RESEARCH ARTICLE


Spatial Analysis of Perceived Health System Capability and Actual Health System Capacity for COVID-19 in South Africa



Tholang Mokhele1, *, Ronel Sewpaul2, Sibusiso Sifunda3, Gina Weir-Smith1, 4, Simangele Dlamini1, Thabang Manyaapelo3, 5, Inbarani Naidoo6, Whadi-Ah Parker7, Natisha Dukhi4, Sean Jooste2, Saahier Parker2, Khangelani Zuma3, 7, Mosa Moshabela8, Musawenkosi Mabaso6, Sasiragha P. Reddy2
1 Geospatial Analytics, eResearch Knowledge Centre, Human Sciences Research Council, Pretoria, South Africa
2 Human and Social Capabilities, Human Sciences Research Council, Cape Town, South Africa
3 Human and Social Capabilities, Human Sciences Research Council, Pretoria, South Africa
4 School of Geography, Archaeology and Environmental Studies, University of Witwatersrand, Johannesburg, South Africa
5 Social Science and Research Ethics Department, Africa Health Research Institute, Mtubatuba, South Africa
6 Human and Social Capabilities, Human Sciences Research Council, Durban, South Africa
7 School of Public Health, University of Witwatersrand, Johannesburg, South Africa
8 School of Nursing and Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa


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Creative Commons License
© 2021 Mokhele et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Geospatial Analytics, eResearch Knowledge Centre, Human Sciences Research Council, Pretoria, South Africa; E-mail: TAMokhele@hsrc.ac.za


Abstract

Introduction:

People’s confidence in the health system's capability in managing the COVID-19 pandemic can determine public support, risk perceptions, and compliance to the required behaviors during the pandemic. Therefore, this paper investigated people’s perception of health system capability to manage the COVID-19 pandemic in different spatial areas across the country using data from an online survey.

Methods:

Multivariate logistic regression models were used to examine factors associated with people’s perception of the health system capability to manage the COVID-19 pandemic at the national and provincial levels. Spatial comparative analysis was conducted to contrast spatial density indicators of the number of hospitals, hospital beds, and ICU beds per given population across various provinces.

Results:

Findings showed that South Africans had low confidence in the health system capability, with only two in five (40.7%) reporting that they thought that the country’s health system was able to manage the COVID-19 pandemic. Sex and knowledge on COVID-19 were significantly associated with the people’s perception of the health system capability to manage the pandemic at the national level and in four of the nine provinces.

Conclusion:

Overall, the findings of this study clearly highlight challenges facing the country’s health system, both perceived or real, that needed to be addressed as part of the preparation for the COVID-19 pandemic. Timeous implementation of a countrywide National Health Insurance (NHI) system is now more critical than ever in improving healthcare outcomes of the South African population beyond the existence of the COVID-19 epidemic.

Keywords: COVID-19, Spatial analysis, Health system, Capability, Capacity, South Africa.