A BETTER HEALTH SYSTEM FOR ALL. ..?

Since 1994, South Africans have experienced the birth of our democracy to be bittersweet. While some enjoy the freedom afforded to us, many still remain burdened by the shackles tied to Apartheid such as the poverty, poor education and corruption.

This blog aims to compare how the data regarding South Africa in the World Health Organisation's SAGE survey (captured between 2007 to 2010) still remains relevant today in our public health sector but also challenging the shortcomings the survey could have prevented in order to achieve data accuracy.

The survey studied 6 countries striving towards a common goal:

TO STRENGTHEN THE HEALTH SYSTEM IN AIMS OF UNIVERSAL COVERAGE 

In South Africa, our approach to public health care focuses mainly on resources and treatments being essential, acceptable, affordable and accessible to be deemed effective for our people, however the inefficiencies in delivering these forms of health services prevents us from achieving the above goal. 

With South Africans being one of the countries evaluated to spend to longest duration getting to a medical facility and spending the most money on transport getting there. This increases the likelihood of more positive cancer screenings and cases of hypertension diagnosed as these patients respectively, may have had difficulties accessing health services to detect and treat these conditions.

The survey showed that South Africa allocated the highest percentage of government expenditure towards our health sector. We fared among the countries who spent the most on prescribing and administering medication to patients and among the lowest in regard to screenings of chronic conditions. This indicated how our health sector prioritizes a biomedical approach to healthcare by aiming to treat conditions and symptoms when present over screen testing for preventative signs and education to promote health and correct causes leading to disease.

The above result could also indicate a mismanagement of funds, such as corruption in our health sector since despite allocating significant funds to our health sector, we still among the countries who fared the lowest in health performance indicators.

Although accepting the above mentioned points to be highly likely in South Africa's health sector there are inaccuracies regarding the manner in which the survey's data was collected which may have negatively influenced performance rates measured by the countries evaluated.

The outcome of survey indicated a poor performance in prevention and management of chronic conditions, such as hypertension and cancer screenings. The data collected was meant to represent  the general population however fails to immediately disclose that a  major percentage of subjects we over the age of 50 and that cancer screenings were only assessed for females in two female-related cancer forms, namely breast and cervical cancer.

Data representing hypertension may have also been inaccurate as none of the subjects were tested for this disease in the survey. All cases of hypertension were self-reported therefore the likelihood for subjects misdiagnosing themselves are high as hypertension symptoms can be generalized to include a greater amount of people.

Not only is age a risk factor to both the prevalence of hypertension and cancer in persons over the age of 50, the chances of females testing positive to female-related cancer forms are also high as only females were assessed. Another factor which could have negatively impact cancer readings were the forms of cancer screenings chosen to be assessed. Particularly in breast cancer, there are numerous studies indicating breast cancer to result in the highest amounts of 'false-positive' diagnosis among other cancer forms. This could be a result of the highly debated inadequacies with mammogram testing.

Therefore in conclusion to all factors listed above, this may have resulted in South Africa seeming to have higher rates for these diseases than actually experienced.

With many aspects of this article still being relevant to South Africa today despite the difference of almost a decade, we have made great strides in closing the gaps left open for regression and stagnation to thrive in our health sector. In order to succeed in achieving greater success in treating and rehabilitating conditions, we have to equally prioritize prevention and promotion of health. This can be done by doing more extensive research into the causes of conditions many South Africans experiences, understanding the needs and circumstances of patients and to educate them what is essential to maintain an optimal quality of life. On the other side funds should be better allocated to provide sufficient infrastructure and resources to healthcare workers to perform to the best of their ability and to provide quality health services to all.