Despite the overall improvements in healthcare of the South Africa, the advances are uneven and in some cases insufficient (Coovadia, Jewkes, Barron, Sanders, & McIntyre, 2009). Several challenges responsible for this can be identified, with at least three – the HIV pandemic and the public health response to it, the poverty rate, and the disparities in healthcare sector – being the most resilient ones. While there is concern regarding their persistent nature, several approaches can be recommended to alleviate the difficulties.
Comparative Analysis
The health issues of South Africa are similar to those of other countries of African region. However, the observable differences in statistics can highlight certain patterns of health care development. For instance, in comparison with Ethiopia, the leading health issues are mostly the same: tuberculosis, pneumonia, cerebrovascular diseases, diabetes mellitus, and human immunodeficiency virus (HIV) are among the ten leading causes of mortality in both countries (Health profile: Ethiopia, 2013; Mortality and causes of death in South Africa, 2015).
This is also reflected in the public health strategies which are currently active in both countries. The Global Health Initiative Strategy in South Africa and Ethiopia’s Country Cooperation Strategy both list the goals targeting medical issues, such as reduction of communicable and non-communicable diseases and reduction of child mortality rates, and social milestones, such as partnerships with UN organizations, and strengthening women position in the currently unequal society.
However, the distribution of the rates varies sufficiently. For instance, malnutrition is the fifth leading cause of death in Ethiopia (Health profile: Ethiopia, 2013) but does not register among the leading causes of deaths in South Africa (Mortality and causes of death in South Africa, 2015). Considering the fact that poverty is one of the prominent causes of health issues in the country (Coovadia et al., 2009), we can assume that social programs currently addressing the most basic of the needs of the population show some progress, although its pace is still unsatisfactory.
A similar conclusion can be drawn from the statistics on the breast cancer, intestinal infectious diseases, and malaria (Health profile: Ethiopia, 2013; Mortality and causes of death in South Africa, 2015). However, the HIV statistics present an alarming trend compared to Ethiopia. In both countries, the mortality from HIV/AIDS is the third among the leading causes of death (Health profile: Ethiopia, 2013; Mortality and causes of death in South Africa, 2015). What’s more, the HIV/AIDS mortality rates progress steadily, rising from the seventh position in 2010 to the third in 2013 (Mortality and causes of death in South Africa, 2015).
While these dynamics can be attributed to some extent to the uneven pace of progress made in different fields, the actual number of deaths have been rising accordingly (Mortality and causes of death in South Africa, 2015). Considering that South Africa has the highest HIV burden in the world (Coovadia et al., 2009), this is hardly unexpected, but signals that the progress in the healthcare industry is uneven.
Future Challenges and Possible Solutions
Given the trends displayed by the comparison with Ethiopia and the data presented in the previous parts of the portfolio, three main future challenges can be outlined.
Public Health Response to HIV Epidemic
Despite the average pace of 48% per year, the issue of HIV has been recognized in South Africa as late as 2003 (Coovadia et al., 2009). Since then the poor allocation of resources has led to the unforeseen expenses which, in turn, resulted in gradual downscaling of the U.S. President’s Emergency Plan for AIDS Relief, the central initiative addressing the issue.
The recommended strategy to address it is the restructuring of the budgeting model, with more resources being allocated to prevention. This solution allows to cut down expenses and slow down the spread of the virus. The new technological advances, such as the PLACE method, will likely improve the monitoring of the disease and allow for timely responses, and the new scientific findings, such as the Tenofovir gel, will provide the population with more effective means of protection (MacQueen et al., 2014).
Poverty
The financial well-being of the South African population remains one of the major causes of shortcomings of the healthcare system. Since the mid-nineties, several major steps have been made to decrease poverty levels, mainly by introducing the policies oriented at the poorest population segment, such as issuing social grants (Coovadia et al., 2009).
However, while addressing the absolute poverty level, these policies has led to growing disparities among economic classes, contributing to the effect known as relative poverty (Skolnik, 2012). Currently, the majority of the population has an income that rarely allows the appropriate nutrition and only a small percentage has financial means for adequate health care (Coovadia et al., 2009).
The only feasible way to approach this challenge is to develop the specific health policies for the poorest population segment and include them in the current health initiative strategies. However, this is only possible through additional funds, so the partnerships should be sought first.
Healthcare Disparities
While the reports show a steady improvement in healthcare, most of the economic and infrastructural growth is attributed to the private sector (Coovadia et al., 2009). At the same time, due to economic conditions described above, the public sector provides services for the majority of the population (Coovadia et al., 2009).
While the situation will likely change once the poverty rates improve, a short-term solution is required to maintain the health at the satisfactory level. For instance, a set of managerial practices regulating the involvement of the public healthcare providers in the private segment may improve the situation. Such practices may be facilitated by introducing shared governance models, which have shown the improvements in decision-making and sharing responsibilities among staff.
Key Partnerships
As at least some of the solutions require external funding (Coovadia et al., 2009), international partnerships should be sought to improve the situation. The advised direction is towards agricultural segment, which is currently among the most perspective ones in South Africa. The global corporations such as Bayer and IoT Enterprise, who focus on healthcare and agriculture, are thus the most likely match. Such organizations seek promising partners and are able to provide solutions for current problems as well as the needed resources.
Conclusion
The three outlined challenges are the broadest ones, covering the social, economic, and political areas, and thus require the multifaceted approach. However, the most promising directions, such as the international partnerships, the reviewing of healthcare policies which the poorest population segment in mind, utilization of the newest scientific and technological findings, and the managerial policies that will strengthen the public health sector are the essential directions to be taken.
References
Coovadia, H., Jewkes, R., Barron, P., Sanders, D., & McIntyre, D. (2009). The health and health system of South Africa: historical roots of current public health challenges. The Lancet, 374(9692), 817-834.
Health profile: Ethiopia. (2016).
MacQueen, K. M., Weaver, M. A., Van Loggerenberg, F., Succop, S., Majola, N., Taylor, D.,… & Karim, S. A. (2014). Assessing adherence in the CAPRISA 004 tenofovir gel HIV prevention trial: Results of a nested case–control study. AIDS and behavior, 18(5), 826-832.
Mortality and causes of death in South Africa, 2013: Findings from death notification. (2015).
Skolnik, R. (2012). Global Health 101. Burlington, MA: Jones & Bartlett Learning.