Health in South Africa and the USA – Health System Example

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"Health in South Africa and the USA" is a great example of a paper on the health system.   South Africa is a country of approximately 50 million people.   It is a melting pot of cultures, races, languages, and sceneries. Health care in South Africa is as diversified as the country itself. The health care system in both public and private with a very wide disparity between the two. The public health system is under-resourced and oversubscribed whereas the private health care system is both enviable and unaffordable. WHO ranking. The WHO ranking for South Africa is 175.

This is very low when compared to the US and many other companies. It is also very surprising as South Africa is quite a developed country. The reason for such a low ranking can be Government expenditure on health Though the government spends a lot on the public health sector, it is not even a fraction of what is spent by the private sector on patients. Spending in the private sector is 13 times that of the public sector. People have to make out of pocket payments for health care.

Health care is only free for children under 6 and pregnant women. The disability-adjusted life expectancy is low. South Africa faces the AIDS epidemic in its full swing like many other African nations. Full-fledged measures are yet to be taken to battle the disease which brings down life expectancy to 40 which is way below the world average. (World Health Organization Assesses the World's Health Systems) The overall responsiveness of the public system is not very satisfactory. Infant mortality is extremely high, standing at 44.2 per 1000 births in 2007. Insurance is available only to the wealthy. The level and the amount of health care vary from province to province and therefore the cash stripped provinces like the Eastern Cape have less health care facilities than richer provinces.

This inconsistency in health provision brings South Africa to a lower rung in the WHO ladder. Comparison with the United States The United States ranks 37 in the WHO ranking. It is higher in the ranking than South Africa because a better public health care system is available in the United States. The disparity between the public and the private health care system is not very huge.   The United States Government also spends a huge fraction (approximately 16%) of its GDP on health.

The United States has control over Sexually transmitted diseases particularly AIDS.   The United States health system was ranked first by the WHO in case of responsiveness though it is undeniably expensive. Life expectancy in the United States is also higher as compared to South Africa. Health in South Africa Since South Africa is a mix of first and third world countries, the health care system very vividly demonstrates it.   Public health care facilities in rural areas are very basic.

Insurance is not available for the poor and the staff at the public hospitals is though competent but overworked. The private sector health organizations have cutting edge technologies with no African nation coming near South Africa in such advanced technology. The attitudes of the general public also demonstrate such divides. For the poor, health care is expensive and costs a fraction of what they earn.   The fertility rate is declining in South Africa with an average childbearing rate being just under 3.

Like health care access, fertility also depends upon race and income in Africa. Thus the highest childbearing rate is that of the African poor. Though the childbearing rate is low and is still falling, adolescent childbirth and the existence of very young mothers is alarming. Over 35% of all girls of age 20 have given birth at least once, though it does not necessarily hinder their education. (Leticia Martellato)   Since South Africa is multi-ethnic and multiracial, a variety of different languages are spoken across the country.

Though English is the commercial language, a patient, especially from poor areas might be speaking any language from the 11 officially recognized and many other nonofficial languages. The languages may include Afrikaans, Ndebele, Sotho, or Tsongo.   The basic concern of the poor, when accessing health care is the cost associated. Many poverty-related illnesses such as Malaria, tuberculosis, cholera, hepatitis B, and measles are common. South Africa has one of the highest TB rates in the world. The growth of multi-drug resistant TB is alarming particularly when fanned by AIDS as it is very life-threatening.   Malnutrition is also on the rise.

27% of children are being affected by stunting and a further 14 million are under threat.   What is needed is a massive poverty alleviation program with proper health and sanitation provisions.   Traditional African beliefs of health and sickness are not necessarily the same as biological ones. The Africans believe in the macro cosmos (the ancestors), the meso-cosmos (witches and sorcerers), and the micro-cosmos (everyday life). There are beliefs that witchcraft causes AIDS and that sex is a symbol of immortality. Polygamous marriages are rife and culture inhibits the use of condoms.

Male circumcision is also mandatory in some tribes. These cultural notions hinder the prevention of AIDS which is a major blow to the South African health system.     Traditional healers are also a part of the health care system in Africa; in fact, they are the only affordable choice for many. They use different herbs to diagnose and treat diseases.   There are both diviners (who diagnose using spirits) and healers (who use herbs in the process).   Increasing efforts are being made to include these traditional healers in the primary health care system by imparting training.

Their help is specially taken in the diagnosis and prevention of AIDS. Thus currently, help from traditional healers is being taken to control the spread of AIDS.   Comparison with the United States The United States has a very well developed health care program. Almost 85% of the population has health insurance whereas in South Africa barely 14% have medical insurance. The United States spends a huge amount of its GDP on health and related issues whereas South Africa barely spends 11% of its GDP.

In the United States, research-based spending is also done whereas in South Africa almost no money is being spent on research. The United States has endemics under control but South Africa still needs to control diseases such as TB and malaria and launch a massive AIDS control program. Both the United States and South Africa have technologically advanced private health systems.   Taking care of a South African patient in the United States A South African patient should be first tested for any contagious diseases particularly AIDS. It should also be checked that he is not a carrier for any disease.

Then medical insurance should be bought for that patient or social security should be made available for that patient. If the patient is in a critically ill condition, he should be kept in a hospice or a nursing home.   Since South Africans are not very conservative, there will be no cultural restrictions. They will easily get assimilated into the American healthcare system like Native Americans. Language barriers also would not pose a problem as most South Africans are well versed in English. Conclusion Though the South African health system has come a long way from the apartheid of 1994, it still has a long way to go.

More focus is needed on spreading awareness about contractible diseases, especially AIDS. A proper public health care system should be developed and steps should be taken to prevent the brain drain of qualified medical professionals. Health insurance or free health care should be made available to all and the budget allocations to provinces should be made on a need basis.


Leticia Marteleto, David Lam, Vimal Ramchod. "Schooling and early child bearing in urban South Africa." 2006.

World Health Organization Assesses the World's Health Systems. 15 0ctober 2010 .

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