Transport Costs and Access to Healthcare in South Africa: Evidence from the National Household Survey

Description

DOI: https://doi.org/10.5281/zenodo.23470699

Muhammad Hoque (Department of Public Health, Sefako Makgatho Health Sciences University, South Africa)

One of the important determinants of health access is transport, especially in developing nations. Transport costs and time spent accessing healthcare facilities remains a challenge in South Africa. The aim of the study was to investigate transport costs, time spent accessing healthcare facilities, transport modes used in reaching healthcare facilities and the relationship between transport cost and healthcare access among South African households. Secondary cross-sectional analysis was performed using nationally representative household survey data. Logistic regression analysis examined the relationship between transport cost and healthcare access. A total of 8,376 South African households reported healthcare related transport costs. The mean total transport cost was ZAR 217.48 (SD= 249.23). Minibus taxi was the mode of transport which contributed the highest share of the transport expenditure (mean= ZAR 209.21, SD= 241.25). The majority of the respondents (82.3%) took less than 30 minutes to travel to healthcare facilities, while 17.5% travelled for more than 30 minutes to reach these facilities. Walking was the leading transport mode (49.5%), followed by minibus taxi (27.5%) and private vehicle (20.5%). Transport cost was significantly related to healthcare access (β=-0.00057, p<0.001). Increase in transport cost was found to decrease odds ratio for poor access to healthcare services (OR=0.9994; 95% CI: 0.9992-0.9997). While most of the respondents accessed healthcare facilities within a short period of time, transport cost remained one of the burdens on the households. Affordable transport and effective healthcare facilities would improve healthcare access.