Introduction: South Africa
Regular improvements in the fields of health care, medicine, and nursing are observed in the modern world. Several years ago, the South Africa region experienced a serious Ebola outbreak and the increase in infectious diseases that resulted in 69% of death (Jimenez, 2015). Bearing about 1/4 of the worldwide disease burden, the territory has access to only 2% of the world’s doctors (Jimenez, 2015). South Africa’s health care was ranked 119 out of 195 countries according to the access and quality index that measures mortality rates because of not fatal diseases (Barber et al., 2017). All at once, the chosen country has good results in maternal and child health care. Infant mortality rates have decreased by 31% during the last years (South African Institute of Race Relations, 2018). Due to these ups and downs, this country is selected for analysis. In this paper, South Africa’s healthcare system, delivery, and priorities will be discussed from its economics, government, culture, and geography perspectives.
Location/Geography
The Republic of South Africa (RSA) or South Africa is located in the southern part of the continent between the South Atlantic and Indian Oceans. Its total area is about 1.22 million sq. km, neighboring with Zimbabwe, Botswana, and Namibia (on the north) and Mozambique and Swaziland (on the east) (“South Africa country profile,” 2019). A temperate climate is one of the main reasons for people to live in the country. The coastal line is characterized by a vast, flat territory where people are able to develop various activities and earn a living. The main geographical features of South Africa include a high plateau that covers most of its land, several mountain ranges, and a well-known Great Escarpment.
Population
The population of South Africa is one of the constantly changing topics. For example, according to the World Health Organization (2016), about 54 million people lived in the nine provinces of the country in 2014. Although the increase in 1.28% compared to the beginning of the 2000s was insignificant, positive prospects were expected (World Health Organization, 2016). Recent research shows that the population is approximately 58 million people in 2019 (“South Africa country profile,” 2019). Having a relatively young population, South Africa has good chances to change the current state of affairs and discover new aspects of development and growth. About 51% of the population are females with life expectancy 54 years, and male life expectancy rate is 53 years (“South Africa country profile,” 2019). The World Health Organization (2016) admitted that such changes occurred due to the implementation of antiretroviral treatment for HIV patients and access to vaccination for newborns and older aged people. Still, racial, geographical, and socio-economic factors remain to be the main causes of inequalities in the country.
Government
At this moment, South Africa does not have one particular capital. On the one hand, there is Pretoria that is defined as an administrative (executive) capital where the seats of the President (Cyril Ramaphosa) and the Cabinet are located (“South Africa country profile,” 2019). On the other hand, Cape Town is a legislative capital because the seat of the Parliament is there. Finally, the Supreme Court of Appeal is in Bloemfontein, and the Constitutional Court is in Johannesburg, which makes these two cities legally significant places for the country. Being a constitutional democratic country, South Africa is governed at three levels – national, provincial, and local. During the last several years, President Ramaphosa made certain contributions to the development of the healthcare system. The steps included insurance policies, quality improvement, the recognition of healthcare needs regardless of socio-economic statuses the population (“Expect a massive change in South African healthcare,” 2019). Additional budget was developed to support early childhood development and public health programs.
Economy
On the continent, South Africa has one of the most properly developed economies. It is defined as a middle-income country with its gross domestic product (GDP) of about $350 billion (World Health Organization, 2016). Despite the existing problems that are inherent to many countries worldwide and caused by migration and industrialization, the citizens of South Africa demonstrate positive intentions to deal with unemployment and ethnic conflicts. Solidarity, cross-subsidization, and bringing new stakeholders will help to stabilize the country’s economy and health care (“Expect a massive change in South African healthcare,” 2019). The President supports the idea of participating in various international programs and organizations that may create particular benefits.
State of Health (Diseases/Violence/Accidents)
The current state of health in South Africa is characterized by a number of positive outcomes, but certain problems remain evident for the locals. According to the Centers for Disease Control and Prevention (2019), an organization that has been working with South Africa since 1989, tuberculosis, diabetes, heart diseases, and HIV are the major causes of death. Today, more than 85% of people who live with HIV are aware of their status, and about 70% receive the required therapy (Centers for Disease Control and Prevention, 2019). In addition to infectious diseases, interpersonal violence and related injuries cause premature death in the country. Violence of different types is inherent to South Africa, including homicide, domestic violence, and gang crimes (Jabar & Matzopoulos, 2017). A decline in road accidents and homicide rates was observed between 2010 and 2015 (Jabar & Matzopoulos, 2017). The cooperation with WHO provides South Africa with an opportunity to develop strategies and funds to prevent and control the threats that challenge the state of health in the country.
Culture/Traditional Medicine
The population has the right to choose any religion and cultural beliefs, and indigenous traditions are frequent in the country. Therefore, indigenous medicine and healing traditions are supported by many South Africans. About 80% of citizens use traditional medicine, known as muti (Ozioma & Chinwe, 2019). Healers, also known as sangomas or inyangas, use herbs, minerals, or animal parts to deal with headache, vomiting, or burns (Ozioma & Chinwe, 2019). However, the supporters of traditional medicine also promote the use of antibiotics and other drugs to control the development of serious diseases when no improvement is observed.
Healthcare System and Delivery
Governmental, private, and global contributions influence the development of the South African healthcare system. Nurses offer primary health care in hospitals and clinics, and patients get access to private (15%) and public health care (Conmy, 2018; “Expect a massive change in South African healthcare,” 2019). Unfortunately, high prices deprive people of an opportunity to use the services of private providers. National systems are used to manage emergencies and communicate risk strategies.
Governmental health-related agencies and health regulatory organizations. In South Africa, there are nine provinces with one Department of Health in each, being responsible for public health delivery and the improvement of health systems. These departments investigate the current situation in their regions and define what promotional and preventative services are necessary. They turn out to be equal parts of the National Department of Health in the Republic of South Africa, the mission of which is to offer a long and healthy life for citizens and improve health status.
Healthcare personnel and hospitals. Among the nine provinces, Western Cape and Gauteng had the highest rates in their infrastructure and facilities rates. In total, in the country, there are 329 public and 426 private hospitals with 74,863 people per facility (South African Institute of Race Relations, 2018). Being of the BRICS (Brazil, Russia, India, China, and South Africa) countries, South Africa takes the third place, offering 2.8 beds per 1,000 people (World Health Organization, 2016). The South African Institute of Race Relations (2018) informed that there are 14,036 general practitioners (27 doctors per 100,000 population) and 142,092 nurses (280 nurses per 100,000 population) in the country. These numbers prove that the country is not the worst in its intentions to provide citizens with high-quality healthcare services.
Nursing education system and accrediting organizations. Education of nurses is regulated by the South African Nursing Council (SANC) and the Nursing Act No. 33 (2005). Special attention is paid to nursing qualifications (high certificate, diploma in nursing, bachelor’s degree in nursing, and advanced diploma in midwifery) and their accreditation criteria established by SANC (Blaauw, Ditlopo, & Rispel, 2014). There are many specialized schools in each province, including Baragwanath Nursing College in Johannesburg, University of Pretoria, Ann Latsky Nursing College in Gauteng, Western Cape College of Nursing, or Thusong Hospital Nursing School. This list may be continued because the government continues supporting academics in their intentions to prepare qualified staff for their local hospitals.
Nursing associations. As well as many developing and developed countries, South Africa has several effective nursing organizations to encourage health. Leadership and governance is not strong, and facilities have to unit to find solutions (Blaauw et al., 2014). Nowadays, Sigma Theta Tau (STT) initiates the Democratic Nursing Organization of South Africa and the South African Society of Occupational Health Nurse Practitioners. The International Council of Nurses (ICN) has its department, cooperating with the Nightingale Initiative of Global Health. These associations focus on advancing nursing and promoting wellbeing regardless of social status, economic relationships, and political situations.
Health Priorities
Taking into consideration the current economic, social, and political situation in South Africa, certain health priorities may be identified. Diagnosis and treatment for patients with HIV, AIDS, and tuberculosis have to be promoted (Centers for Disease Control and Prevention, 2019). Many Africans continue living with these diseases without an opportunity to learn about their signs and threats. Nursing care is essential for supporting and caring for such patients. Contributions to maternal and child health care cannot be ignored because nurses are able to gather information, observe, and identify new aspects of care. Finally, preventive, primary, and tertiary healthcare services must be developed. They include immunization to prevent infectious diseases, personnel for offering emergency services, and equipment to treat patients with serious but not fatal diseases.
Conclusion: Nursing Implications
In general, South Africa is the country with not the worst health status globally. Although many countries have better ratings and achievements, the government of the chosen country also proves its abilities to improve its healthcare services and living conditions. From the point of view of the nursing profession, a number of implications may be recommended to the country. In addition to the fact that citizens have to enhance their knowledge, new stakeholders and partners may introduce new equipment and diagnostic opportunities, and properly trained nurses should assist patients and other medical staff. The economic situation in South Africa and the participation of the government allow developing of the health system. Protection against the diseases that are not fatal but still cause death in the population due to the lack of preventive practices and high-quality treatment plans has to be encouraged.
References
Barber, R. M., Fullman, N., Sorensen, R. J. D., Bollyky, T., McKee, M., Nolte, E., … Abbas, K. M. (2017). Healthcare access and quality index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: A novel analysis from the Global Burden of Disease Study 2015. The Lancet, 390(10091), 231–266. Web.
Blaauw, D., Ditlopo, P., & Rispel, L. C. (2014). Nursing education reform in South Africa – Lessons from a policy analysis study. Global Health Action, 7(1). Web.
Centers for Disease Control and Prevention. (2019). Global health – South Africa. Web.
Conmy, A. (2018). South African health care system analysis. Public Health Review, 1(1). Web.
Expect a massive change in South African healthcare: Ramaphosa. (2019). BusinessTech. Web.
Jabar, A., & Matzopoulos, R. (2017). Violence and injury observatories: Reducing the burden of injury in high-risk communities. SA Crime Quarterly, 59. 47-57. Web.
Jimenez, J. (2015). 3 ways to improve healthcare in Africa. Web.
Ozioma, E. O. J., & Chinwe, O. A. N. (2019). Herbal medicines in African traditional medicine. In P. F. Builders (Ed.), Herbal medicine (pp. 191-214). London, England: Books on Demand.
South Africa country profile. (2019). BBC News. Web.
South African Institute of Race Relations. (2018). South Africa’s state of health. FreeFacts, 3. Web.
World Health Organization. (2016). WHO country cooperation strategy 2016-2020: South Africa. Web.