Tuberculosis and Social Stratification in South Africa

1990 ◽  
Vol 20 (1) ◽  
pp. 141-165 ◽  
Author(s):  
Neil Andersson
Keyword(s):  
South Africa ◽  
Health Care ◽  
Social Stratification ◽  
Access To Health Care ◽  
Racial Classification ◽  
Tb Control ◽  
The Past ◽  
Access To Health ◽  
Gold Miners ◽  
The Republic

Tuberculosis (TB) continues to be a barometer of poverty, determined by racial classification, in both town and countryside in the Republic of South Africa. Despite the fact that whites with the disease stand a greater chance of being diagnosed than their black counterparts, because they have very much better access to health care, the risks of TB for people classified by the state as black and colored are 27 and 16 times, respectively, the risk for whites. Black gold miners, the nutritional elite of the workforce, have also experienced an increase in TB rates. Tuberculosis accounts for 50 percent of all black compensation cases and some 2.5 percent of white cases. The risks of TB have increased over recent years among coloreds and blacks. Rates of tuberculous meningitis have also increased over the past decade, and show the dramatically worse health care available to people classified as black and colored. Although about 60,000 new TB cases are reported in the country each year, there have been cutbacks in the resources available for TB control and treatment.

scholarly journals Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: a nationwide study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dhokotera Tafadzwa ◽  
Riou Julien ◽  
Bartels Lina ◽  
Rohner Eliane ◽  
Chammartin Frederique ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cervical Cancer ◽  
South African ◽  
Access To Health Care ◽  
Health Facilities ◽  
Hiv Positive ◽  
The South ◽  
Hiv Positive Women ◽  
Access To Health

Abstract Background Disparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the potential risk factors among HIV positive women in South Africa. Methods We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004–2014. We used the Thembisa model, a mathematical model of the South African HIV epidemic to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models, using a reparameterization of the Besag-York-Mollié to capture spatial autocorrelation, to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We corrected our estimates to account for ICC case underascertainment, missing data and data errors. Results We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all municipalities and corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43 in the model without any covariates. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. Conclusions The results show an increased incidence of cervical cancer in affluent municipalities and in those with more health facilities. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.

scholarly journals Health Care Access Among Essential Critical Infrastructure Workers, 31 States, 2017-2018

2021 ◽  
pp. 003335492199668
Author(s):  
Winifred L. Boal ◽  
Jia Li ◽  
Sharon R. Silver
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Personal Health ◽  
The Past ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Objectives Essential workers in the United States need access to health care services for preventive care and for diagnosis and treatment of illnesses (coronavirus disease 2019 [COVID-19] or other infectious or chronic diseases) to remain healthy and continue working during a pandemic. This study evaluated access to health care services among selected essential workers. Methods We used the most recent data from the Behavioral Risk Factor Surveillance System, 2017-2018, to estimate the prevalence of 4 measures of health care access (having health insurance, being able to afford to see a doctor when needed, having a personal health care provider, and having a routine checkup in the past year) by broad and detailed occupation group among 189 208 adults aged 18-64. Results Of all occupations studied, workers in farming, fishing, and forestry occupations were most likely to have no health insurance (46.4%). Personal care aides were most likely to have been unable to see a doctor when needed because of cost (29.3%). Construction laborers were most likely to lack a personal health care provider (51.1%) and to have not had a routine physical checkup in the past year (50.6%). Compared with workers in general, workers in 3 broad occupation groups—food preparation and serving; building and grounds cleaning and maintenance; and construction trades—had significantly lower levels of health care access for all 4 measures. Conclusion Lack of health insurance and underinsurance were common among subsets of essential workers. Limited access to health care might decrease essential workers’ access to medical testing and needed care and hinder their ability to address underlying conditions, thereby increasing their risk of severe outcomes from some infectious diseases, such as COVID-19. Improving access to health care for all workers, including essential workers, is critical to ensure workers’ health and workforce stability.

Why equity in health and in access to health care are elusive: Insights from Canada and South Africa

2017 ◽  
Vol 13 (11) ◽  
pp. 1533-1557 ◽  
Author(s):  
Solomon Benatar ◽  
Terrence Sullivan ◽  
Adalsteinn Brown
Keyword(s):  
South Africa ◽  
Health Care ◽  
Access To Health Care ◽  
Equity In Health ◽  
Access To Health

scholarly journals DOES THE RIGHT TO ACCESS TO HEALTH CARE SERVICES IN TERMS OF SECTION 27 OF THE CONSTITUTION OF SOUTH AFRICA, 1996 CATER FOR CANCER PATIENTS?

Obiter ◽  
2018 ◽  
Vol 39 (1) ◽  
Author(s):  
Charles Maimela
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cancer Patient ◽  
Cancer Patients ◽  
Access To Health Care ◽  
Health Care Services ◽  
Right To Health Care ◽  
Care Services ◽  
Access To Health ◽  
The Right

Does the right to health care services as provided in terms of the Constitution of the Republic of South Africa, cater for cancer patients due to the expensive nature of cancer treatment and, if so, to what extent? One of the major socio-economic rights which cancer patients struggle to access is the right to health care services, which is currently dependent on the economic or financial position of a cancer patient, which is, unfortunately, the deciding factor in South Africa as well the entire continent of Africa. The financial or economic standing of a patient or a cancer patient, in this case, will determine if the patient will receive adequate cancer treatment or not. Does the economic or financial position of the cancer patient serve as a valid and justifiable reason for the right to access to health care services to the 75 per cent of people in South Africa who rely on public health care services for different health deformities that include cancer and, if so, to what extent?

scholarly journals Access to health care for persons with disabilities in rural South Africa

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
R. Vergunst ◽  
L. Swartz ◽  
K.-G. Hem ◽  
A. H. Eide ◽  
H. Mannan ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Access To Health Care ◽  
Rural South ◽  
Persons With Disabilities ◽  
Access To Health ◽  
Rural South Africa

scholarly journals Intersection of Migration and Access to Health Care: Experiences and Perceptions of Female Economic Migrants in Canada

2020 ◽  
Vol 17 (10) ◽  
pp. 3682
Author(s):  
Solina Richter ◽  
Helen Vallianatos ◽  
Jacqueline Green ◽  
Chioma Obuekwe
Keyword(s):  
South Africa ◽  
Health Care ◽  
Access To Care ◽  
Health Care System ◽  
Access To Health Care ◽  
Social Connectedness ◽  
Reproductive Age ◽  
African Countries ◽  
Access To Health ◽  
Care System

More people are migrating than ever before. There are an estimated 1 billion migrants globally—of whom, 258 million are international migrants and 763 million are internal migrants. Almost half of these migrants are women, and most are of reproductive age. Female migration has increased. The socioeconomic contexts of women migrants need investigation to better understand how migration intersects with accessing health care. We employed a focused ethnography design. We recruited 29 women from three African countries: Ghana, Nigeria, and South Africa. We used purposive and convenient sampling techniques and collected data using face-to-face interviews. Interviews were audio-recorded and transcribed verbatim. Data were analyzed with the support of ATLAS.ti 8 Windows (ATLAS.ti Scientific Software Development GmbH), a computer-based qualitative software for data management. We interviewed 10 women from both South Africa and Ghana and nine women from Nigeria. Their ages ranged between 24 and 64 years. The four themes that developed included social connectedness to navigate access to care, the influence of place of origin on access to care, experiences of financial accessibility, and historical and cultural orientation to accessing health care. It was clear that theses factors affected economic migrant women’s access to health care after migration. Canada has a universal health care system but multiple research studies have documented that migrants have significant barriers to accessing health care. Most migrants indeed arrive in Canada from a health care system that is very different than their country of origin. Access to health care is one of the most important social determinants of health.

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