Metiso Nonhlanhla Fortunate, Mboweni Sheillah Hlamalani
Department of Health Studies, College of Human Sciences, University of South Africa, Pretoria, Gauteng, South Africa.
Health Serv Insights. 2025 Aug 8;18:11786329251356931. doi: 10.1177/11786329251356931. eCollection 2025.
The utilisation of healthcare services is critical to maintaining and improving the health status of communities, however, numerous barriers and enablers can either hinder or facilitate an individual's ability to access and benefit from these services, and this is the case in South Africa.
This study aimed to identify and describe barriers to and enablers of healthcare service utilisation in a rural village of Mpumalanga province, South Africa.
A quantitative descriptive survey design was conducted with 415 adults who met the inclusion criteria, selected using a systematic sampling technique. Data were gathered through a researcher-administered questionnaire. Descriptive statistics were conducted, using the IBM SPSS version 29 software, to explain and summarise the data. The study was guided by Andersen and Newman's Behavioural Model, focusing on barriers and enabling factors to Health services utilisation.
Key barriers identified in this study included cultural beliefs (58.7%), treatment shortages (54.4%), staff shortages (45.6%), negative staff attitudes (88%), long wait times (84.1%), lack of grievance mechanisms (77.8%), and poor interpersonal skills from nurses (88.5%), leading to low patient satisfaction. Men showed disengagement from chronic care (13%) compared to women (2.9%). A significant portion (20%) had no education, impacting health literacy. Enabling factors included a preference for the local clinic (98.8%) due to its proximity (69.3%) and confidence in nurses' abilities (88.7%).
The study highlighted that healthcare access is hindered by resource limitations, staff issues, attitude and communication problems, and cultural factors. Women, young adults, and less educated individuals underutilise services. This necessitates age and gender targeted programs, culturally sensitive strategies, and improved service delivery and quality assurance policies. Counselling for healthcare workers and accessible feedback mechanisms can enhance patient interactions and satisfaction. Further research is recommended to comprehensively address these barriers to healthcare access and utilisation.
医疗服务的利用对于维持和改善社区健康状况至关重要，然而，众多障碍和促进因素可能会阻碍或促进个人获取这些服务并从中受益的能力，南非的情况正是如此。
本研究旨在识别和描述南非姆普马兰加省一个乡村医疗服务利用的障碍和促进因素。
采用定量描述性调查设计，对415名符合纳入标准的成年人进行研究，使用系统抽样技术进行选择。数据通过研究人员管理的问卷收集。使用IBM SPSS 29版软件进行描述性统计，以解释和总结数据。本研究以安德森和纽曼的行为模型为指导，重点关注医疗服务利用的障碍和促成因素。
本研究确定的主要障碍包括文化信仰（58.7%）、治疗短缺（54.4%）、工作人员短缺（45.6%）、工作人员态度消极（88%）、等待时间长（84.1%）、缺乏申诉机制（77.8%）以及护士人际沟通能力差（88.5%），导致患者满意度较低。与女性（2.9%）相比，男性对慢性病护理的参与度较低（13%）。很大一部分人（20%）没有接受过教育，影响了健康素养。促成因素包括由于距离近（69.3%）而对当地诊所的偏好（98.8%）以及对护士能力的信任（88.7%）。
该研究强调，资源限制、工作人员问题、态度和沟通问题以及文化因素阻碍了医疗服务的获取。女性、年轻人和受教育程度较低的人未充分利用医疗服务。这就需要针对年龄和性别的项目、具有文化敏感性的策略以及改进的服务提供和质量保证政策。为医护人员提供咨询和建立可及的反馈机制可以增强医患互动和满意度。建议进一步开展研究，全面解决这些医疗服务获取和利用的障碍。
