We are lucky in South Africa that we have a constitution in which the principle of equity is enshrined. In addition, there has been a concerted effort since 1994 to attempt to redress the inequities forged during the apartheid era. In all spheres of social welfare equity promoting policies underpin the plans and practices of departments such as education, housing and health.
However, implementation of these policies has proved harder than many imagined it would be and unfortunately it remains the case that in South Africa at the moment it is usually those who have most who have access to the best resources. Schooling provides a very stark example of how this happens. Children raised in families with sufficient resources to provide a solid preparation for learning, usually go on to study in well-equipped schools with good and dedicated teachers.,We are lucky in South Africa that we have a constitution in which the principle of equity is enshrined. In addition, there has been a concerted effort since 1994 to attempt to redress the inequities forged during the apartheid era. In all spheres of social welfare equity promoting policies underpin the plans and practices of departments such as education, housing and health.
However, implementation of these policies has proved harder than many imagined it would be and unfortunately it remains the case that in South Africa at the moment it is usually those who have most who have access to the best resources. Schooling provides a very stark example of how this happens. Children raised in families with sufficient resources to provide a solid preparation for learning, usually go on to study in well-equipped schools with good and dedicated teachers. Children with a less fortunate start in life are often condemned (for financial reasons) to attend schools which lack even the most basic resources. For these children achieving matric exemption requires almost superhuman effort, whilst for many children at Model C and private schools, matric exemption - the passport to higher learning and a better opportunities - is often fairly routine. So too it is with health care. Those whose health is most vulnerable often have least access to good quality health care while at the other extreme there are numerous accounts of money being wasted in the private sector on unnecessary and superfluous interventions.
Before 1994, Gauteng, the Western Cape, and parts of KwaZulu-Natal were far better endowed with hospitals, health facilities and staff than other more rural parts of the country. The Department of Health has attempted to redistribute resources. However a myriad of problems inhibits this, not least lack of infrastructure coupled with the dilapidated condition of many health centres in rural areas. This impacts upon the ability and willingness of health workers to locate themselves in some of the countrys most needy areas. The problem is compounded by the fact that the systems needed to provide information necessary to ensure a fairer distribution of resources take time to put into place and to begin working effectively. Linked to this, slow progress with the establishment of districts, which will be further complicated by the new demarcation of municipal boundaries and the devolvement of running health care to local authorities, has also impeded progress with transformation of the health system.
The Equity Gauge is a tool to help us monitor how we are progressing with achieving equity. It measures progress in achieving equity in health and health care in a number of key areas including distribution of finances, distribution of personnel and quality of care. The Gauge monitors equity between provinces, equity between races and equity between rural and urban areas. Over the years the information in the Gauge will be updated.
The Equity Gauge project is a partnership between national and provincial legislators. In addition to the Equity Gauge the project aims to support legislators by providing training and information support in a number of areas. One important component of the project are site visits in which legislators are given the opportunity to visit services on the ground, both to better understand the problems as well as to see innovative solutions.
The Equity Gauge paints a very broad picture. What it does not do is recount the many instances where nurses and other health workers strive against overwhelming odds to provide a service that is outstanding both because of its excellent quality as well as because of the dedication of the staff involved. Around the country there are numerous examples of such pockets of excellence, where innovative solutions have been found to intractable problems, where a few inspired health professionals have joined together with local people to really make a difference to the health of a community. In the end it will be individuals like this at all levels of the system who by their inspiration and example, their commitment to equity and their care for fellow human beings, will be responsible for stemming the tide of inequality and ensuring that those most in need are those who are most served.
Good policies provide an important starting point. However they rely on people to implement them!
Children with a less fortunate start in life are often condemned (for financial reasons) to attend schools which lack even the most basic resources. For these children achieving matric exemption requires almost superhuman effort, whilst for many children at Model C and private schools, matric exemption - the passport to higher learning and a better opportunities - is often fairly routine. So too it is with health care. Those whose health is most vulnerable often have least access to good quality health care while at the other extreme there are numerous accounts of money being wasted in the private sector on unnecessary and superfluous interventions.
Before 1994, Gauteng, the Western Cape, and parts of KwaZulu-Natal were far better endowed with hospitals, health facilities and staff than other more rural parts of the country. The Department of Health has attempted to redistribute resources. However a myriad of problems inhibits this, not least lack of infrastructure coupled with the dilapidated condition of many health centres in rural areas. This impacts upon the ability and willingness of health workers to locate themselves in some of the countrys most needy areas.
The problem is compounded by the fact that the systems needed to provide information necessary to ensure a fairer distribution of resources take time to put into place and to begin working effectively. Linked to this, slow progress with the establishment of districts, which will be further complicated by the new demarcation of municipal boundaries and the devolvement of running health care to local authorities, has also impeded progress with transformation of the health system.
The Equity Gauge is a tool to help us monitor how we are progressing with achieving equity. It measures progress in achieving equity in health and health care in a number of key areas including distribution of finances, distribution of personnel and quality of care. The Gauge monitors equity between provinces, equity between races and equity between rural and urban areas. Over the years the information in the Gauge will be updated.
The Equity Gauge project is a partnership between national and provincial legislators. In addition to the Equity Gauge the project aims to support legislators by providing training and information support in a number of areas. One important component of the project are site visits in which legislators are given the opportunity to visit services on the ground, both to better understand the problems as well as to see innovative solutions. The Equity Gauge paints a very broad picture. What it does not do is recount the many instances where nurses and other health workers strive against overwhelming odds to provide a service that is outstanding both because of its excellent quality as well as because of the dedication of the staff involved. Around the country there are numerous examples of such pockets of excellence, where innovative solutions have been found to intractable problems, where a few inspired health professionals have joined together with local people to really make a difference to the health of a community. In the end it will be individuals like this at all levels of the system who by their inspiration and example, their commitment to equity and their care for fellow human beings, will be responsible for stemming the tide of inequality and ensuring that those most in need are those who are most served. Good policies provide an important starting point. However they rely on people to implement them!
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