Nearly eight million children in South Africa live in households headed by a grandparent. According to Stats SA’s 2023 data, 3.4 million grandparents lead these households, with 64.5% headed by grandmothers, locally known as gogos. For these older women, caregiving is a full-time responsibility, often alongside limited income and their own health needs. It can also bring pressures that are easily overlooked, including caregiving stress, economic insecurity, grief and loss, emotional labour and household decision-making.
Social grants are the main source of income for 48.4% of these households. Among households where grandparents live with children, 40.6% have no employed member, while 86.3% turn first to a public clinic when someone falls ill and only 5.2% have medical aid cover. When a gogo’s wellbeing is overlooked, the strain can travel through the same relationships that sustain the children in her care. This makes older caregivers’ wellbeing part of the household’s wider health.
“Gogos are often the people everyone turns to, but that can make it easy to overlook what they themselves are carrying. Their wellbeing needs to be part of how we think about the health of a household,” says Jane Simmonds, Founder of goGOGOgo.
Creating space to pause and breathe
Phefumula GOGO! is a community-based group programme delivered by Breathwork Africa with goGOGOgo, creating dedicated breathing space for gogos and the grandchildren they raise. The programme was presented at the World Congress on Public Health in Cape Town in September 2026. The word Phefumula means “breathe”. Sessions take place in a secure community setting and are led by Breathwork Africa-certified practitioners, combining guided breathing practice with discussion, reflection and practical tools.
Participants arrive, name the pressures they carry, notice where stress shows up in the body, practise structured breathing exercises, reflect on what felt useful, and choose simple tools to use at home and with their grandchildren.
“Breath is the one resource every gogo already carries with her. It is free, always available, and belongs to everyone. Phefumula GOGO! begins there, giving gogos practical ways to pause, recognise stress and settle, and share those tools with the children they raise,” says Dr Ela Manga, Founder and CEO of Breathwork Africa.
Early findings point to connection and demand
More than 50 gogos and 10 grandchildren have participated in the intergenerational breathing classes pilot across 3 provinces- Limpopo, Mpumalanga and Gauteng through three sessions. Reflections gathered before and after sessions tracked participants’ confidence in using breathwork and captured their feedback directly.
Early feedback points to lower perceived tension and stress, a strong desire for the sessions to continue and a sense of connection among participants. Gogos also said the group made stress and coping easier to discuss and helped them recognise their experiences in those of their peers.
“I used to go to my room after shouting at my grandchild and pray. After doing the Warrior Breath exercise, I felt relieved,” says one gogo from Mpumalanga.
These findings are preliminary and based on participant feedback. Larger groups, consistent measures and longer follow-up will be needed to understand longer-term outcomes.
From pilot to community practice
The programme is intended to complement existing health and social support, rather than replace clinical care. Next steps include repeat sessions, peer-led practice, delivery through trusted community organisations linked to appropriate services, and further research.
“Supporting gogos supports the children they raise and the community around them. We hope Phefumula GOGO! encourages more organisations to bring caregiver wellbeing into community health work,” concludes Simmonds.