Preventing non-communicable diseases, including cardiovascular disease (CVD), is a public health priority that has currently dominated both global [1] and African regional health policy [2]. This as a result of the growing evidence that shows that stroke and ischaemic heart disease are responsible for 20% of premature mortality globally [3]. In addition, stroke is the highest cause of disability. In Africa, the reasons for the increase in CVD are varied. They include urbanization and globalization which have harmonized cultures towards 'leisurely ' unhealthy lifestyles and their accompanying health risks [4] [5]. This is compounded by a demographic transition in which life expectancy has increased, and along with it, rates of chronic diseases
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The latter includes both direct costs of treatment and indirect costs of seeking care. Indirect costs of care comprise lost production and earnings due to illness or death of a working age adult as well as income loss by family members who act as informal caregivers of those with disease. Few studies exist in developing or developed countries to document the overall economic losses of cardiovascular disease. According to these studies, CVD cost the European Union (€196 billion), United States ($320 billion) and Canada ($11.4 billion) in 2009, 2011 and 2008 respectively. These direct costs represent approximately 10% of the health systems expenditure. Studies conducted in Africa have primarily focussed on stroke. Those studies showed that productivity losses comprise a significant proportion of the economic losses since cardiovascular disease tends to occur at younger ages in …show more content…
However, similar to regional based analyses, most national level studies are underpowered to capture the heterogeneity that exists in the country. Two decades after the end of the apartheid era, there remains stark differences in health status, profile of disease and in access to services across racial lines and geographical locations in South Africa. For example, whilst health outcomes are generally poor in both urban and rural areas, the two most urbanised provinces, Gauteng and Western Cape, fare much better in health outcomes than the more rural provinces [10]. Similarly, specialised and emergency services are typically less resourced than in urban areas which hinders access to care. Health expenditure is biased towards more urbanized districts with PHC expenditure in 2014/15 estimated at R308 per person (about US$23 ). Four of the five districts with the highest per capita spending (>R380) are in the more urbanized province of Gauteng, whilst five districts with the lowest per capita spending on primary health care (<R250) are all rural provinces [11]. Furthermore, access to health care is constrained by factors such as cost of transport which could affect access to secondary interventions that are delivered within the facilities. The social determinants - migrancy and poverty in particular - continue to shape rural health and influence where and
The latter includes both direct costs of treatment and indirect costs of seeking care. Indirect costs of care comprise lost production and earnings due to illness or death of a working age adult as well as income loss by family members who act as informal caregivers of those with disease. Few studies exist in developing or developed countries to document the overall economic losses of cardiovascular disease. According to these studies, CVD cost the European Union (€196 billion), United States ($320 billion) and Canada ($11.4 billion) in 2009, 2011 and 2008 respectively. These direct costs represent approximately 10% of the health systems expenditure. Studies conducted in Africa have primarily focussed on stroke. Those studies showed that productivity losses comprise a significant proportion of the economic losses since cardiovascular disease tends to occur at younger ages in …show more content…
However, similar to regional based analyses, most national level studies are underpowered to capture the heterogeneity that exists in the country. Two decades after the end of the apartheid era, there remains stark differences in health status, profile of disease and in access to services across racial lines and geographical locations in South Africa. For example, whilst health outcomes are generally poor in both urban and rural areas, the two most urbanised provinces, Gauteng and Western Cape, fare much better in health outcomes than the more rural provinces [10]. Similarly, specialised and emergency services are typically less resourced than in urban areas which hinders access to care. Health expenditure is biased towards more urbanized districts with PHC expenditure in 2014/15 estimated at R308 per person (about US$23 ). Four of the five districts with the highest per capita spending (>R380) are in the more urbanized province of Gauteng, whilst five districts with the lowest per capita spending on primary health care (<R250) are all rural provinces [11]. Furthermore, access to health care is constrained by factors such as cost of transport which could affect access to secondary interventions that are delivered within the facilities. The social determinants - migrancy and poverty in particular - continue to shape rural health and influence where and