Abstract
South Africa has a large population of more 50million people. Such a population necessitates effective systems to meet the healthcare needs of the people. The country suffers from a great burden of disease contributed by increased cases of accidents and injuries due to domestic violence, increased cases of tuberculosis and HIV/AIDS, and other infectious diseases. Nevertheless, the government has introduced several healthcare strategies and interventions to help in improving the quality of healthcare services in the country and address the country’s of diseases. Through strategic partnerships and other collaborations, the country has showed efforts as far as meeting the Millennium Development Goals. In comparison to Zambia, South Africa has a more improved healthcare system.
Demographic Profile
Leading health indicators and burden of disease
South Africa requires effective, precise and timely information on health for the country to formulateimportant policies to improve the country’s healthcare sector (McLeod, 2005). Such information is very important in making appropriate plans for the purpose of meeting the healthcare goals in the country. The cornerstone of South Africa’s information on the burden of diseaseis based on high mortality rate (Sinclair, 2013).
According to Knijn and Slabbert (2012), the country has experienced an enormous transformation in the pastespecially in issues associated with poor delivery of services, and the increased cases of HIV and AIDS. In addition, there has been rapid transformation in the health sector which has increased the number of challenges (Skolnik, 2012). The effortsof the government towards the achievement of the Millennium Development Goals have been adversely affected by increasing challenges within the healthcare sector resulting from the complex transition.
Population size
South Africa’s demographics comprises of more than 53 million people from different parts of the world, who show diverse characteristics in terms of religion, language, and culture. In 2011, the country had 3.2 million foreigners. Nonetheless, Omideyi (2013) inferred from the trends in the current population growth that there is a high possibility that such number will double in the future.For example, in 1950, the population of was 13, 683,000 people but rose to 50,133,000 people in 2010, and 54,490,000 people in 2015.
According to the projections provided by the United Nations, South Africa is likely to have a total population of more than 55 million people by 2020, and more than 56 million people by 2025. This is based on the fact that there has been a high population growth rate in the past. For example, the population has been increasing for the last two decades due to improved economic growth, better healthcare services, and improved nutrition.
Socioeconomic data
A review of the country based on the last 15 years shows that there have been inconsiderable achievements in social economic areas such as in healthcare, housing, education, as well as in water and sanitation (Skolnik, 2012). Nonetheless, there have been a number of social-economic challenges which ought to be addressed for the country to achieve its Millennium Development Goals.Some of the areas affected by the social-economic challenges are related to aspects of fiscal decentralization, economic growth and globalization effects, inequality and poverty, labor market, macroeconomic policy and the social sector.
The level of poverty in South Africa, inequality and unemployment rateshave increased. Knijn and Slabbert (2012) asserted that lack of employment has adversely affected the formal employment sector and hence there have been increase in crime rate. With such negative social factors, the business environment is no longer attractive to foreign investors (Skolnik, 2012). In spite of this, the government has put a lot of efforts in dealing the socio-economic challenges.
Health priorities and progress toward accomplishing the Millennium Development Goals
There are eight Millennium Development Goals that every country in the world strives to fulfill. These goals include the need to eliminate hunger and poverty, achieve universal primary education in all countries, and ensure that there is gender equality and empowerment of women, reduction in child mortality, and improvement in maternal health, combating malaria, HIV/AIDS and other diseases, ensuring environmental sustainability and development of ‘a global partnership for development’ (Skolnik, 2012). South Africa has put a lot of effort in ensuring that it achieves all the above goals with a lot of emphasis in the healthcare sector.
Concerning the Millennium Development Goals in the country, Knijn and Slabbert (2012) observed that some milestones have been made in complying with international instruments and in setting up the necessary legislations and policies to govern and help the implementation of the MDGs. According to Plaks and Butler (2012), first priority has been given to activities that assist in meeting the goals. For example, Skolnik (2012) noted that the adoption of Vision 2030 initiative was aimed at the elimination of poverty and the reduction of inequality in the country. Also, the country has been working on the diagnostic analysis to help the improvement of the delivery of healthcare services and reduction of great disease burden in South Africa.
Third, by working towards fast economic growth and transformation of the economy for sustainable livelihoods and the creation of decent work, the goalis to reduce the burden of diseases (Knijn&Slabbert, 2012). Additionally, massive programs have been initiated that are focused on building social and economic structures to help in alleviating the challenges affecting the country in all sectors of the economy.
Four, the country has been working towards the development of a comprehensive approach in rural areas that connects together the aspects of food security, agrarian reform and land (Sibeko & Moodley, 2006). Such a priority is based on the fact that most people living in the rural areas are affected by numerous diseases due to poor nutrition. Furthermore, the country has prioritized to set up the necessary measures and strategies towards improved health profile among all citizens.
A description of structure and role of major health systems in South Africa
The period within which the country expects essential reforms in the political arena comes with the expectations of changes that will lead to the transformation of the health sector. This is because the country expects to have full implementation of the set policies in the healthcare sector (Skolnik, 2012). The country’s health structure is currently fragmented by the people in charge of the administration and provision of the services (Sibeko & Moodley, 2006).
There are various advantages that can be obtained by integrating the services of both the public and the private health sectors into one National Health Sector. While there would be policies set by individuals from both sectors, coordination of the services and the strategic planning if done at the national level would lead to reasonable decentralization of health care responsibilities for all the levels of services provision. In spite of this, the government suffers from inequalities in the health system.
There is a need for an in-depth investigation of possible ways that can be used to ensure efficient distribution of resources to ensure better delivery of services among the public and private health systems (Sibeko & Moodley, 2006).
For instance, the government ought to invest its resources in ensuring that there are no issues of racial and geographical disparities. In addition, it should try hard to curb the existing barriers in financial resources that play a significant role in the provision of healthcare services. However, since the practitioners in various areas are likely to compete with one another for the scarce resources, there is a need for adequate democracy (Sibeko & Moodley, 2006).
In addition, the government aims at investigating alternative sources that can be adopted to ensure thewellbeing of citizens. For instance, it planned to implementa system that was responsiblefor the introduction of the National Health Insurance. The insurance system gets support from various individuals and groups in the country as the healthcare challenges are felt by people from all parts (Plaks & Butler, 2012). However, the solutions obtained need to be long-term so that they can help in increasing life expectancy in South Africa.
The healthcare structure is divided into the NGO sector, public sector and the private sector (Sibeko& Moodley, 2006). The largest sector is the public that consumes the highest budget from the national government’s funds allocated to improve healthcare provision. There are more than 4,200 healthcare facilities in South Africa (Knijn & Slabbert, 2012). Though the provision by the WHO is 10,000 patients per clinic, every clinic provides for 13,718.
The facilities can freely be accessed by all patients as they provide their services for free. In addition, the sector has indicated an improvement in quality since 1994. The private sector, on the other hand, has regulations that provide guidance for the provision of health carebased on private arrangements. For instance, the private sector is involved in service delivery trough the subscriptions of medical aid schemes (Sibeko & Moodley, 2006). Finally, the NGO sector plays a significant role in ensuring a healthy country through focusing on TB and HIV/Aids.
The National Health Insurance is another system that the government has been a priority aimed at strengthening the health-related services in the public sector (Sibeko & Moodley, 2006). In support of this, the government introduced universal insurance schemes that are mandatory for all citizens so that the services provided can be universal. The insurance schemes help in ensuring affordability, equity, solidarity, rights to access healthcare, effectiveness, and appropriateness of the healthcare services (Sibeko & Moodley, 2006).
A description of the cultural practices that promote health and those harmful to health in South Africa
Culture is defined as the way of doing things, which is widely acceptable so as to be passed to new generations in a country. In South Africa, several cultural practices help in the promotion of health for citizens (Knijn & Slabbert, 2012). For instance, the coordination within and among departments in the healthcare sector is essential as it promotes the cultural belief of sharing good practices.
The strategies and policies help in the clarification of the critical role played by the health promotion officials in both the health and non-health sectors (Knijn & Slabbert, 2012).Such policies promote improvement and maintenance of people by placing quality practices at the top of development agenda in the country. As a result, culture can be helpful in the creation of a suitableenvironment for people to help one another, hence ensuring national health promotion.
The health departmental heads have to foster the culture of sharing by ensuring that people can freely access the available national health resources. The NGOs from all levels are also called upon to ensure promotion of the similar culture for the national improvement of health services (Sibeko & Moodley, 2006). Such policies and strategies are more beneficial since they foster innovation and creativity among citizens in the process of assisting one another to overcome any health challenges (Skolnik, 2012).There are some cultural practices that may be harmful to the health of the citizens in South Africa.
This is due to the freedom that citizens have to follow the cultural beliefs of their ancestors. For instance, there is a culture of marriage by inheritance that allows men to marry the wives of their deceased brothers or relatives to their sister-in-law. As such, it is very easy for diseases to be transmitted to various individuals within the same family. Such a culture points out how such practices make women vulnerable to the transmission of disease to women through the forced marriages if they are unwilling to be inherited by the brothers of their husbands.
A description of the burden of disease and priority health issues in South Africa
As noted earlier, information on the burden of disease in South Africa is inadequate. The major illnesses that cause death have been identified. Nevertheless, the burden of disease in the country is quite complicated. Skolnik (2012) attributed such complication to the fact that the country has chronic degenerative diseases, increased cases of nutritional deficiencies and infectious diseases. For example, an analysis of the disease profile shows that there has been a high mortality rate as a result of infectious diseases such as the Human Immunodeficiency Virus (HIV) and AIDS, alongside other related infections diseases (Knijn & Slabbert, 2012).
In addition, Sinclair (2013) observed that the burden of diseases data includes cases of accidents and violence between individuals, malnutrition and diarrhea in children, and non-communicable diseases such as cancers, diabetes, and vascular illness among others.
According to 2005 data, the prevalence of HIV among pregnant women increased between 2001and 2005 (Sibeko&Moodley, 2006). On the other hand, the number of deaths caused by tuberculosis has increased over the last 10 years (Skolnik, 2012). Also, the country has been reported to suffer from overwhelming effects of tuberculosis and HIV and AIDS (Plaks& Butler, 2012). In addition, there has been an increase in the number of people dying from cervix and prostate cancer, chronic kidney disease and diabetes.
Additionally, cases of violence and injuries are high and contribute extensively to the number of deaths in the country. Interpersonal violence such as violence based on gender, and injuries from roads, unintentional and suicide cases has been reported to account for the highest rates of deaths (Knijn & Slabbert, 2012). In most rural areas, there are many cases of increased non-communicable diseases’ risk factors, which have put most women at a high risk of suffering from metabolic diseases such as obesity, while the men are experiencing increased cases of hypertension.
A description of current public health strategies and interventions in South Africa
It is worth noting that the country’s health care sector is very important as far as the achievement of the Millennium Development Goals is concerned. In spite of the high number of challenges, there are several strategies and interventions that are aimed at addressing the existing challenges, as well as in ensuring high quality healthcare services (Knijn & Slabbert, 2012; Skolnik, 2012).
For example, the South African Government (SAG) along with the health team in the country has been working towards the support of the Medium Term Strategic Framework’s Outcome Two of ensuring a long and healthy life for all South Africans by improving the quality of healthcare in the country. This intervention has been possible through the collaboration of the South African Government and the healthcare team through the Global Health Initiative (GHI).
The National Department of Health (DoH) has set up health strategies to ensure that the healthcare sector provides quality services to all citizens. For example, there have been strategies towards the creation of strategic leadership in the healthcare sector, as well as strategies advocating for better health outcomes in the country (Knijn & Slabbert, 2012). Secondly, the National Health Insurance has been very instrumental in ensuring that all citizens get better healthcare services.
According to the department of health, achieving quality care services requires a completechange of the current system by ensuring that the management team has the necessary skills and knowledge to champion for improvement in the quality of health services (Sibeko & Moodley, 2006).For this reason, there have been strategies to revitalize the healthcare infrastructure, improve planning and development, as well as improve the human resources management activities within the healthcare sector.
Additionally, numerous interventions have been adopted that focus on addressing the burden of disease in the country. For example, strategies have been established towards the elimination of the burden of TB, Sexually Transmitted Infections and HIV and AIDS (Knijn & Slabbert, 2012). The country’s Sexually Transmitted Infections National Strategic Plan of 2007-2011 has been very instrumental in dealing with increased cases of tuberculosis, HIV and AIDS, as well as other types of transmissible diseases.
A description of the collaboration efforts to address burden of disease in South Africa
The burden of disease has had adverse effects both in the healthcare sector and the general economy (Knijn & Slabbert, 2012). For this reason, there has been a need for the country to address the burden of disease. As such, collaboration efforts have been adopted to address the burden of disease in South Africa. Skolnik (2012) inferred from trends that there is a shift in the burden of disease, with non-communicable disease conditions accounting for about 40% of the total number of deaths in the country.
To reduce the burden of disease from such conditions and others, the government has entered into bilateral, trilateral and other collaborations for the purpose of seeking any necessary support (Sibeko & Moodley, 2006). For example, through the Forum on China-Africa Co-operation (FOCAC), the country received support in terms of funding from China that focused on training South African citizens in areas of education, medicine, agriculture, defense and economics.
In addition, through the trilateral collaboration between South Africa, India and Brazil (IBSA), the nation benefited from the health working group which has been very instrumental in reengineering the primary healthcare. HIV and AIDS is one of the major health issues faced by South Africans nowadays. However, the collaboration led to the initiative to develop an AIDS Vaccine.
Comparison between South Africa and Zambia’s key health features
This section compares and contrasts some key features between South Africa and Zambia in relation to the two countries’ health systems. First, Zambia has arelatively low population of about 15 million compared to South Africa’s population of more than 53 million people. For this reason, the health care expenditure in Zambia is not as high as in the case of South Africa. Even though Zambia has a low population, the country is faced with numerous healthcare challenges just like South Africa.
One of the main challenges affecting Zambia is the lack of efficiency in the healthcare setting, lack of the skilled labor, and a high burden of disease caused by increased cases of HIV/AIDS (Makasa, Fylkesnes, & Sandy, 2012). However, the country has introduced several healthcare strategies to ensure effective delivery of healthcare services to all Zambians. For example, the Zambian Ministry of Health has been working hard towards ensuring that the country has better human resources in the healthcare sector (Makasa et al., 2012).
Some of the strategies implemented include investing in training institutions as a way to improve the skills and knowledge of existing healthcare workers. In addition, the ministry of health in Zambia has been conducting systematic surveys and numerous studies on the extent of staffing and distribution of human resources in all healthcare settings in the country. Further, Moszynski (2006) pointed out that Zambia allows the poor people in the rural areas free healthcare.
Just like South Africa, Zambia has adopted several interventions and collaborations to ensure the delivery of better healthcare services to all Zambians (Moszynski, 2006). For example, over the past decade, the country has been involved in strategic partnerships involving various stakeholders such as the Civil Society Organizations (CSO), government departments and ministers, faith-based institutions, private sectors, local communities and Cooperative Partners (CPs).
Future challenges and possible future directions of the health issues in South Africa.
The country has various challenges that are likely to affect its people in the future. For instance, several researchers and scholars have indicated that the rate at which TB is transmitted is very high. For instance, it is predicted that eighty percent of South Africa’s total population is likely to have latent TB (Sibeko & Moodley, 2006). Even though the people suffering from this disease remain unrecognized, it is further expected that the new cases of the disease infection will rise by 400% over a period of twenty years (Omideyi, 2013).
Second, the prevalence of HIV/Aids is very many. As a result, such a population remains at the risk of getting latent TB which then translates to the TB disease. The third challenge is that most of the people suffering from HIV/Aids mostly die from TB. Therefore, it is credible to assert that TB is the common killer disease in the country. The disease is said to have developed resistance to the drugs that were used to treat it traditionally.
To assist in addressing the challenges mentioned above, the National Health Service in collaboration with the public health sector have set forth some strategies that will assist in curbing the mortality rates associated with the diseases (Omideyi, 2013). For instance, priority will be given top research and development so that they can establish the best medicines that can help in curing the diseases. In addition, the government aims at providing free antiretroviral tablets to all the HIV/Aids patients in South Africa. In addition, they have set strategies that help in ensuring even distribution of the national resources available for health care provision.
Contribution of science and technology towards improved health status of South Africa
The constant advancement in technology has led to the improvement in the provision of health care services for most countries in the world. The breakthroughs that have been made in the healthcare sector help in research and gathering of information that assist the providers in communication and treatment (Makasa et al., 2012). As a result, technology has helped in the provision of services by the use of new and advanced tools as well as fresh ways for medical practices.
First, medical information is easily accessible through the use of the internet. Several studies indicated that almost 66% patients obtain medical information from the internet. This clearly indicates that people use the knowledge they have about the internet to solve their medical issues (Sibeko & Moodley, 2006). They can thus make informed decisions such as seeking the relevant medical attention.
Second, the patients can easily communicate with the healthcare specialist by the use of social media (Sibeko & Moodley, 2006). As a result, most patients can establish contacts with their doctors and the doctors can as well create public awareness in the community available in social media. Third, technology has led to the purchase of sophisticated machines that help in the provision of better services as well as ensuring reduced intensity of pain during treatment. For instance, people suffering from pulmonary diseases can easily be treated with the use of new and improved technology.
The forth benefit is that the available databases that are online can help in the prediction of various disease trends. For instance, Google has severally helped in the prediction of several epidemics such as flu. The fifth benefit is that doctors are now easily accessible and can provide better services. For instance, the ability to share videos, conference facilities, texts and emails eases the way through which doctors can communicate to their patients (Sibeko & Moodley, 2006). In addition, the doctors can be involved in consultative talks with experts from various places to seek assistance in the diagnosis, treatment and research for complex patient conditions. Lastly, the doctors have improved the efficiency with which they work and the care to the patients have also improved. For instance, they utilize electronic database to put all information about lab results, the signs of diseases as well as the appropriate medication.
Impact of key organizations in addressing health issues in South Africa
To help in addressing health challenges in South Africa, the government has put in place strategies and policies that foster quality health provision to all citizens (Sibeko & Moodley, 2006). In addition, it has signed partnerships with various organizations that aim at helping reduce the spread are and mortality rates that are caused by several diseases such as TB and HIV/Aids among others (Rose & van Rensburg-Bonthuyzen, 2015).
Some of the key organizations that have had a lot of influence in the health issues include the United Nations (U.N.), African Union (A.U.), and World Health Organization (WHO) among others. For instance, the South Africa’s government has been receiving support from some the global organizations such as the WHO, the UN, SADC and the AU. These organizations provide both expertise and financial support to ensure the wellbeing of patients in the country (Rose & van Rensburg-Bonthuyzen, 2015).
For instance, the U.N. is really devoted to helping South Africa if only it helps in the definition and execution of more active roles in the assistance for development. As far as future problems in South Africa are concerned, there is the need for strong partnership and financial support from such organizations.
References
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