to explore working conditions and childcare practices among informal women workers in KwaZulu-Natal, South Africa: identifying opportunities to support childcare for mothers in informal work. BMC Pediatrics (2019) 19:382

Haskins L., Phakathi S., Grant M., and Horwood C.  2019. Integrating services for impact and sustainability: a proof of concept project in KwaZulu-Natal, South Africa. South African Family Practice

Doherty T., Horwood C., Haskins L., Magasana V., Goga A., Feucht U., Sanders D., Tylleskar T., Kauchali S., Dhansay MA., Rollins N., Kroon M, Engebretsen IMA. 2019. Breastfeeding advice for reality: women’s perspectives on infant feeding support received in primary health care settings in South Africa. Maternal and Child Nutrition.

Horwood C., Haskins L., Phakathi S., and McKerrow N. 2019. A health systems strengthening intervention to improve quality of care for sick and small newborn infants: results from an evaluation in district hospitals in KwaZulu-Natal, South Africa. BMC Pediatrics (2019) 19:29. https://doi.org/10.1186/s12887-019-1396-8

Masango-Muzindutsi Z., Haskins, L., Wilford, A., and Horwood, C. 2018. Using an Action Learning methodology to develop skills of health managers: experiences from KwaZulu-Natal, South Africa. BMC Health Services Research (2018) 18:907. https://doi.org/10.1186/s12913-018-3693-6

Horwood C., Jama N., Haskins L., Coutsoudis A., and Spies L. 2018.  A qualitative study exploring infant feeding decisionmaking between birth and 6 months among HIVpositive mothers.  Maternal and Child Nutrition. 2018; e12726. https://doi.org/10.1111/mcn.12726

Horwood C., Haskins L., Engebretsen, IMS., Phakathi S., Connolly C., Coutsoudis A., and Spies L. 2018 Improved rates of exclusive breastfeeding at 14 weeks of age in KwaZulu Natal, South Africa: what are the challenges now? BMC Public Health. 18:757. https://doi.org/10.1186/s12889-018-5657-5

Haskins L., Nyasulu D., Davidge R., McKerrow N. and Horwood C. 2018. First experiences of accrediting district hospitals for excellence in newborn care in KwaZulu-Natal, South Africa: successes and challenges. Journal of Hospital Administration, 2018;7(3):25-34.

Jama, N., Wilford, A., Haskins, L, Coutsoudis, A., Spies, L., and Horwood, C. 2018. Autonomy and infant feeding decision-making among teenage mothers in a rural and urban setting in KwaZulu-Natal, South Africa. BMC Pregnancy Childbirth. 2018 Feb 17;18(1):52. doi: 10.1186/s12884-018-1675-7.

Wilford, A., Phakathi, S., Haskins, JL., Jama, N., Mntambo, N. and Horwood, C.  2018.  Exploring the care provided to mothers and children by community health workers in South Africa: missed opportunities to provide comprehensive care.  BMC Public Health, 23;18(1):171. doi: 10.1186/s12889-018-5056-y.

Jama, N., Wilford, A., Masango, Z., Haskins, L., Coutsoudis, A., Spies, L., and Horwood, C. 2017.  Enablers and barriers to success among mothers planning to exclusively breastfeed for 6 months: a qualitative prospective cohort study in KwaZulu-Natal, South Africa. International Breastfeeding Journal. 12:43

Horwood, C., Butler, L., Barker, P., Phakathi, S., Haskins, L., Grant, M., Mntambo, N. and Rollins, N. 2017. A continuous quality improvement intervention to improve the effectiveness of community health workers providing care to mothers and children: a cluster randomized controlled trial in South Africa. Human Resources for Health

Haskins, L., Grant, M., Phakathi, S., Wilford, A., Jama, N., & Horwood, C. 2017. Insights into healthcare seeking behaviour for children in communities in KwaZulu-Natal, South Africa. African Journal of Primary Health Care & Family Medicine. 2017;9(1), a1378. https://doi.org/10.4102/phcfm.v9i1.1378 

Grant, M., Wilford,  A., Haskins, L., Phakathi,  S., Mntambo,  N. & Horwood, C. 2017. Trust of community health workers is a key barrier to acceptance of community-based maternal and child health services in KwaZulu-Natal, South Africa: a qualitative study. African Journal of Primary Health Care & Family Medicine. 2017;9(1), a1281. https://doi. org/10.4102/phcfm.v9i1.1281 

Haskins, L., Grant, M., Phakathi, S., & Horwood, C. Factors influencing recruitment and retention of professional nurses, doctors and allied health professionals in rural hospitals in KwaZulu Natal. Health SA Gesondheid 22 (2017): 174-183

Haskins, L., Grant, M., Phakathi, S., Mntambo, N., Wilford, A., & Horwood, C. 2016. Fragmentation of maternal, child and HIV services: a missed opportunity to provide comprehensive care. African Journal of Primary Health Care & Family Medicine. ISSN: (Online) 2071-2936, (Print) 2071-2928

Haskins, J.L.M., Phakathi, S., Grant, M. and Horwood, C.M. Attitudes of nurse towards patient care at a rural district hospital in KwaZulu-Natal, South Africa. Africa Journal of Nursing and Midwifery. 2014, 16 (1): 32-44

Horwood, C., Butler, L.M., Haskins, L., Phakathi, S. and Rollins, N. HIV-infected adolescent mothers and their infants: Low coverage of HIV services and high risk of HIV transmission in KwaZulu-Natal, South Africa. PLOS One: 2013, 10.1371/journal.pone.0074568

Grant, M., Haskins, L., Gaede, B. and Horwood, C. 2013. Bridging the gap: exploring the attitudes and beliefs of nurses and patients about coexisting traditional and biomedical healthcare systems in a rural setting in KwaZulu-Natal. South African Family Practice. 2013, 55 (2): 175-179

Horwood C., Vermaak K., Butler, L., Haskins, L., Phakathi S. and Rollins N. 2012. Elimination of paediatric HIV from Kwa-Zulu Natal, South Africa: large scale assessment of interventions for the prevention of mother-to-child transmission. 2012. WHO Bulletin

Horwood, C., Butler, L.M., Vermaak, K., Rollins, N., Haskins, L., Nkosi, P., Nielands, T.B., and Qazi, S. 2011. Disease profile of children under 5 years attending primary health clinics in a high HIV prevalence setting in South Africa. Tropical Medicine and International health, 16(1): 42-52

Horwood, C., Haskins, L., Vermaak, K., Phakathi, S., Subbaye, R. and Doherty, T. 2010. Prevention of mother to child transmission of HIV (PMTCT) programme in KwaZulu Natal, South Africa: an evaluation of PMTCT implementation and integration into routine maternal, child and women’s health services. Tropical Medicine and International health. 2010, 15(9): 992-999.

Nkosi P, Horwood C, Vermaak K, Cosser C, Haskins JL. 2009. Role of doctors in provision of support for primary health care clinics in rural KwaZulu-Natal. SA Journal of Family Practice 2009, 51(5): 408-412

Horwood C, Vermaak K, Rollins N, Haskins L, Nkosi P, Qazi S. 2009. Paediatric HIV management at primary care level: an evaluation of the integrated management of childhood illness (IMCI) guidelines for HIV. BMC Pediatr. 2009 Sep 22; 9(1):59.

Horwood C, Vermaak K, Rollins N, Haskins L, Nkosi P, Qazi S. 2009. An evaluation of the quality of IMCI assessments among IMCI trained health workers in South Africa. PLoS One. 2009; 4(6):e5937

Haskins, J.L.M. 2006. To what extent are nurses using recognised IMCI protocols to identify and manage children with HIV: an evaluation of IMCI trained nurses in KwaZulu Natal in the use of the HIV portion of the IMCI algorithm. Africa Journal of Nursing and Midwifery. 2006, Volume 8, Issue 2: Page 3 – 14. 

Haskins, J.L.M. and Grainger, L.D. 2005. Accuracy of the use of the IMCI algorithm. An evaluation of IMCI trained nurses in KwaZulu Natal, South Africa. Africa Journal of Nursing and Midwifery. 2005, Volume 7, Issue 2: Page 3 – 16.