Accessibility, affordability and use of health services in an urban area in South Africa

BACKGROUND: Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. OBJECTIVES: The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured) population in the Western Cape, South Africa. METHOD: A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6%) was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. RESULTS: The hypothesis was accepted. The statistical association between affordability (p = < 0.01), accessibility (p = < 0.01) and the use of health services was found to be significant using the Chi-square (χ(2)) test. CONCLUSION: The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.