Healthcare service problems reported in a national survey of South Africans.

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.