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Access to health care in post-apartheid South Africa: availability, affordability, acceptability

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  • Burger, Ronelle
  • Christian, Carmen

Abstract

We use a reliable, intuitive and simple set of indicators to capture three dimensions of access – availability, affordability and acceptability. Data are from South Africa’s 2009 and 2010 General Household Surveys (n=190,164). Affordability constraints were faced by 23% and are more concentrated amongst the poorest. However, 73% of affordability constraints are due to travel costs which are aligned with findings of the availability constraints dimension. Availability constraints, involving distances and transport costs, particularly in underdeveloped rural areas, and inconvenient opening times, were faced by 27%. Acceptability constraints were noted by only 10%. We approximate acceptability with an indicator measuring the share of community members bypassing the closest health care facility, as we argue that reported health care provider choice is more reliable than stated preferences. However, the indicator assumes a choice of available and affordable providers, which may often not be an accurate assumption in rural areas. We recommend further work on the measurement of acceptability in household surveys, especially considering this dimension’s importance for health reform.

Suggested Citation

  • Burger, Ronelle & Christian, Carmen, 2020. "Access to health care in post-apartheid South Africa: availability, affordability, acceptability," Health Economics, Policy and Law, Cambridge University Press, vol. 15(1), pages 43-55, January.
    • Handle: RePEc:cup:hecopl:v:15:y:2020:i:1:p:43-55_4
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    Cited by:

    1. Fourie, Johan & Jayes, Jonathan, 2021. "Health inequality and the 1918 influenza in South Africa," World Development, Elsevier, vol. 141(C).
    2. Limakatso Lebina & Mary Kawonga & Tolu Oni & Hae-Young Kim & Olufunke A Alaba, 2020. "The cost and cost implications of implementing the integrated chronic disease management model in South Africa," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-15, June.
    3. Sibusiso Mkwananzi & Ololade Julius Baruwa, 2022. "Chasing the Youth Dividend in Nigeria, Malawi and South Africa: What Is the Role of Poverty in Determining the Health and Health Seeking Behaviour of Young Women?," IJERPH, MDPI, vol. 19(21), pages 1-9, October.
    4. Bell, Griffin J. & Ncayiyana, Jabulani & Sholomon, Ari & Goel, Varun & Zuma, Khangelani & Emch, Michael, 2022. "Race, place, and HIV: The legacies of apartheid and racist policy in South Africa," Social Science & Medicine, Elsevier, vol. 296(C).
    5. David Mhlanga & Rufaro Garidzirai, 2020. "The Influence of Racial Differences in the Demand for Healthcare in South Africa: A Case of Public Healthcare," IJERPH, MDPI, vol. 17(14), pages 1-10, July.

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