Marginalised categories of patients are considered less deserving of essential services by South African health workers, according to a recent University of Cape Town study probing healthcare inequalities, which uncovered persistently harsh perceptions regarding the worthiness of patients among clinicians.
IOL reports that Dr Sara Jacobson’s PhD thesis, titled There is a human being there: A Critical Pedagogic Approach to shifting perceptions of patient worthiness in South Africa, highlights a trend of socially marginalised individuals – ranging from sex workers and LGBTQ+ community members to the homeless – being considered “unworthy” and less deserving of essential health resources.
The research suggests that these patients may end up not only receiving inferior care but also being outright denied access to health services.
“Worthiness determinations on the part of clinicians, support staff, and even patients from the general population justify dehumanising actions that harm socially marginalised patients, maintain social and institutional hierarchies, and preserve the unequal status quo,” Jacobson said.
Despite strategies aimed at tackling this inequity, the findings suggest that little progress has been made in changing clinician attitudes towards certain groups, with traditional training approaches, often termed “sensitivisation”, being ineffective.
Jacobson has called for a more dialogue-based methodology.
Through her year-long engagement with nurses and cross-border migrants, this study encourages critical reflection on entrenched assumptions and beliefs that perpetuate these harmful biases.
The implications of this research are significant. As South Africa continues to grapple with social inequities, the study highlights an urgent need to re-evaluate how value is assigned in healthcare settings.
Addressing this issue not only contributes to better health outcomes for marginalised communities, but also aligns with the broader goal of health equity on a socio-political scale, she suggested.
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