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Introduction
More than two decades have passed since South African liberation from apartheid but to say that all challenges have been overcome would be an understatement. In spite of a number of progress reports stating South African progress towards the accomplishment of MDGs, the HIV/AIDS issue is still a problem, as well as maternal health and air pollution leading to upper respiratory passage diseases in the population. Vulnerable groups include mothers, men who have sex with other men (MSMs), and children (Chopra et al., 2009). The following paper is aimed at outlining the disease burden, including the HIV/AIDS, NDC, and maternal mortality, and the governments priorities in this respect.
Demographic Profile
South Africa is located at the southern tip of African continent, with the area slightly more than 1.2 mln square kilometers, or twice the size of Texas. The total population is more than 53.6 mln, of which 80.2% are Black African, 8.4 % are White, and the rest is unevenly distributed between Indian, Asian, and persons with mixed racial ancestry. Total GDP of South Africa is $350.1, with 8.9% of it spent on health care. By 2014, the total HDI of the country amounted to 0.666, and the poverty prevalence was 45% (Chopra et al., 2009).
Health services are provided either through work insurance or on the private basis, with the public and private systems existing and functioning simultaneously. Public health establishments render services to the overwhelming majority of the population but seem to experience a permanent shortage of funding and staffing. The 8.9% spent on public health is largely constituted by governmental expenses. Among the population that use private health facilities, none falls within the range of the poverty prevalence.
Most of the higher-income-level residents follow the Western health paradigm, which is why they are likely to use private establishments. With the majority of the population aged 22-54, the percentage of those having access to health facilities is painfully small. In addition, research indicates that white population (66%) are more likely to have access to health services than the black South Africans (Bor et al., 2015).
As in any country, there are certain cultural practices that promote health as well as those that can be deemed potentially harmful. Within the first category, one can state the fact that the male population of South Africa is being taught to respect the rights of women, acknowledge their free choice and autonomy. Additionally, the children with birth impairments and defects are generally treated well. Which is to say that such children are usually left within families and given the treatment and support that the household can afford.
On the other hand, some researchers give an alarming account of the practices that undermine South African potential of fulfilling the MGMs. For instance, considering the rates of poverty prevalence, it is understandable that the food present in poor households might not always be nutritious enough. What is more, in some communities, pregnant women and mothers are discouraged to eat proteins. Generally, women have less control than men over their reception of medical care.
Finally, a separate space should be devoted to MSMs and their behaviors that are harmful for health. In rural South African communities, MSMs are generally tabooed and stigmatized; such intercourse is not discussed within communities. As a result, those who engage in such intercourse at some point in their life are under- or misinformed of behaviors that ensure basic sexual safety. As a consequence, the HIV/AIDS percentage among MSMs is the highest (Imrie, Hoddinott, Fuller, Oliver, & Newell, 2013).
Burden of Disease and Health Priorities
HIV/AIDS are only a part of South African disease burden, with the total of 6.3 million adult persons living with HIV (Bor et al., 2015). HIV mortality has shown a steady decline for both men and women since the year 2004 but there are more problems to solve. A study conducted in areas of residence located in Ekurhuleni Metropolitan Municipality shows a positive association between air pollution and some of the non-communicable diseases, such as asthma (Shirinde, Wichmann, & Voyi, 2014).
The more so, due to poor access to medical facilities for those in need of prenatal, delivery, and postnatal care, the country suffers significant maternal and childhood mortality. The vulnerable groups include women aged 15-25 residing in rural areas, with the womens and their partners education and socio-economic status as important predictors of the womens access to health care facilities The burden is, thus, threefold, including the rates of HIV/AIDS, lack of delivery care, and the NCDs.
With respect to the maternal mortality, the situation in South Africa is similar to that of the neighboring Namibia, where young mothers residing in rural areas are prone to the same risks (Mamunur & Antai, 2014).
Considering the limited resources and the high poverty prevalence rates, the Governments strategy is mainly consistent with promotive measures. Another strategy is to integrate health-promotion and disease prevention in relation to both HIV/AIDS and NCDs. Such model makes use of social workers to increase the communities participation and advocate for equity. In the pursuit of reducing health costs, the Department of Health tries to combine the costliest practices for NCDs and HIV/AIDS. For example, the chronic non-communicable disease screening can be combined with counseling for those who is HIV/AIDS infected (Bor et al., 2015).
Conclusion
The government, thus, is focused on extermination of South African disease burden, primarily on the aspects of HIV/AIDS and NCDs. It is also aimed at further pursuing MDGs and the goals related to them. The government is well aware that if no attention is paid to NCDs, the outcome will be likely the same as in the case of HIV/AIDS.
The cooperative measures to tackle these issues are actively used by the Government (a unified commission to address the communicable and non-communicable diseases by bringing together separate ministries, improving cost-efficacy, promoting vaccination and equity, etc.). Such multispectral approach is still on the project stage but the prognosis can be positive. These services are easily delivered and are likely to succeed, based on Nigeria and Cameroon experience (Skolnik, 2012).
References
Bor, J., Rosen, S., Chimbindi, N., Haber, N., Herbst, K., Mutevedzi, T.,&Bärnighausen, T. (2015). Mass HIV Treatment and Sex Disparities in Life Expectancy: Demographic Surveillance in Rural South Africa. PLoS Medicine, 12(11), 1-21.
Chopra, M., Lawn, J. E., Sanders, D., Barron, P., Karim, S. S. A., Bradshaw, D.,&Coovadia, H. (2009). Achieving the health Millennium Development Goals for South Africa: Challenges and Priorities. The Lancet, 374(9694), 1023-1031.
Imrie, J., Hoddinott, G., Fuller, S., Oliver, S., & Newell, M. (2013). Why MSM in Rural South African Communities Should be an HIV Prevention Research Priority. AIDS and Behavior, 17, 70-76.
Mamunur, R., & Antai, D. (2014). Socioeconomic Position as a Determinant of Maternal Healthcare Utilization: A Population-Based Study in Namibia. Journal of Research in Health Sciences, 14(3), 187-192.
Shirinde, J., Wichmann, J., & Voyi, K. (2014). Association between wheeze and selected air pollution sources in an air pollution priority area in South Africa: a cross-sectional study. Environmental Health: A Global Access Science Source, 13(1), 1-24.
Skolnik, R. (2012). Global Health 101 (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
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