ArticleAfrican journal of primary health care & family medicine2017
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.
Article in African journal of primary health care & family medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 40 citations in OpenAlex.
- Occupational Therapy Referral Pathways for Upper Limb Conditions in Tygerberg, South Africa: Stakeholder Perspectives.Occupational therapy international · 2026Article
- Cultural and linguistic competence in chiropractic university students: Insights from a cross-sectional study.The Journal of chiropractic education · 2025Article
- The black hole of dealing with a disability diagnosis: Views of South African rural parents.African journal of disability · 2021Article
- COVID-19, disability and the context of healthcare triage in South Africa: Notes in a time of pandemic.African journal of disability · 2020Article
- Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approach.International journal for equity in health · 2019Article
- Factors affecting access to primary health care services for persons with disabilities in rural areas: a "best-fit" framework synthesis.Global health research and policy · 2018Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere 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.
aimThis 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.
settingWe 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.
methodsOne 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.
resultsFirst, 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.
conclusionThe 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.
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Registered trials
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