The South African Health Review

Equity is of course a complicated goal. When we talk about equity in health care are we talking about everyone having access to exactly the same amount and type of care? Or are we talking about provision of health care which recognises that vulnerable groups who shoulder the greatest burden of disease are likely to have greater need of health care and should therefore have greater access to care than less vulnerable groups? Or are we talking about provision which recognises the backlogs in our health system and attempts to redress them? Or are we just meaning fair shares for all? The SAHR does not try to grapple with these issues, but assumes that the starting point for achieving equity is at least fair shares for all.

The research commissioned by the Health Systems Trust and intended to provide some answers as to how far the process of transformation has been successful in promoting equity shows that despite excellent policies, we are still some way away from achieving equity in our health system. Almost all chapters highlight findings which imply that it is rural, low income families who are least likely to be able to access quality health care. The reasons are manifold and range from infrastructural issues to inequity in financial allocations, and the training and distribution of personnel. However the findings also raise many questions which need to be answered in order to overcome persistent inequities.