Health spending 'perpetuates inequality'

2010-12-09 13:04
Johannesburg - Government spending policies which favour wealthier provinces have resulted in healthcare in post-apartheid South Africa not improving much, according to results of a study by an Oxford University professor released on Thursday.

"There was great optimism that the end of apartheid in South Africa would tackle profound inequalities in health," said Dr David Stuckler, who led the research.

"However, when you look at the data the situation has, in many respects, not changed much. Our study found that part of the problem owes to long-standing shortages of doctors, clinics and infrastructure, making it impossible to address adequately the health needs of deprived black populations."

They found that, for example, in 2007, the Northern Cape had twice as many doctors and more than four times as many hospitals per head of population than the poorest province of Limpopo.

But, the Northern Cape received the most government funding per head of population at $168 per capita, compared with $101 in Limpopo.


"The research paper, published in the American Journal of Public Health, argues that President Nelson Mandela's ambitions to address historical inequalities in the health system are far from being realised," a statement read.

They found that a combination of policy changes in the late 1990s created a cycle where the provinces with the greatest health needs attracted the least government health spending.

"Inequalities in health care are not only historical; they also appear to influence ongoing allocations."

Health system capacity, measured by the numbers of doctors and hospitals, emerged as a significant driver of inequalities in health spending.

Places with existing private hospitals attracted more health funding, but the same was not true for existing public hospitals.

"This cycle appears to have created an infrastructure-inequality trap, in which capacity determines new funds, thus widening existing inequalities in health care infrastructure."

Read more on:    health  |  service delivery

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