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Brenna Marshall

Gligorije Rakocevic

Ahmed Alhashmi

Mohammed Al Khalifa

Saif Alhajry

South Africa: Weekly Report #1

For a long period of time South Africa has experienced a dysfunctional health system and a range of communicable and non-communicable diseases that rooted in the policies developed in periods of the country’s history. Aspects of colonial subjugation, apartheid dispossession, racial and gender discrimination in the post-apartheid error, vast inequalities in income, and extreme violence have worsened the situation and increased disease burden in South Africa. The country’s troubled past has significantly affected health service delivery and many health challenges still persist decades after apartheid. Most of the macroeconomic policies established fostered growth instead of redistribution continuing the disparities which still existed during apartheid. Notably, South Africa’s health system has undergone transformation to become a comprehensive and integrated national service. However, failures by the leadership and weak management of the system have resulted in the poor implementation of the well-drafted policies. Fundamental aspects of primary healthcare are missing and a human resources crisis is facing the sector. Further, the HIV epidemic has complicated the present challenges in South Africa’s healthcare system.

South Africa has experienced notable inequalities in healthcare access. Thus, understanding the history of South Africa’s healthcare from the social and political contexts is vital. The existing power structures in the country ought to be acknowledged to enable the trickling of inequalities. Mayosi & Benatar (2014) agrees to the health and wellbeing of many South Africans is still plagued by a continued burden of non-communicable and infectious diseases, social inequalities, human resources in a rising population, and a migrant and refugee influx. Therefore, in understanding the determinants of health and measuring the burden of disease in South Africa, it is essential to discuss the history, health status and health determinants in the country.

The health sector in South Africa has been on constant development and transformation throughout the history of the country. Changes in the industry can be seen when a comparison is made between the healthcare status in the colonial reign, apartheid withdrawal, and the post-apartheid period — political and social factors influence history of Health and medicine in South Africa.

Health development in South Africa began with a focus on biomedical studies. As evidence shows, early researches in South Africa emphasized diseases that affected economic progress (Linegar et al., 2011). These diseases included mostly water-borne diseases such as cholera and bilharzia as they had a direct impact on public health. By the year 1958, medicine in South Africa was dominantly practiced by the whites, precisely British practitioners who came into the country as colonizers, adventurers or missionaries. During the apartheid reign, health provision in South Africa was distributed solely on social segregation. The whites received medical treatment in specific hospitals that offered advanced services as opposed to the hospitals for the black race. The exceptional blacks who were eligible for good health care were those in the political class. Additionally, more research work was done in public health in diseases such as tuberculosis, and syphilis.

Since 1994 when the apartheid regime came to an end with Nelson Mandela becoming the county’s first black president, the health system has transformed into a pluralistic one. In early 1996, free medical care was introduced in the country (Linegar et al., 2011). Later that year, medical services were made free for all the people. From the beginning of the 21st century, the public health sector has been improving although its standard still lower as compared to the private health facilities. Majority of the funding in the public health sector comes from the government whereas both the government and other investors dominate the private one. As of 2016, life expectancy in South Africa was estimated to be 49.99 years (Roser, 2016). As more health advancements are made in the country, the life expectancy is likely to rise.

South Africa is considered as one of the most important countries when it comes to health status. According to the latest Lancet Healthcare Access and Quality Index, South Africa’s healthcare has ranked 119 out of 195 countries in the world. The health “quality” can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (Writer, S., 2017). The population of South Africa is also very low compared to other countries around the world. It has around 56 million people and South Africa has a high rate of communicable diseases, which more specifically here. First, HIV is a real client killer that had killed 78% of total deaths from 1988 to 1995 in the world, this disease was discovered in West Africa in 1930, and it is spread all over the world. However, HIV is ranked first in causes of death in South Africa, and the health representatives in South Africa are working hard to educate people about how to avoid it and adapt with it to reduce this range of risk in next generation. Second, Malaria is caused of fear for many people who would like to travel to poor country such as South Africa, Furthermore, Malaria could be infected easier than any diseases but hopefully it is a curable disease. According to Health department in South Africa “malaria is transmitted through the bites of female Anopheles mosquitoes. There are more than 400 different species of Anopheles” so this fact could be increased probably of death of Malaria to people who live in South Africa (Hofman, K. n.d.).

Also South Africa has a high rate of non-communicable diseases that could kill you without infection, according to The South African Medical Journal “ The accumulated losses to South Africa (SA)’s gross domestic product between 2006 and 2015 from diabetes, stroke and coronary heart disease alone are estimated to cost the country US$1.88 billion.” Which is describing the amount of money that government spend it to cure these non-commutable disease. Finally, Country with 62.77 life expectancy is considering a unhealthy country. Nevertheless, 38 child death per 1000 in South Africa is a good stats comparing with other countries in Africa.

There are several determinants of health in South Africa. A few that have a major impact on the population include; education, transportation, income, employment and safety (Chiwire, P., 2016). Although there are national and provincial efforts being made to increase access to healthcare, the lack of education that many of the people have, who come from rural parts of South Africa have kept the people from getting the healthcare and jobs they need. Economic circumstances are much poorer in rural communities in terms of not only affordability, but also in transportation (Chiwire, P., 2016). With that in mind, traditional healers then become the go-to doctors; many of which are bogus and only some actually have the capability of treating someone (Chiwire, P., 2016)

The lack of income is also a major determinant of health in South Africa. While money can't buy happiness, it’s an important factor in achieving higher living standards. The average household net-adjusted disposable income per capita is $10,872 per year, which is lower than the Organization for Economic Co-operation and Development (OECD) average of $30,563 per year (South Africa, n.d.). The lack of employment, particularly of black South Africans, is a huge reason there is such high income inequality and ultimately affects the quality of healthcare that those individuals are receiving. Having a good education is very important when looking for a job in South Africa and only 43% of adults ages 25-64 have completed upper secondary education, which is also much lower than the OECD average of 73% (South Africa, n.d.).

References

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Hofman, K. (n.d.). Non-communicable diseases in South Africa: A challenge to economic

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Mayosi, B. M., & Benatar, S. R. (2014). Health and health care in South Africa—20 years after

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Roser, M. (2016). Life expectancy. OurWorldInData. org. Available at ourworldindata. org/data/population-growth-vital-statistics/life-expectancy/. Accessed February, 3, 2016.

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Writer, S. (2017, May 17). The quality of South Africa's healthcare vs the world. Retrieved from

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