Point of view: the importance of healthcare quality for everyone

As someone who’s spent years immersed in the world of consumer advocacy and healthcare communication, I’ve come to appreciate the power of data, not just as numbers on a page, but as stories about real people navigating our health system.

The latest Health Quality Assessment (HQA) results for 2024 offer exactly that: a snapshot of how South Africa’s private healthcare sector is performing when it comes to prevention, early detection, and chronic disease management.

These findings aren’t just for policymakers or scheme executives. They’re for all of us, the parents booking vaccinations, the young professionals managing chronic conditions, the daughters urging their mothers to go for mammograms. Because behind every percentage point is a person, and behind every missed screening is a missed opportunity to intervene early.

Let’s start with something close to home: diabetes care. HbA1c testing, which tracks average blood sugar levels over three months, is critical for managing diabetes and preventing complications like kidney failure, heart disease, and stroke. The data shows that since 2010, coverage for at least one test per year has climbed impressively, with some schemes nearing 90%. But clinical guidelines recommend two tests annually, and that’s where we still see variation. It’s a reminder that consistency matters, not just ticking a box.

Then there’s HIV viral load testing, newly added to public reporting this year. For people living with HIV, regular testing isn’t just about their health; it’s about preventing transmission and keeping communities safe. Yet, according to the data, only 85% of those on treatment had a test last year, down from 95% in 2015. That’s not just a dip in data, it’s a signal that we need to refocus our efforts. HIV care in South Africa has come a long way, and we can’t afford to lose momentum.

One stat that really made me pause was the Caesarean section rate. The WHO recommends a rate of 10-15% for medically necessary cases. Ours? Over 70%. That’s not just a number, it’s a conversation we need to have about informed choices, maternal health, and what’s best for our babies. According to the data, research shows that elective C-sections scheduled before 39 weeks can carry risks for both mother and child, from respiratory issues to long-term developmental concerns. We need to empower expectant parents with balanced information, not just convenience-driven options.

Breast cancer screening is another area where we’re doing okay, but could do better. The results show that only about 21-25% of eligible women had a mammogram in the past two years. Some schemes are pushing above 40%, which is encouraging. But here’s the kicker: most schemes cover mammograms. So why aren’t more women getting them? Maybe it’s a lack of awareness, maybe it’s fear. Either way, we need to talk about it more, in our WhatsApp groups, at church, at work. Early detection saves lives.

And what about our elders? Flu vaccination rates for those over 65 have more than doubled since 2010, from 8% to 21%. That’s progress, but still far from ideal. My own mother didn’t know her flu shot was covered until I told her. That’s the thing, benefits mean nothing if people don’t know they exist. We need to make preventive care part of everyday conversation, not just something we remember when we’re already ill.

Colorectal cancer screening is another area where awareness campaigns are starting to pay off. Colonoscopy rates have climbed from 7% to 12% in the past decade, with some schemes reaching 25%. It’s not glamorous, but it’s life-saving. And with younger adults increasingly affected, we can’t afford to ignore it. Screening helps catch cancer early and remove pre-cancerous polyps before they become a threat.

The fact is, there are less invasive colon cancer screening tests available, which can even be requested by a patient's general practitioner. One of these is a stool test called FOBT (faecal occult blood test), and its utilisation in the at-risk age group is lower than it should ideally be. The colonoscopy or sigmoidoscopy screening mentioned earlier is a great tool for detection, and is often used when a problem is flagged by another test, like FOBT. But in reality, many people only undergo scopes once symptoms appear, not proactively for screening. That’s why it would be even better if more at-risk individuals opted for an FOBT. It’s simple, accessible, and could make a real difference in catching cancer early.

What I appreciate most about the HQA report is that it’s not just a data dump. It’s a call to action. It shows that when schemes voluntarily measure quality, they perform better. That’s not just theory, it’s backed by international studies. And it’s why I believe we need to keep pushing for transparency, accountability, and value-based care.

Because at the end of the day, healthcare isn’t just about hospitals and pills. It’s about dignity. It’s about making sure every Rand spent on our health actually works for us. And it’s about making sure no one, whether they’re living with HIV, managing diabetes, expecting a baby, or just trying to stay well, falls through the cracks.

So next time you get a reminder for a screening or a vaccine, don’t ignore it. Ask questions. Use your benefits. And if something doesn’t feel right, speak up. Because quality healthcare isn’t a luxury, it’s a right. And we all have a role to play in making sure it delivers.

* Maleke is the editor of Persona Finance.

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