Socio-economic inequalities in the multiple dimensions of access to healthcare: the case of South Africa
Open accessAbstract
Background: The 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. Method: The 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. Results: In 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. Conclusion: In 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.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The observed drop-off when analyzing the cascade of respondents who express symptoms, to those who seek facility-based care, to those who are treated by a trained healthcare provider, is also observed in similar research contexts.
“Additionally, the observed drop-off when analyzing the cascade of respondents who express symptoms, to those who seek facility-based care, to those who are treated by a trained healthcare provider, is also observed in similar research contexts [30–32].”
From Community and facility-level barriers to achieving UHC in Kono District, Sierra Leone and Maryland County, Liberia (2023) · cites this paper as [30]
The Discussion (page not available) describes a pathway from healthcare need through seeking, reaching and utilisation. The Results, under “Socio-economic inequalities in access to healthcare” (page not available), report that some respondents needed healthcare but did not receive it. The paper does not report the specific drop-off from expressing symptoms to seeking facility-based care to treatment by a trained provider. (LLM, conf=0.84)
Experimental — accuracy not yet measuredExternal results from studies conducted in similar research contexts cite high visit costs as a primary deterrent from seeking medical care.
“External results from studies conducted in similar research contexts cite high visit costs as a primary deterrent from seeking medical care [30, 33, 34].”
From Community and facility-level barriers to achieving UHC in Kono District, Sierra Leone and Maryland County, Liberia (2023) · cites this paper as [30]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Transforming Our World: The 2030 Agenda for Sustainable Development
Desa, U. (2018) · Springer Publishing Company eBooks · doi:10.1891/9780826190123.ap02 · Cited by 19,434 · see citing works
Levesque, J.-F., Harris, M. F., & Russell, G. (2013) · International Journal for Equity in Health · doi:10.1186/1475-9276-12-18 · Cited by 3,484 · see citing works
The Concepts and Principles of Equity and Health
Whitehead, M. (1992) · International Journal of Health Services · doi:10.2190/986l-lhq6-2vte-yrrn · Cited by 2,284 · see citing works
On the measurement of inequalities in health
Wagstaff, A., Paci, P., & van Doorslaer, E. (1991) · Social Science & Medicine · doi:10.1016/0277-9536(91)90212-u · Cited by 1,810 · see citing works
Health disparities and health equity: Concepts and measurement
Braveman, P. (2006) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.27.021405.102103 · Cited by 1,570 · see citing works
The health and health system of South Africa: Historical roots of current public health challenges
Coovadia, H., Jewkes, R., Barron, P., Sanders, D., & McIntyre, D. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60951-x · Cited by 1,413 · see citing works
Socioeconomic inequalities in health: Measurement, computation, and statistical inference
Kakwani, N., Wagstaff, A. R., & van Doorslaer, E. K. A. (1997) · Journal of Econometrics · doi:10.1016/s0304-4076(96)01807-6 · Cited by 1,382 · see citing works
Health systems financing and the path to universal coverage
EVANS, D. B., & Etienne, C. F. (2010) · Bulletin of the World Health Organization · doi:10.2471/blt.10.078741 · Cited by 1,286 · see citing works
Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and their Implementation
O'Donnell, O., van Doorslaer, E., Wagstaff, A., & Lindelow, M. (2007) · doi:10.1596/978-0-8213-6933-3 · Cited by 1,156 · see citing works
Wagstaff, A. R., van Doorslaer, E. K. A., & Watanabe, N. (2002) · Journal of Econometrics · doi:10.1016/s0304-4076(02)00161-6 · Cited by 1,099 · see citing works
Correcting the Concentration Index
Erreygers, G. (2008) · Journal of Health Economics · doi:10.1016/j.jhealeco.2008.02.003 · Cited by 870 · see citing works
Self-Reported Utilization of Health Care Services: Improving Measurement and Accuracy
Bhandari, A., & Wagner, T. H. (2006) · Medical Care Research and Review · doi:10.1177/1077558705285298 · Cited by 732 · see citing works
Explaining income‐related inequalities in doctor utilisation in Europe
van Doorslaer, E. K. A., Koolman, X., & Jones, A. M. (2004) · Health Economics · doi:10.1002/hec.919 · Cited by 725 · see citing works
Income-related inequalities in health: some international comparisons
van Doorslaer, E. K. A., Wagstaff, A. R., Han Bleichrodt, A., Calonge, S., Gerdtham, U., Gerfin, M., Geurts, J. J., Gross, L., Häkkinen, U., Leu, R. E., et al. (1997) · Journal of Health Economics · doi:10.1016/s0167-6296(96)00532-2 · Cited by 695 · see citing works
Access to health care in developing countries: breaking down demand side barriers
O'Donnell, O. (2007) · Cadernos de Saúde Pública · doi:10.1590/s0102-311x2007001200003 · Cited by 567 · see citing works
Health and Health Care in South Africa — 20 Years after Mandela
Mayosi, B. M., & Benatar, S. R. (2014) · New England Journal of Medicine · doi:10.1056/nejmsr1405012 · Cited by 533 · see citing works
Inequities in access to health care in South Africa
Harris, B., Goudge, J., Ataguba, J. E.-O., McIntyre, D., Nxumalo, N., Jikwana, S., & Chersich, M. (2011) · Journal of Public Health Policy · doi:10.1057/jphp.2011.35 · Cited by 507 · see citing works
Conindex: Estimation of Concentration Indices
O'Donnell, O., O'Neill, S., Van Ourti, T., & Walsh, B. (2016) · The Stata Journal: Promoting communications on statistics and Stata · doi:10.1177/1536867x1601600112 · Cited by 491 · see citing works
Perceived barriers in accessing food among recent Latin American immigrants in Toronto
Vahabi, M., & Damba, C. (2013) · International Journal for Equity in Health · doi:10.1186/1475-9276-12-1 · Cited by 344 · see citing works
Marten, R., McIntyre, D., Travassos, C., Shishkin, S. V., Longde, W., Reddy, S., & Vega, J. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60075-1 · Cited by 328 · see citing works
Access as a policy-relevant concept in low- and middle-income countries
McIntyre, D., Thiede, M., & Birch, S. (2009) · Health Economics Policy and Law · doi:10.1017/s1744133109004836 · Cited by 323 · see citing works
MILLS, A. J., Ataguba, J. E.-O., Akazili, J., Borghi, J., Garshong, B., Makawia, S., Mtei, G., Harris, B., Macha, J., Meheus, F., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60357-2 · Cited by 313 · see citing works
Inequities in under-five child malnutrition in South Africa
Zere, E., & McIntyre, D. (2003) · International Journal for Equity in Health · doi:10.1186/1475-9276-2-7 · Cited by 305 · see citing works
Analyzing Health Equity Using Household Survey Data
O’Donnell, O., van Doorslaer, E. K. A., Wagstaff, W., & Lindelöw, M. (2008) · University Libraries (University of Maryland) · doi:10.13016/fcm7-vvv1 · Cited by 292 · see citing works
McIntyre, D. (2008) · Bulletin of the World Health Organization · doi:10.2471/blt.08.053413 · Cited by 265 · see citing works
Socioeconomic-related health inequality in South Africa: evidence from General Household Surveys
Ataguba, J. E.-O., Akazili, J., & McIntyre, D. (2011) · International Journal for Equity in Health · doi:10.1186/1475-9276-10-48 · Cited by 247 · see citing works
On correcting the concentration index for binary variables
Kjellsson, G., & Gerdtham, U. (2012) · Journal of Health Economics · doi:10.1016/j.jhealeco.2012.10.012 · Cited by 233 · see citing works
Shisana, O., Labadarios, D., Rehle, T. M., Simbayi, L. C., Zuma, K. K., Dhansay, M. A., Reddy, P., Parker, W. W., Hoosain, E., Naidoo, P., et al. (2014) · Cited by 211 · see citing works
Bias in patient satisfaction surveys: a threat to measuring healthcare quality
Dunsch, F. A., Evans, D. K., Macis, M., & Wang, Q. (2018) · BMJ Global Health · doi:10.1136/bmjgh-2017-000694 · Cited by 162 · see citing works
Das‐Munshi, J., Lund, C., Mathews, C., Clark, C., Rothon, C., & Stansfeld, S. A. (2016) · PLoS ONE · doi:10.1371/journal.pone.0154478 · Cited by 149 · see citing works
Patient experiences and health system responsiveness in South Africa
Peltzer, K. (2009) · BMC Health Services Research · doi:10.1186/1472-6963-9-117 · Cited by 148 · see citing works
Income Inequality, Trust, and Population Health in 33 Countries
Elgar, F. J. (2010) · American Journal of Public Health · doi:10.2105/ajph.2009.189134 · Cited by 147 · see citing works
Distance decay and persistent health care disparities in South Africa
McLaren, Z. M., Ardington, C., & Leibbrandt, M. (2014) · BMC Health Services Research · doi:10.1186/s12913-014-0541-1 · Cited by 145 · see citing works
Macha, J., Harris, B., Garshong, B., Ataguba, J. E.-O., Akazili, J., Kuwawenaruwa, A., & Borghi, J. (2012) · Health Policy and Planning · doi:10.1093/heapol/czs024 · Cited by 137 · see citing works
Socioeconomic Inequalities in Adult Obesity Prevalence in South Africa: A Decomposition Analysis
Alaba, O. A., & Chola, L. (2014) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph110303387 · Cited by 108 · see citing works
Billmeyer, F. W., & Chen, Y. (1985) · Color Research & Application · doi:10.1002/col.5080100410 · Cited by 107 · see citing works
Explaining the role of the social determinants of health on health inequality in South Africa
Ataguba, J. E.-O., Day, C., & McIntyre, D. (2015) · Global Health Action · doi:10.3402/gha.v8.28865 · Cited by 102 · see citing works
Myburgh, N. G., Solanki, G. C., Smith, M. J., & Lalloo, R. (2005) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzi062 · Cited by 101 · see citing works
Unmet need as an indicator of health care access
Allin, S. M., & Masseria, C. (2009) · London School of Economics and Political Science Research Online (London School of Economics and Political Science) · Cited by 96 · see citing works
Yang, W. Y. L. (2013) · International Journal for Equity in Health · doi:10.1186/1475-9276-12-20 · Cited by 93 · see citing works
Mondor, L., Cohen, D., Khan, A. I., & Wodchis, W. P. (2018) · International Journal for Equity in Health · doi:10.1186/s12939-018-0800-6 · Cited by 90 · see citing works
Yiengprugsawan, V., Lim, L. L.-Y., Carmichael, G. A., Dear, K. B. G., & Sleigh, A. C. (2010) · BMC Research Notes · doi:10.1186/1756-0500-3-57 · Cited by 89 · see citing works
Mutyambizi, C., Booysen, F., Stokes, A. C., Pavlova, M., & Groot, W. N. J. (2019) · PLoS ONE · doi:10.1371/journal.pone.0211208 · Cited by 85 · see citing works
Self-citationPrice competition and quality differentiation with multiproduct firms
Cheng, Y., & Peng, S. (2013) · Journal of Economics · doi:10.1007/s00712-013-0367-z · Cited by 84 · see citing works
Caron, J., & Liu, A. (2010) · Community Mental Health Journal · doi:10.1007/s10597-010-9306-4 · Cited by 82 · see citing works
Saito, E., Gilmour, S., Yoneoka, D., Gautam, G., Rahman, M. M., Shrestha, P. K., & Shibuya, K. (2016) · Health Policy and Planning · doi:10.1093/heapol/czv137 · Cited by 78 · see citing works
Does the distribution of healthcare utilization match needs in Africa?
Bonfrer, I., van de Poel, E., Grimm, M., & Van Doorslaer, E. (2014) · Health Policy and Planning · doi:10.1093/heapol/czt074 · Cited by 76 · see citing works
Health disparities between racial groups in South Africa: A decomposition analysis
Charasse-Pouélé, C., & Fournier, M. (2006) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.11.020 · Cited by 71 · see citing works
Improving literacy as a means to reducing health disparities
Saha, S. S. (2006) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2006.00546.x · Cited by 67 · see citing works
Foulds, J., Wells, J. E., & Mulder, R. (2014) · International Journal of Social Psychiatry · doi:10.1177/0020764014521394 · Cited by 58 · see citing works
Who benefits from health services in South Africa?
Ataguba, J. E.-O., & McIntyre, D. (2012) · Health Economics Policy and Law · doi:10.1017/s1744133112000060 · Cited by 53 · see citing works
Nkonki, L. L., Chopra, M., Doherty, T., Jackson, D. J., & Robberstad, B. (2011) · International Journal for Equity in Health · doi:10.1186/1475-9276-10-13 · Cited by 53 · see citing works
Walsh, B., Silles, M. A., & O’Neill, C. (2011) · Health Economics · doi:10.1002/hec.1784 · Cited by 48 · see citing works
Wabiri, N., Chersich, M., Shisana, O., Blaauw, D., Rees, H., & Dwane, N. (2016) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-016-1048-z · Cited by 44 · see citing works
Lifestyle and Income-related Inequality in Health in South Africa
Mukong, A. K., van Walbeek, C., & Ross, H. (2017) · International Journal for Equity in Health · doi:10.1186/s12939-017-0598-7 · Cited by 43 · see citing works
NATIONAL HEALTH INSURANCE IN SOUTH AFRICA
(1929) · BMJ · doi:10.1136/bmj.2.3581.359 · Cited by 43 · see citing works
Cabieses, B., & Bird, P. (2014) · International Journal of Health Services · doi:10.2190/hs.44.4.j · Cited by 41 · see citing works
Ward, K., Sanders, D. M., Leng, H. M. J., & Pollock, A. M. (2014) · Bulletin of the World Health Organization · doi:10.2471/blt.13.130005 · Cited by 41 · see citing works
Decomposing socioeconomic health inequalities
Speybroeck, N., Könings, P., Lynch, J. W., Harper, S. B., Berkvens, D. L., Lorant, V., Gecková, A. M., & Hosseinpoor, A. R. (2010) · International Journal of Public Health · doi:10.1007/s00038-009-0105-z · Cited by 40 · see citing works
Schneider, H. M., Besada, D., Sanders, D. M., Daviaud, E., & Rohde, S. S. (2018) · UWC Research Repository (University of the Western Cape) · Cited by 38 · see citing works
Inequalities in multimorbidity in South Africa
Ataguba, J. E.-O. (2013) · International Journal for Equity in Health · doi:10.1186/1475-9276-12-64 · Cited by 38 · see citing works
Wabiri, N., Chersich, M., Zuma, K. K., Blaauw, D., Goudge, J., & Dwane, N. (2013) · PLoS ONE · doi:10.1371/journal.pone.0073864 · Cited by 36 · see citing works
Income-related inequalities in health care utilization in Mongolia, 2007/2008–2012
Dorjdagva, J., Batbaatar, E., Bayarsaikhan, D., & Kauhanen, J. (2015) · International Journal for Equity in Health · doi:10.1186/s12939-015-0185-8 · Cited by 35 · see citing works
Monitoring and Evaluating Progress towards Universal Health Coverage in South Africa
Ataguba, J. E.-O., Day, C., & McIntyre, D. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001686 · Cited by 30 · see citing works
Commercialisation and extreme inequality in health: the policy challenges in South Africa
McIntyre, D., Gilson, L., Wadee, H., Thiede, M., & Okarafor, O. (2006) · Journal of International Development · doi:10.1002/jid.1293 · Cited by 30 · see citing works
Jacobsen, K. H., & Hasumi, T. (2014) · Pan African Medical Journal · doi:10.11604/pamj.2014.18.172.4084 · Cited by 27 · see citing works
Lee, M., & Jones, A. M. (2007) · Health Policy · doi:10.1016/j.healthpol.2007.01.007 · Cited by 25 · see citing works
Healthcare service problems reported in a national survey of South Africans
Hasumi, T., & Jacobsen, K. H. (2014) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzu056 · Cited by 24 · see citing works
Vallejo‐Torres, L., & Morris, S. (2012) · Health Economics · doi:10.1002/hec.2821 · Cited by 19 · see citing works
Are self reported morbidities deceptive in measuring socio-economic inequalities.
Jain, K., Goli, S., & Arokiasamy, P. (2012) · Europe PMC (PubMed Central) · Cited by 16 · see citing works
Inequity in inpatient healthcare utilisation 10 years after Apartheid
Buisman, L. R., & García‐Gómez, P. (2014) · Development Southern Africa · doi:10.1080/0376835x.2014.984374 · Cited by 13 · see citing works
The Influence of Socioeconomic Status on Psychological Distress in Canadian Adults With ADD/ADHD
Pond, E., Fowler, K., & Hesson, J. (2016) · Journal of Attention Disorders · doi:10.1177/1087054716653214 · Cited by 11 · see citing works
Haughton, D., & Haughton, J. (2011) · Springer eBooks · doi:10.1007/978-1-4614-0385-2_11 · Cited by 1 · see citing works
Flagged first, then by citations
1 of the 74 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- [3]World Health Organisation. The World Health Report Health System Financing the path to universal coverage. Geneva: World Health Organization; 2010. PMC2878164 20539847
- [27]Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K, Dhansay A, et al. The South African National Health and Nutrition Examination Survey SANHANES-1. Ann Behav Med. 2009;37:45–60.
Cited by
Sorted by citations
Assessing healthcare access using the Levesque’s conceptual framework– a scoping review
Cu, A., Meister, S., Lefebvre, B., & Ridde, V. (2021) · International Journal for Equity in Health · doi:10.1186/s12939-021-01416-3 · Cited by 311 · see citing works
Rossouw, L., & Ross, H. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18052571 · Cited by 222 · see citing works
Liu, C., He, L. N., Li, Y., Yang, A., Zhang, K., & Luo, B. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1197947 · Cited by 46 · see citing works
Mokwele, R. N., Schellack, N., Bronkhorst, E., Brink, A. J., Schweickerdt, L., & Godman, B. (2021) · JAC-Antimicrobial Resistance · doi:10.1093/jacamr/dlab196 · Cited by 43 · see citing works
Gaffney, H. J., & Hamiduzzaman, M. (2022) · PLoS ONE · doi:10.1371/journal.pone.0269840 · Cited by 39 · see citing works
Akokuwebe, M. E., & Idemudia, E. S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031766 · Cited by 38 · see citing works
Prescribing, care and resistance: antibiotic use in urban South Africa
Manderson, L. H. (2020) · Humanities and Social Sciences Communications · doi:10.1057/s41599-020-00564-1 · Cited by 37 · see citing works
Socioeconomic Inequalities and Obesity in South Africa—A Decomposition Analysis
Goetjes, E., Pavlova, M., Hongoro, C., & Groot, W. N. J. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18179181 · Cited by 37 · see citing works
Magodoro, I. M., Okello, S., Dungeni, M., Castle, A. C., Mureyani, S., & Danaei, G. (2022) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2022.05.035 · Cited by 35 · see citing works
Dual Use of Public and Private Health Care Services in Brazil
Silva, B., Hens, N., Gusso, G. D. F., Lagaert, S., Macinko, J. A., & Willems, S. J. T. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031829 · Cited by 33 · see citing works
Kota, K., Chomienne, M., Geneau, R., & Yaya, S. (2023) · Reproductive Health · doi:10.1186/s12978-023-01644-6 · Cited by 32 · see citing works
Harriman, N. W., Williams, D. R., Morgan, J. W., Sewpaul, R., Manyaapelo, T., Sifunda, S., Mabaso, M., Mbewu, A. D., & Reddy, S. P. (2021) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-021-02175-w · Cited by 37 · see citing works
Biks, G. A., Shiferie, F., Tsegaye, D. A., Alemayehu, W. A., Mekuria, L. A., Wondie, T., Seboka, G., Hayes, A., Ralph-Opara, U., Zelalem, M., et al. (2024) · Vaccine X · doi:10.1016/j.jvacx.2024.100454 · Cited by 30 · see citing works
Abel, Z. D. V., Roope, L. S. J., Duch, R. M., & Clarke, P. (2024) · BMC Public Health · doi:10.1186/s12889-024-20147-y · Cited by 29 · see citing works
Kludacz-Alessandri, M., Walczak, R., Hawrysz, L., & Korneta, P. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10163502 · Cited by 29 · see citing works
Bauer, J., Klingelhöfer, D., Maier, W., Schwettmann, L., & Groneberg, D. A. (2020) · International Journal of Health Geographics · doi:10.1186/s12942-020-00223-3 · Cited by 28 · see citing works
Makgopa, S., & Madiba, S. (2021) · Health Services Insights · doi:10.1177/11786329211054035 · Cited by 26 · see citing works
Sewpaul, R., Mbewu, A. D., Fagbamigbe, A. F., Kandala, N., & Reddy, S. P. (2021) · Public Health in Practice · doi:10.1016/j.puhip.2021.100193 · Cited by 25 · see citing works
Malta, D. C., Bernal, R. T. I., Gomes, C. S., Cardoso, L. S. D. M., Lima, M. G., & Barros, M. B. D. A. (2021) · Revista Brasileira de Epidemiologia · doi:10.1590/1980-549720210003.supl.2 · Cited by 25 · see citing works
Reddy, S. P., Mbewu, A. D., Williams, D. R., Harriman, N. W., Sewpaul, R., Morgan, J. W., Sifunda, S., Manyaapelo, T., & Mabaso, M. (2021) · SSM - Population Health · doi:10.1016/j.ssmph.2021.100986 · Cited by 25 · see citing works
Tshabalala, G., Blanchard, C. L., Mmoledi, K. C., Malope, D., O’Neil, D. S., Norris, S. A., Joffe, M., & Dietrich, J. J. (2023) · PLOS Global Public Health · doi:10.1371/journal.pgph.0001826 · Cited by 21 · see citing works
Collaborative, T. I. H. I. S. (2021) · BMJ Global Health · doi:10.1136/bmjgh-2021-007265 · Cited by 20 · see citing works
The multicultural conceptualisation of well-being
Adedeji, A., Olonisakin, T. T., Buchcik, J., Metzner, F., Tsabedze, W. F., Boehnke, K., & Idemudia, E. S. (2023) · BMC Public Health · doi:10.1186/s12889-023-16966-0 · Cited by 20 · see citing works
Grosman, Y., & Kalichman, L. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22040547 · Cited by 23 · see citing works
Equitable access to cell and gene therapies in South Africa: opportunities and hurdles
Hendricks, C. L., Alessandrini, M., & Pepper, M. S. (2022) · Gene Therapy · doi:10.1038/s41434-021-00309-y · Cited by 19 · see citing works
Mabetha, D., Ojewola, T., van der Merwe, M., Mabika, R., Goosen, G., Sigudla, J., Hove, J., Witter, S., & D’Ambruoso, L. (2023) · International Journal for Equity in Health · doi:10.1186/s12939-023-01894-7 · Cited by 20 · see citing works
Effenberger, S., Greenwall, L. H., Cebula, M., Myburgh, N. G., Simpson, K., Smit, D., Wicht, M. J., & Schwendicke, F. (2021) · Community Dentistry And Oral Epidemiology · doi:10.1111/cdoe.12702 · Cited by 16 · see citing works
Mapanga, W., Norris, S. A., Craig, A., Ayeni, O., Chen, W. C., Jacobson, J. S., Neugut, A. I., Ruff, P., Cubasch, H., O’Neil, D. S., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0281916 · Cited by 16 · see citing works
Correia, A. T. L., Forshaw, P. E., Roden, L. C., Lipinska, G., Rauch, L., Lambert, E. V., Layden, B. T., Reutrakul, S., Crowley, S. J., Luke, A. H., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-54032-w · Cited by 16 · see citing works
Khoza‐Shangase, K., & Sebothoma, B. (2022) · doi:10.4102/aosis.2022.bk209.02 · Cited by 15 · see citing works
Ng’ambi, W. F., Mangal, T. D., Phillips, A. N., Colbourn, T., Nkhoma, D., Mfutso-Bengo, J. M., Revill, P. A., & Hallett, T. B. (2020) · PubMed Central · doi:10.4314/mmj.v32i4.5 · Cited by 15 · see citing works
Preventive audiology: An African perspective
Sebothoma, B., Govender, S., Joubert, K., Kanji, A., Moroe, N., Masuku, K. P., Maluleke, N. P., & Ntlhakana, L. (2022) · doi:10.4102/aosis.2022.bk209 · Cited by 15 · see citing works
Akokuwebe, M. E., & Idemudia, E. S. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19010125 · Cited by 14 · see citing works
Fagunwa, O., Mthiyane, T., Fagunwa, A. O., Olayemi, K. I., Alozie, A., Onyeaka, H. N., Akinsemolu, A. A., & Ojo, A. (2023) · Environment Development and Sustainability · doi:10.1007/s10668-023-03992-6 · Cited by 13 · see citing works
Todd, M., Guetterman, T. C., Volschenk, J., Kidd, M., & Joubert, E. (2022) · Nutrients · doi:10.3390/nu14142801 · Cited by 14 · see citing works
Mnguni, L. E. (2024) · International Medical Education · doi:10.3390/ime3010005 · Cited by 12 · see citing works
Healthcare access and deprivation in low-income urban households
Mazenda, A., & Lubinga, M. H. (2024) · Discover Social Science and Health · doi:10.1007/s44155-024-00108-x · Cited by 12 · see citing works
Russo, G., Jesus, T. S., Deane, K. D., Osman, A. Y., & McCoy, D. (2021) · International Journal of Health Policy and Management · doi:10.34172/ijhpm.2021.155 · Cited by 11 · see citing works
Changing Inequalities in Health-Adjusted Life Expectancy by Income and Race in South Africa
Bredenkamp, C., Burger, R., Jourdan, A., & van Doorslaer, E. K. A. (2021) · Health Systems & Reform · doi:10.1080/23288604.2021.1909303 · Cited by 11 · see citing works
Social determinants of health in non-communicable diseases prevention policies in South Africa
Rasesemola, R. M., Mmusi-Phetoe, R., & Havenga, Y. (2023) · Curationis · doi:10.4102/curationis.v46i1.2387 · Cited by 11 · see citing works
Mesa-Vieira, C., Didden, C., Schomaker, M., Mouton, J. P., Folb, N., van den Heuvel, L. L., Gastaldon, C., Cornell, M., Tlali, M., Kassanjee, R., et al. (2024) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796024000052 · Cited by 10 · see citing works
Organ transplantation in Africa: Confronting socioeconomic, cultural, and infrastructural hurdles
Olawade, D. B., Odetayo, A., Marinze, S., Egbon, E., & Chinwah, V. (2025) · Current Research in Translational Medicine · doi:10.1016/j.retram.2025.103516 · Cited by 12 · see citing works
Review on Alopecia Areata in the Middle East and Africa: Landscape and Unmet Needs
Hammadi, A. A., Parmar, N. V., Aljefri, K., Sharif, O. A., Abdallah, M., Ahmed, H. M., & Ammoury, A. (2023) · Dermatology and Therapy · doi:10.1007/s13555-023-00946-8 · Cited by 10 · see citing works
Sodi, T., Modipane, M., Asante, K. O., Quarshie, E. N., Asatsa, S., Mutambara, J., & Khombo, S. (2021) · South African Journal of Psychology · doi:10.1177/00812463211012177 · Cited by 10 · see citing works
Mkhwanazi, T. W., Modjadji, P., Mokgalaboni, K., Madiba, S., & Roomaney, R. A. (2023) · Diseases · doi:10.3390/diseases11040129 · Cited by 11 · see citing works
Fang, Y., Fu, L., Xu, Y., & Dong, Y. (2024) · Social Indicators Research · doi:10.1007/s11205-023-03286-4 · Cited by 9 · see citing works
Barriers to Chronic Disease Healthcare Access in Rural Eastern Cape Province, South Africa
Mntungwana, S., Khosa, N. V., Buso, A., & Sithole, N. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22121881 · Cited by 9 · see citing works
Socioeconomic Inequalities and Vaccine Uptake: An Umbrella Review Protocol
Sacre, A., Bambra, C. L., Wildman, J. M., Thomson, K. H., Sowden, S. L., & Todd, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191811172 · Cited by 10 · see citing works
Low self-reported penicillin allergy in South Africa—implications for global public health response
Day, C., Mendelson, M., Peter, J., ADvISE study group, Deetlefs, M., O’Brien, A., Smith, J., Boyd, M., Embling, N., Patel, S., et al. (2022) · JAC-Antimicrobial Resistance · doi:10.1093/jacamr/dlad015 · Cited by 9 · see citing works
Michel, J., & Tanner, M. (2021) · IntechOpen eBooks · doi:10.5772/intechopen.95901 · Cited by 9 · see citing works
Public health practice and artificial intelligence: views of future professionals
Mwase, N. S., Patrick, S. M., Wolvaardt, L., van Wyk, M., Junger, W. L., & Wichmann, J. (2023) · Journal of Public Health · doi:10.1007/s10389-023-02127-5 · Cited by 8 · see citing works
Pilusa, S. I., Myezwa, H., & Potterton, J. L. (2021) · International Journal of Therapy and Rehabilitation · doi:10.12968/ijtr.2021.0005 · Cited by 8 · see citing works
Musimar, Z., Mpetani, M., Abramson, J. S., Chabner, B. A., & Mohamed, Z. (2023) · The Oncologist · doi:10.1093/oncolo/oyad069 · Cited by 8 · see citing works
Multimorbidity in South Africa: Is the health system ready?
Roomaney, R. A., van Wyk, B. E., & Wyk, V. P. (2023) · Journal of Multimorbidity and Comorbidity · doi:10.1177/26335565231182483 · Cited by 10 · see citing works
Zhang, J., Zhou, S., Feng, Y., Liu, H., & Li, C. (2025) · Scientific Reports · doi:10.1038/s41598-025-02615-6 · Cited by 9 · see citing works
Pilusa, S. I., Myezwa, H., & Potterton, J. L. (2021) · South African Medical Journal · doi:10.7196/samj.2021.v111i12.15761 · Cited by 8 · see citing works
Alaba, O. A., Hongoro, C., Thulare, A., & Lukwa, A. T. (2022) · BMC Public Health · doi:10.1186/s12889-022-14482-1 · Cited by 8 · see citing works
Blickfeldt, S., Day, R. D., Roby, J. L., & Maistry, S. M. (2022) · International Social Work · doi:10.1177/00208728221086151 · Cited by 7 · see citing works
Rossouw, L., & Filby, S. (2022) · PLoS ONE · doi:10.1371/journal.pone.0277702 · Cited by 7 · see citing works
The caregiver’s experience of childhood cancer treatment in South Africa
Joosse, I. R., van den Ham, H. A., Mantel-Teeuwisse, A. K., & Suleman, F. (2024) · Journal of Pharmaceutical Policy and Practice · doi:10.1080/20523211.2024.2312382 · Cited by 7 · see citing works
Golby, R., Lobban, F. A., Laverty, L., Velemis, K., Aggarwal, V. R., Berry, K., Morris, A., Elliott, E., Harris, R. V., Ross, A. J., et al. (2024) · Health Expectations · doi:10.1111/hex.70090 · Cited by 7 · see citing works
Calvert, C., Kolkenbeck‐Ruh, A., Crouch, S. H., Soepnel, L. M., & Ware, L. J. (2022) · Scientific Reports · doi:10.1038/s41598-022-11072-4 · Cited by 7 · see citing works
Medication use in patients with functional seizures from a public and a private hospital
Vilyte, G., Butler, J. T., Ives-Deliperi, V. L., & Pretorius, C. (2024) · Seizure · doi:10.1016/j.seizure.2024.02.017 · Cited by 7 · see citing works
Khosa, T. M., Shibiya, M. N., & Mshunqane, N. (2022) · Southern African Journal of Public Health · doi:10.7196/sajph.2022.v6.i1.159 · Cited by 6 · see citing works
Lukwa, A. T., Okova, D., Bodzo, P., Maseko, S. C., Bhebe, M., Akinsolu, F. T., Abodunrin, O. R., Nzeribe, E. C., Siya, A., Nyabunze, A., et al. (2025) · Global Transitions · doi:10.1016/j.glt.2025.04.008 · Cited by 6 · see citing works
COVID-19 and regional inequalities in childhood vaccination uptake in England: a spline regression
Sacre, A., Sowden, S. L., Bambra, C. L., Bennett, N. C., & Todd, A. (2025) · BMC Public Health · doi:10.1186/s12889-025-24207-9 · Cited by 6 · see citing works
A resuscitation systems analysis for South Africa: A narrative review
van Rensburg, L. C., Majiet, N., Geldenhuys, A., King, L. L., & Stassen, W. (2024) · Resuscitation Plus · doi:10.1016/j.resplu.2024.100655 · Cited by 6 · see citing works
Motivation and Behaviour Change in Parkrun Participants in the Western Cape Province, South Africa
Chivunze, E., Burgess, T. L., Carson, F., & Buchholtz, K. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18158102 · Cited by 6 · see citing works
Vilyte, G., Butler, J. T., & Pretorius, C. (2023) · Seizure · doi:10.1016/j.seizure.2023.10.001 · Cited by 6 · see citing works
Beidelman, E. T., Bärnighausen, T., Wing, C., Tollman, S. M., Phillips, M. L., & Rosenberg, M. S. (2023) · BMC Public Health · doi:10.1186/s12889-023-17043-2 · Cited by 6 · see citing works
Raad, R., Dixon, J., Gorsky, M., & Hoddinott, G. (2024) · Global Public Health · doi:10.1080/17441692.2024.2356623 · Cited by 6 · see citing works
Wen, X., Qiao, L., Deng, F., Zhou, J., Li, M., Wang, L., Deng, H., Amhare, A. F., Han, J., & Guo, Y. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1567747 · Cited by 5 · see citing works
Wu, Y., Andescavage, N. N., Weiner, S. L., Liggett, M., Ngwa, J. S., Kapse, A., Kapse, K. J., McDermott, C., Donofrio, M. T., Wisner, K. L., et al. (2026) · Pediatric Research · doi:10.1038/s41390-026-04859-y · Cited by 5 · see citing works
Healthcare Disparities in the Treatment and Outcomes of Hepatocellular Carcinoma in South Africa
Sobnach, S., Emmamally, M., Venter, K., Krige, J. E. J., Bernon, M. M., Kloppers, C., Sonderup, M. W., Spearman, C. W., Khan, R., Kotze, U. K., et al. (2025) · World Journal of Surgery · doi:10.1002/wjs.12559 · Cited by 5 · see citing works
Socioeconomic status significantly impacts childhood cancer survival in South Africa
Hendricks, M. G., Cois, A., Geel, J. A., van Heerden, J., Dandara, C., Mohamed, K., Donald, K. A., & Kruger, M. (2023) · Pediatric Blood & Cancer · doi:10.1002/pbc.30669 · Cited by 5 · see citing works
Factors affecting quality of life in adults with HIV: A local cross-sectional study
Berner, K., & Louw, Q. A. (2023) · South African Journal of Physiotherapy · doi:10.4102/sajp.v79i1.1921 · Cited by 5 · see citing works
Aashima, A., & Sharma, R. (2024) · International Journal of Social Determinants of Health and Health Services · doi:10.1177/27551938241230761 · Cited by 5 · see citing works
Maluleke, N. P. (2024) · South African Journal of Communication Disorders · doi:10.4102/sajcd.v71i1.992 · Cited by 5 · see citing works
Joosse, I. R., van den Ham, H. A., Mantel-Teeuwisse, A. K., Perumal-Pillay, V. A., & Suleman, F. (2024) · Journal of Pharmaceutical Policy and Practice · doi:10.1080/20523211.2024.2372033 · Cited by 5 · see citing works
Gong, H., Zhang, T., Wang, X., Chen, B., Wu, B., & Zhao, S. (2024) · Risk Management and Healthcare Policy · doi:10.2147/rmhp.s479911 · Cited by 5 · see citing works
Vay, J. N. L., Fraser, A., Byass, P., Tollman, S. M., Kahn, K., D’Ambruoso, L., & Davies, J. I. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-048592 · Cited by 5 · see citing works
Higgins, J., JEROME, J. G., Boima, F., Dally, E., Krangar, L., Boley, E. J., Toussaint, S., Dibba, Y., Kachimanga, C., Mhango, M., et al. (2023) · PLOS Global Public Health · doi:10.1371/journal.pgph.0002045 · Cited by 4 · see citing works
Are graduate optometrists in South Africa practice ready?
Putter, T.-L., Munsamy, A. J., & van Staden, D. B. (2023) · African vision and eye health · doi:10.4102/aveh.v82i1.806 · Cited by 4 · see citing works
The profile of people undergoing lower limb amputations at Groote Schuur Hospital
Limakatso, K., Tucker, J., Banda, L., Robertson, C., & Parker, R. (2024) · African Journal of Disability · doi:10.4102/ajod.v13i0.1152 · Cited by 4 · see citing works
Lubinga, E., Sitto, K., & Molebatsi, K. (2021) · Catalan Journal of Communication & Cultural Studies · doi:10.1386/cjcs_00054_1 · Cited by 4 · see citing works
Masuku, S. D., Mandrik, O., Mdege, N. D., Mishra, G. A., Muwonge, R., Meyer‐Rath, G., Lince-Deroche, N., & Brennan, A. (2025) · Value in Health Regional Issues · doi:10.1016/j.vhri.2025.101127 · Cited by 3 · see citing works
Hongoro, D. J., Kengne, A. P., Peer, N., Nguyen, K. A., Bobrow, K., & Alaba, O. A. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22101488 · Cited by 3 · see citing works
Waseem, M., Cao, E., Jamil, I., Mughal, B., & Yu, M. Y. (2025) · Journal of Integrative Agriculture · doi:10.1016/j.jia.2025.11.019 · Cited by 3 · see citing works
Mengistu, A. K., Bitew, K. G., Alemayehu, T., Yeneakal, K. A., Gedefaw, A. E., Teym, A., Endalew, B., & Assaye, B. T. (2026) · Discover Artificial Intelligence · doi:10.1007/s44163-025-00794-9 · Cited by 3 · see citing works
Greyling, C., Truter, I., & Barry, J. (2026) · International Journal of Pharmacy Practice · doi:10.1093/ijpp/riaf135 · Cited by 3 · see citing works
Social Determinants of Health in Africa
Amzat, J., Aminu, K., & Muchabveyo, B. (2022) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197608494.013.12 · Cited by 3 · see citing works
Zhou, J., Wang, C., Zhang, X., & Wang, S. (2022) · Sustainability · doi:10.3390/su141912757 · Cited by 3 · see citing works
Self-reported beta-lactam allergy in government and private hospitals in Cape Town, South Africa
Day, C., Deetlefs, M., O’Brien, A., Smith, J., Boyd, M., Embling, N., Patel, S., Moody, K., Ramabele, T., Budge, A., et al. (2023) · South African Medical Journal · doi:10.7196/samj.2023.v113i2.16760 · Cited by 3 · see citing works
Moyegbone, J. E. (2024) · Journal of Ophthalmology and Advance Research · doi:10.46889/joar.2024.5102 · Cited by 3 · see citing works
Tukisi, K. P. (2024) · International Journal of Research in Business and Social Science (2147-4478) · doi:10.20525/ijrbs.v13i5.3503 · Cited by 3 · see citing works
Maseko, L. J., Myezwa, H., & Adams, F. (2024) · Journal of Patient Experience · doi:10.1177/23743735241261222 · Cited by 3 · see citing works
Mudali, M. C., & Munongi, L. (2025) · British Journal of Learning Disabilities · doi:10.1111/bld.12645 · Cited by 2 · see citing works
Sathar, F., du Toit, C., Chihota, V. N., Charalambous, S., Evans, D. H., & Chetty-Makkan, C. M. (2025) · Tropical Medicine and Infectious Disease · doi:10.3390/tropicalmed10100283 · Cited by 2 · see citing works
Global Progress Toward Universal Health Coverage: Learning from Successes and Failures
Thomas-McLean, H., Mak, R., Noonan, C. M., & Yip, W. C.-M. (2025) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-100824-103712 · Cited by 2 · see citing works
Tan, Y. R., Lokman, N., & Marhazlinda, J. (2026) · International Dental Journal · doi:10.1016/j.identj.2025.109389 · Cited by 2 · see citing works
- Authors
- Gordon, T., Booysen, F., & Mbonigaba, J.
- Affiliations
- Human Sciences Research Council (ZA)
- University of the Witwatersrand (ZA)
- University of KwaZulu-Natal (ZA)
- Corresponding author
- Gordon, Tanja
- Venue
- BMC Public Health
- Published
- 2020-03-04
- Volume
- 20
- Issue
- 1
- Pages
- 289-289
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC7057636
- OpenAlex
- W3012082939
- Cited by
- 209
- References
- 74
- Citations by year
- 2026: 37 · 2025: 45 · 2024: 51 · 2023: 26 · 2022: 21 · 2021: 26 · 2020: 3
- FWCI
- 19.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Department for International Development
- Topics
- Social Sciences › Economics, Econometrics and Finance › Finance › Healthcare Systems and Reforms
- Social Sciences › Health › Public Health and Social Inequalities
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- socioeconomic inequalities in health, health care access, universal health coverage, health care utilization, health care affordability, health care satisfaction, national health insurance, health literacy, decomposition analysis, concentration index, South Africa
- MeSH terms
- Adult, Female, Humans, Male, Nutrition Surveys, Socioeconomic Factors, South Africa, Healthcare Disparities
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
