Exploring the interaction of activity limitations with context, systems, community and personal factors in accessing public health care services : a presentation of South African case studies
Date
2017-02
Journal Title
Journal ISSN
Volume Title
Publisher
AOSIS Publishing
Abstract
Background: There are many factors that influence access to public health services, such as the
context people live in, the existing health services, and personal, cultural and community
factors. People with disabilities (activity limitations), through their experience of health
services, may offer a particular understanding of the performance of the health services, thus
exposing health system limitations more clearly than perhaps any other health service user.
Aim: This article explores how activity limitations interact with factors related to context,
systems, community and personal factors in accessing public health care services in South Africa.
Setting: We present four case studies of people with disabilities from four low-resource diverse
contexts in South Africa (rural, semi-rural, farming community and peri-urban) to highlight
challenges of access to health services experienced by people with activity limitations in a
variety of contexts.
Methods: One case study of a person with disabilities was chosen from each study setting to
build evidence using an intensive qualitative case study methodology to elucidate individual
and household experiences of challenges experienced by people with activity limitations when
attempting to access public health services. In-depth interviews were used to collect data,
using an interview guide. The analysis was conducted in the form of a thematic analysis using
the interview topics as a starting point.
Results: First, these four case studies demonstrate that equitable access to health services for
people with activity limitations is influenced by a complex interplay of a variety of factors for
a single individual in a particular context. Secondly, that while problems with access to public
health services are experienced by everyone, people with activity limitations are affected in
particular ways making them particularly vulnerable in using public health services.
Conclusion: The revitalisation of primary health care and the introduction of national health
insurance by the Health Department of South Africa open a window of opportunity for policy
makers and policy implementers to revisit and address the areas of access to public health
services for people with activity limitations.
Description
CITATION: Mji, G. et al. 2017. Exploring the interaction of activity limitations with context, systems, community and personal factors in accessing public health care services: A presentation of South African case studies. African Journal of Primary Health care & Family Medicine, 9(1):a1166. doi:10.4102/phcfm.v9i1.1166.
The original publication is available at https://phcfm.org/index.php/phcfm
The original publication is available at https://phcfm.org/index.php/phcfm
Keywords
Public health -- South Africa, People with disabilities
Citation
Mji, G. et al. 2017. Exploring the interaction of activity limitations with context, systems, community and personal factors in accessing public health care services: A presentation of South African case studies. African Journal of Primary Health care & Family Medicine, 9(1):a1166. doi:10.4102/phcfm.v9i1.1166.