Primary Health Care in South Africa - Term Paper Example

PRIMARY HEALTH CARE IN SOUTH AFRICA Contents Introduction………………………………………………………………………..2 2. Demographic and Epidemiological Profile………………………………………..3 3. Comparison of illness patterns with developed economies……………………….5 4. Relationship between development and health……………………………….......6 5. Conclusion………………………………………………………………………...7 References…………………………………………………………………………8 1. Introduction The achievements in terms of primary health care in South Africa, in spite of several efforts in the past, still remains largely fragmented. There have been several persistent attempts including those at local as well as international levels, to revive the health care services in the country, but the impact of such efforts has been limited and the country continues to lag behind in terms of providing satisfactory levels of primary health care facilities to its citizens. The failure of such policies to revive and elevate the status of the countrys health care system could be on account of several factors such as hostile state interventions, or the unfavorable policy environment that dominated the apartheid era. The country has struggled for decades to provide primary health care facilities to eradicate the large scale health issues faced by a substantial part of its population which includes pandemics like HIV and AIDS, and other problems such as inadequate health workers, widespread disparities in resource allocation, political limitations, inefficient public sector reforms, lack of medical and health leadership and a complicated health transition. Successive governments in the country have failed so far, to implement a people oriented health care system which aims at addressing the health related issues faced by them. This essay on Primary Health Care in South Africa aims to assess, study and analyze the status of the primary health care services in the democratic nation state and discusses various aspects related to it, such as the epidemiological profile, illness patters as compared to that in developed countries as well as the relationship between health and development among others. 2. Demographic and Epidemiological Profile South Africa has a unitary system of government comprising of three distinct spheres. All the nine provinces have their independent legislatures, administrative structures and committees and the national and provincial governments are in charge of supervising the provision of basic amenities which includes housing, health and welfare, and education. The provision of primary health care is the prerogative of the local governments. However, they have not yet been able to provide substantial services owing to the rift between the local governments and provincial health authorities. Also there is serious confusion regarding the provision of finance required for offering primary health care services which explains the deficit in funding. Figure 1: Basic Indicators1 However, certain governmental initiatives such as the Batho Pele (People First) program which was launched across the public sector and the Patients Rights Charter in the health sector, provides evidence about the determination of the countrys government to offer good quality humane service programs. These initiatives also aimed at enhancing the accountability of civil servants to local communities as well as those relying on government services for provision of health care facilities. Figure 2: Adult HIV prevalence in South Africa provinces2 The country is among one of the hardest hit regions in terms critical epidemics and has the highest rate of HIV / AIDS related cases in the world with as many as 5 700 000 living with the deadly disease of which 18.1% fall between the age group of 15 and 49. Women are one of the most affected groups with over 3 200 000 women above the age of 15 suffering from HIV / AIDS3. Figure 3: Health Profile4 Some of the major diseases documented in South Africa include HIV/ AIDS, Malaria, Tuberculosis, Schistosomiasis, Cholera, Amoebiasis, Typhoid Fever, and Leprosy. As many as forty four different species of malaria parasites have been confirmed in the country the transmission of which occurs mainly in the three major northern provincial areas along the Mozambique and Swaziland borders which lasts from any where between 1 to 7 months during the months of October and April. There is no uniform drug policy in any of the three provinces mentioned above and differs widely in terms of treatment and drugs prescribed. 3. Comparison of illness types with developed economies The pattern of illness differs from country to country and it particularly varies according to the economic status of countries since it largely depends on various factors such as environmental, social, and economic as well as others such as the manner of treatment, availability of consumer health services, efficiency of professional health care sector and medical advancement. South Africa can be characterized as an economically less developed country with rapid population growth, high rates of unemployment and poverty and a privileged minority (comprising of white population). The pattern of illness and mortality is hence typical to those associated with such economies i.e., diseases caused are mostly on account of poor socio economic conditions, over crowding, poor housing, poor sanitation, alcoholism, drug abuse and sexually transmitted diseases such as HIV / AIDS. The pattern of illness also differs widely between the minorities (whites) and the colored population. The main diseases that lead to high mortality among whites include cerebro - vascular diseases, cardiovascular diseases and carcinoma while the colored population mostly suffers from high rates of infectious diseases such as TB, gastro enteritis, measles and respiratory infections5. There is a marked disparity in terms of health status in developed countries such as Australia where there is easy availability of proper health care facilities, a sound primary health care system, ambulance services, efficient health care workers and prompt medical assistance. Moreover, the financial status of the people is relatively higher as compared to poor countries and hence treatment is easily available and accessible. 4. Relationship between development and health A sound health is a "means and end" to sustaining livelihood and in case of developing nations like South Africa, where there is widespread poverty and unemployment, it is more of an asset. There is a strong relationship between an individuals health as well as the sustainability of a community. The factors that determine and influence an individuals health include access to basic amenities including proper housing, health care, employment and a high quality environment. This fact is further substantiated by Wilkinson (1996) whereby he states that “Health is powerfully affected by social position and by the scale of social and economic differences among the population”6. A vast majority of people living in the African subcontinent live in dire poverty. The population is exposed to political instability, economic setbacks, unsuitable environment and probably one of the worst situations of poverty in the hemisphere. According to the report provided by the Department for International Development (DPI)7, environmental risk factors constitute about 21% of the overall burden of disease worldwide, and this figure is higher in developing countries. The report further states that approximately 1.7 million young children die each year from diarrhea which in turn is an outcome of insufficient water supplies, proper sanitation and hygiene. In order to elevate the status of the people in developing economies such as South Africa for instance, would require implementation of primary health care strategies among others, to target principal diseases and eradicate deteriorating health among the poor which is a major cause for lack of development. 5. Conclusion The South African government has been involved in taking active steps to provide adequate health care facilities but the current status suggests that such measures are clearly lacking in achieving the desired goals. Hence it requires more effort in terms of promotion of such services, preventing obstacles including social political and economical; and dealing with the challenges faced, through effective policy making and strengthening the health care system. There is an urgent need to identify the deprived areas and implement adequate resources to ensure provision of primary health care facilities across all categories of population irrespective of race or any other social biases which can be achieved through decentralizing decision making and allocating resources at the provincial level. References: Primary Sources: UNICEF (2009). South Africa: Basic Indicators, viewed: March 26, 2009, from: World Health Organization (2009). UNAIDS: South Africa – Epidemiological Country Profile on HIV and AIDS, viewed: March 26, 2009 from: < http://www.who.int/globalatlas/predefinedReports/EFS2008/short/EFSCountryProfiles2008_ZA.pdf> UNAIDS, (2009). South Africa: HIV and AIDS Estimates, viewed: March 27, 2009 from: < http://www.unaids.org/en/CountryResponses/Countries/south_africa.asp> UNICEF (2009). South Africa: Basic Indicators, viewed: March 26, 2009, from: DPI (2003). Health, Environment and The Burden of Disease, viewed: March 27, 2009 from: Secondary Sources Nagle, G., (1998). Development and Underdevelopment, Nelson Thornes, Pp. 46 Wilkinson, R. G., (1996). Unhealthy Societies: The Afflictions of Inequality, Routledge, Pp. 3 Read More