Healthcare service problems reported in a national survey of South Africans

Int J Qual Health Care. 2014 Aug;26(4):482-9. doi: 10.1093/intqhc/mzu056. Epub 2014 May 19.


Objective: To identify common types of health service problems reported by South African adults during their most recent visit to a healthcare provider.

Design: Secondary analysis of South Africa's cross-sectional General Household Survey (GHS).

Setting: Nationally representative weighted sample of households in South Africa.

Participants: 23,562 household representatives interviewed during the 2010 GHS.

Main outcome measure: Problems experienced during the most recent visit to the usual healthcare provider.

Results: In total, 43.8% of participants reported experiencing at least one problem during their last visit; 19.1% reported multiple problems. The most common problems experienced were a long waiting time (34.8% of household representatives), needed drugs not being available (14.1%) and staff who were rude or uncaring or turned patients away (10.1%). Of the 73.6% of participants using public providers, 54.9% reported at least one problem; of the 26.4% of participants using private providers, only 18.0% reported a problem, usually cost. Similar differences in reported problems at public and private providers were reported for all racial/ethnic groups and income groups. Black Africans reported more problems than other population groups due in large part to being significantly more likely to use public providers.

Conclusions: Addressing commonly reported problem areas-in particular, long waiting times, unavailable medications and staff who are perceived as being unfriendly-might help prevent delayed care seeking, increase the acceptability of healthcare services and reduce remaining health disparities in South Africa.

Keywords: South Africa; health attitudes; health services accessibility; healthcare acceptability; healthcare systems; patient satisfaction.

MeSH terms

  • Attitude of Health Personnel
  • Cross-Sectional Studies
  • Health Services Accessibility / statistics & numerical data
  • Health Services Administration / statistics & numerical data*
  • Humans
  • Patient Satisfaction / ethnology
  • Patient Satisfaction / statistics & numerical data*
  • Private Sector / statistics & numerical data*
  • Public Sector / statistics & numerical data*
  • Quality of Health Care / statistics & numerical data*
  • Racial Groups
  • Socioeconomic Factors
  • South Africa
  • Waiting Lists