The Blackwell Companion to Medical Sociology

386 H. C. J. van Rensburg and Charles Ngwena
attention from a treatment point of view ± expensive treatment procedures and
free option to utilize these have certainly diminished.
Regarding the outcomes of the health reforms on the health and well-being of
the people, one could then conclude that the reforms over the past five years in
all probability contributed constructively to improvingthe health of the population
and alleviatingthe heavy burden of disease and ill health of the deprived and
vulnerable. However, areas remain where the new policies and structures
of health care as yet do not in practice make any significant difference. Only
an improved standard of livingand changed lifestyles would render such a
difference.
Conclusion
onclusion
Africa's heavy burden of disease, scarce health resources, and ailinghealth
systems are unenviable. However, in South Africa's case, there are some hopeful
signs. In the short period since 1994, transformation of the health system
has been remarkable. The country's constitution, health policy, health structures,
and contents of health care have changed fundamentally. The constitution
is categorical about the commitment toward recognizing the injustices of the
past and effectingredress so as to establish a society based on social justice,
improve the quality of life for all citizens, and free the potential of each person.
It thus frowns upon the historical lottery of race, income, and geographical
location as the major determinant of access to health care. Instead, access to
health care is cast in egalitarian terms as a right for everyone. It is apparent,
however, that there are formidable obstacles to the realization of equitable access
to health care. Though the transformation of the South African health care
system is on track and in numerous ways irreversible, it is far from complete.
Moreover, the implementation of the new policies has been slow and tardy,
hampered by many difficulties, not least by forces with different convictions,
aims, and interests.
References
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Alubo, S. O. and F. Vivekananda. 1995. Beyond the Illusion of Primary Health Care in
an African Society: The Political Economy of Health Care and Crisis in Nigeria: With
a Discourse on Kenya, Tanzania, Brazil, Cuba. Stockholm: Bethany Books.
ANC (African National Congress). 1994a. The Reconstruction and Development Programme
± A Policy Framework. Johannesburg: Umanyano Publications.
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Banda, E. N. and G. Walt. 1995. ``The Private Health Sector in Malawi: Openinga
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