ArticleBMC public health2020
Socio-economic inequalities in the multiple dimensions of access to healthcare: the case of South Africa.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
100 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Epidemics, Lockdown Measures and Vulnerable Populations: A Mixed-Methods Systematic Review of the Evidence of Impacts on Mother and Child Health in Low-and Lower-Middle-Income Countries.International journal of health policy and management · 2022Pooled it
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- The impact of ethical implications intertwined with tuberculosis household contact investigation: A qualitative study.PloS one · 2026Trial
- Economic Burden of Human Immunodeficiency Virus and Hypertension Care Among MOPHADHIV Trial Participants: Patient Costs and Determinants of Out-of-Pocket Expenditure in South Africa.International journal of environmental research and public health · 2025Trial
- Predictors of COVID-19 vaccination status among youth in eThekwini, South Africa: results from the AYAZAZI RIGHTS study.Global health action · 2026Article
- Food insecurity and mental health in South Africa: Structural pathways linking socioeconomic position, behavioural risk factors and comorbidity.Preventive medicine reports · 2026Article
- Socioeconomic Inequalities in Health Service Utilization in the Peruvian Population: A National Population-Based Study.Healthcare (Basel, Switzerland) · 2026Article
- Adapting a United States cancer education programme for South Africa: A participatory, culturally tailored approach using Card's Seven-Step adaptation framework.African journal of primary health care & family medicine · 2026Article
- Mitigating risk in audiology and speech therapy practice: Essential risk management and control strategies for private and public practices in resource-constrained health systems.Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management · 2026Article
- Public Oral Healthcare Utilisation and Its Associated Factors in Malaysian Adults: A Time-Series Analysis (1992-2019).International dental journal · 2026Article
- Battling with HIV infection in children in a resource-poor setting: an analysis of the coping strategies of the caregivers.BMC pediatrics · 2026Article
- Prenatal maternal psychological distress is associated with neurodevelopmental outcomes in toddlers with congenital heart disease.Pediatric research · 2026Article
- Clinical Characteristics, Long-Term Pharmacokinetics, and Outcomes in Kidney Transplant Recipients from an African Tertiary Centre: A 10-Year Single-Centre Retrospective Review.Pharmaceutics · 2026Article
- Exploring Factors Associated With the Stalled Implementation of a Ground-Up Electronic Health Record System in South Africa: Qualitative Insights From the E-Tick Case Study Using the Consolidated Framework for Implementation Research (CFIR).JMIR medical informatics · 2026Article
- Direct healthcare cost comparison of fluticasone/salmeterol and budesonide/formoterol maintenance and reliever therapy for moderate to severe asthma in the South African public sector.African journal of thoracic and critical care medicine · 2026Article
- Article
- From social capital to informal power: A qualitative exploration of cancer care inequalities in Morocco.Journal of education and health promotion · 2026Article
- Religious life, monastic support, and healthcare inequity among aged Han Buddhist monks in China: an explanatory mixed-methods study.Frontiers in public health · 2026Article
- Co-producing adult attention-deficit/hyperactivity disorder (ADHD) care in South Africa: A patient-centred framework for agency, trust, satisfaction and continuity.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2026Article
- Barriers to Chronic Disease Healthcare Access in Rural Eastern Cape Province, South Africa.International journal of environmental research and public health · 2025Article
40 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe National Development Plan (NDP) strives that South Africa, by 2030, in pursuit of Universal Health Coverage (UHC) achieve a significant shift in the equity of health services provision. This paper provides a diagnosis of the extent of socio-economic inequalities in health and healthcare using an integrated conceptual framework.
methodThe 2012 South African National Health and Nutrition Examination Survey (SANHANES-1), a nationally representative study, collected data on a variety of questions related to health and healthcare. A range of concentration indices were calculated for health and healthcare outcomes that fit the various dimensions on the pathway of access. A decomposition analysis was employed to determine how downstream need and access barriers contribute to upstream inequality in healthcare utilisation.
resultsIn terms of healthcare need, good and ill health are concentrated among the socio-economically advantaged and disadvantaged, respectively. The relatively wealthy perceived a greater desire for care than the relatively poor. However, postponement of care seeking and unmet need is concentrated among the socio-economically disadvantaged, as are difficulties with the affordability of healthcare. The socio-economic divide in the utilisation of public and private healthcare services remains stark. Those who are economically disadvantaged are less satisfied with healthcare services. Affordability and ability to pay are the main drivers of inequalities in healthcare utilisation.
conclusionIn the South African health system, the socio-economically disadvantaged are discriminated against across the continuum of access. NHI offers a means to enhance ability to pay and to address affordability, while disparities between actual and perceived need warrants investment in health literacy outreach programmes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.