Socio-economic inequalities in the multiple dimensions of access to healthcare: the case of South Africa

Show simple item record 2022-08-17T13:07:10Z 2022-08-17T13:07:10Z 2020-03-30 en
dc.description.abstract The National Development Plan (NDP) strives that South Africa, by 2030, in pursuit of Universal Health Coverage (UHC) achieve a significant shift in the equity of health services provision. This paper provides a diagnosis of the extent of socio-economic inequalities in health and healthcare using an integrated conceptual framework. The 2012 South African National Health and Nutrition Examination Survey (SANHANES-1), a nationally representative study, collected data on a variety of questions related to health and healthcare. A range of concentration indices were calculated for health and healthcare outcomes that fit the various dimensions on the pathway of access. A decomposition analysis was employed to determine how downstream need and access barriers contribute to upstream inequality in healthcare utilisation. In terms of healthcare need, good and ill health are concentrated among the socio-economically advantaged and disadvantaged, respectively. The relatively wealthy perceived a greater desire for care than the relatively poor. However, postponement of care seeking and unmet need is concentrated among the socio-economically disadvantaged, as are difficulties with the affordability of healthcare. The socio-economic divide in the utilisation of public and private healthcare services remains stark. Those who are economically disadvantaged are less satisfied with healthcare services. Affordability and ability to pay are the main drivers of inequalities in healthcare utilisation. In the South African health system, the socio-economically disadvantaged are discriminated against across the continuum of access. NHI offers a means to enhance ability to pay and to address affordability, while disparities between actual and perceived need warrants investment in health literacy outreach programmes. en
dc.format.medium Print en
dc.subject HEALTH SERVICES en
dc.subject INEQUALITY en
dc.title Socio-economic inequalities in the multiple dimensions of access to healthcare: the case of South Africa en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber ZBBBBB en
dc.Volume 20 en
dc.BudgetYear 2019/20 en
dc.ResearchGroup Research Use and Impact Assessment en
dc.SourceTitle BMC Public Health en
dc.ArchiveNumber 11277 en
dc.PageNumber Online en
dc.outputnumber 10411 en
dc.bibliographictitle Gordon, T., Booysen, F. & Mbonigaba, J. (2020) Socio-economic inequalities in the multiple dimensions of access to healthcare: the case of South Africa. BMC Public Health. 20:Online. en
dc.publicationyear 2020 en
dc.contributor.author1 Gordon, T. en
dc.contributor.author2 Booysen, F. en
dc.contributor.author3 Mbonigaba, J. en

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