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What do we know about health service utilisation in South Africa?


  • Olufunke A Alaba
  • Di McIntyre


This paper compares data from two household surveys to assess the effect of questionnaire design on estimated use of health services and analyses this across geographic areas and different groups. Deficiencies in the design of Statistics South Africa's General Household Survey led to a substantial underestimation of utilisation (capturing less than a third of visits). The South Africa Consortium for Benefit Incidence Analysis survey, which was more comprehensive, indicated that three out of four outpatient visits are to public sector facilities. Medical scheme membership is the most important predictor of using a private provider, particularly for inpatient care. Socioeconomic status and rural versus urban residence also influence overall utilisation rates and use of public versus private providers. It is critical to improve the design of routine household surveys to monitor utilisation patterns during the implementation of the proposed health system reform.

Suggested Citation

  • Olufunke A Alaba & Di McIntyre, 2012. "What do we know about health service utilisation in South Africa?," Development Southern Africa, Taylor & Francis Journals, vol. 29(5), pages 704-724, December.
  • Handle: RePEc:taf:deveza:v:29:y:2012:i:5:p:704-724 DOI: 10.1080/0376835X.2012.730973

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    References listed on IDEAS

    1. Thurlow, James, 2006. "Has trade liberalization in South Africa affected men and women differently?:," DSGD discussion papers 36, International Food Policy Research Institute (IFPRI).
    2. Murray Leibbrandt & Laura Poswell & Pranushka & Matthew Welch & Ingrid Woolard, 2004. "Measuring recent changes in South African inequality and poverty using 1996 and 2001 census data," SALDRU/CSSR Working Papers 084, Southern Africa Labour and Development Research Unit, University of Cape Town.
    3. Ardington, Cally & Lam, David & Leibbrandt, Murray & Welch, Matthew, 2006. "The sensitivity to key data imputations of recent estimates of income poverty and inequality in South Africa," Economic Modelling, Elsevier, vol. 23(5), pages 822-835, September.
    4. Murray Leibbrandt & James Levinsohn & Justin McCrary, 2005. "Incomes in South Africa Since the Fall of Apartheid," NBER Working Papers 11384, National Bureau of Economic Research, Inc.
    5. Servaas Van der berg & Megan Louw & Derek Yu, 2008. "Post-Transition Poverty Trends Based On An Alternative Data Source," South African Journal of Economics, Economic Society of South Africa, vol. 76(1), pages 58-76, March.
    6. Ranjan Ray, 2000. "Poverty and expenditure pattern of households in Pakistan and South Africa: a comparative study," Journal of International Development, John Wiley & Sons, Ltd., vol. 12(2), pages 241-256.
    7. Paula Armstrong & Bongisa Lekezwa & Krige Siebrits, 2008. "Poverty in South Africa: A profile based on recent household surveys," Working Papers 04/2008, Stellenbosch University, Department of Economics.
    8. Haroon Bhorat & Carlene van der Westhuizen & Pranushka Naidoo, 2006. "Shifts in Non-Income Welfare in South Africa: 1993-2004," Working Papers 06108, University of Cape Town, Development Policy Research Unit.
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