How does the lack of basic services have a negative impact on the health of the poor people in south Africa?
Answers
Explanation:
There is overwhelming evidence that the quality of health care in South Africa has been compromised by various challenges that impact negatively on healthcare quality. Improvement in quality care means fewer errors, reduced delays in care delivery, improvement in efficiency, increased market share and lower cost. Decline in quality health care has caused the public to lose trust in the healthcare system in South Africa.
Objectives
The purpose of this study was to identify challenges that are being incurred in practice that compromise quality in the healthcare sector, including strategies employed by government to improve the quality of health delivery.
Method
Literature search included the following computer-assisted databases and bibliographies: Medline (Medical Literature Online), EBSCOhost, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google, Google Scholar and ScienceDirect. Furthermore, websites were used to source policy documents of organisations such as the National Department of Health in South Africa and the World Health Organization.
Results
Seventy-four articles were selected from 1366 retrieved. These articles quantify problems facing quality care delivery and strategies used to improve the healthcare system in South Africa.
Conclusion
The findings revealed that there were many quality improvement programmes that had been initiated, adapted, modified and then tested but did not produce the required level of quality service delivery as desired. As a result, the Government of South Africa has a challenge to ensure that implementation of National Core Standards will deliver the desired health outcomes, because achieving a lasting quality improvement system in health care seems to be an arduous challenge.
Keywords: challenges in healthcare, healthcare system, lack of resources, quality service delivery, South Africa
Introduction
Delivery of quality health care is a constitutional obligation in South Africa (Stuckler, Basu & Mckee 2011:165). Government has therefore introduced numerous developments and programmes to improve health care, efficiency, safety and quality of delivery and access for all users (Mogashoa & Pelser 2014:142), and there have been major changes in health policy and legislation to ensure compliance in delivering quality care (Moyakhe 2014:80). Despite a number of commendable goals having been set by government for improved quality of service delivery in healthcare settings, reports by media and communities in 2009 revealed that services in public health institutions were nonetheless failing to meet basic standards of care and patient expectations (National Department of Health 2012:4). This has caused the public to lose trust in the healthcare system (Zubane 2011:1). Koelble and Siddle (2014:1118) describe the healthcare system in South Africa as ruined and in serious need of repair.
Many of problems in the South African healthcare system can be traced back to the apartheid period (1948–1993) in which the healthcare system was highly fragmented, with discriminatory effect, between four different racial groups (black, mixed race, Indian and white) (Baker 2010:79). To worsen the situation, the apartheid government developed 10 Bantustans (the so-called ethnic homelands) into which Africans were unwillingly segregated, and each of which had their own departments of health with their professional bodies (Baker 2010:80). This led to deterioration in health system delivery because of lack of resources, and poor communities were especially affected (Chassin & Loeb 2013:462).
Huge efforts have been made to improve the quality of healthcare delivery in South Africa since 1994 elections, but several issues have been raised by the public regarding public institutions. Among the many, the following seven issues are discussed in this article: prolonged waiting time because of shortage of human resources, adverse events, poor hygiene and poor infection control measures, increased litigation because of avoidable errors, shortage of resources in medicine and equipment and poor record-keeping.