Patterns of Physical Assaults and the State of Healthcare Systems in South African Communities: Findings from a 2008 Population-Based National Survey

Abstract

A national population-based household survey on HIV prevalence, incidence, behaviour, and communication was conducted in South Africa in 2008, by the Human Sciences Research Council (HSRC). A multi-stage stratified random sampling approach was used. Questions on the perceptions people hold regarding physical assaults, healthcare systems and service delivery in the community were incorporated into the questionnaire. This study presents findings based on these questions. Evidence on physical assaults occurring within a community exist, where 5.1% (n = 14,359) of respondents aged 12 years and older reported to have witnessed someone in the household being physically assaulted by another person in the community, within the past 12 months. Physical assaults occurred more frequently among adults, with male strangers being the main assaulters. Perceptions on the performance of the government were rated poorly in fighting violence against women (49%) and children (48%). The health services available to female victims of physical and sexual violence are insufficient, as indicated by 58% of the respondents, while 11% indicated that there were no services at all. Marital status and race are the key demographic characteristics associated with violence in the community. Healthcare systems require much improvement, as respondents indicated dissatisfaction with (1) the amount of time patients had to wait for services (76%), (2) the treatment by healthcare personnel (60%), (3) the availability of emergency services (67%), and (4) the availability of medicines (58%) in medical centres in their areas. Specific interventions to address violence issues in society as well as inequality and cultural relations need to be formulated. Formulation and implementation of interventions that strengthen healthcare systems need to be done in a fair and equitable manner. Such interventions should ensure a steady supply of medical products, and create a more effective and efficient delivery system.

Keywords

assault community gender-based violence healthcare systems household survey intervention

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References

Asling-Monemi

Pena

Ellsberg

M.C.

Persson

L.A.

(2003). Violence against women increases the risk of infant and child mortality: A case-referent study in Nicaragua. Bulletin of the World Health Organisation, 81, 10–18

Bowman

Matzopoulos

Butchart

Mercy

J. A.

(2008). The impact of violence on development in low- to middle-income countries. International Journal of Injury Control Safety Promotion, 15, 209–219

Cammack

N. L.

Lambert

S. F.

Ialongo

N. S.

(2011). Community violence exposure and perceived neighborhood violence. Journal of Community Psychology, 39, 106–120

Centers for Disease Control and Prevention (CDC). (2006a). Preventing youth violence: Program activities guide. Retrieved from http://www.cdc.gov/ViolencePrevention/pub/PreventingYV.htm

Centers for Disease Control and Prevention. (2006b). School health policies and programs study. Retrieved from http://www.cdc.gov/healthyyouth/podcast/

Centers for Disease Control and Prevention. (2008). Understanding school violence. Retrieved from http://www.cdc.gov/ViolencePrevention/pdf/SchoolViolence_FactSheet-a.pdf

Centre for the Study of Violence and Reconciliation (CSVR). (2007). The violent nature of crime in South Africa. Safety & Security Department, Republic of South Africa

Cooley-Quille

Boyd

R. C.

Frantz

Walsh

(2001). Emotional and behavioral impact of exposure to community violence in inner-city adolescents. Journal of Clinical Child Psychology, 30, 199–206

Davids

(2005). An explorative study of the influence of gang violence on the cognitions and behaviors of adolescents in a specific community within the Western Cape. (Unpublished Masters dissertation). University of the Western Cape, Cape Town South Africa

10.

Diehl

R. L.

(2004). Violence exposure and externalizing symptoms in inner-city youth as mediated by fear of crime and perceived risk of victimization. (Unpublished doctoral thesis). Virginia Commonwealth University, Virginia

11.

Global Health. (2005). Advancing evidence-based policy: Bridging the boundaries between global health researchers and policy-makers. Global Health Conference, June 1, 2005, Washington, DC. Retrieved from http://www.globalhealth.org

12.

Gorman-Smith

Henry

D. B.

Tolan

P. H.

(2004). Exposure to community violence and violence perpetration: The protective effects of family functioning. Journal of Clinical Child and Adolescent Psychology, 33, 439–449

13.

Heise

L. L.

Pitanguy

Germain

(1994). Violence against women: The hidden health burden. World Bank Discussion Papers #255, Washington, DC

14.

Keikelame

Ferreira

(2000). Elder abuse in black townships on the Cape Flats (Research Report). Cape Town, RSA: HSRC/UCT Centre for Gerontology

15.

Koenig

M. A.

Lutalo

Zhao

Nalugoda

Wabwire-Mangen

Kiwanuka

Gray

(2003). Domestic violence in rural Uganda: Evidence from a community based study. Bulletin of the World Health Organisation, 81, 53–60

16.

Liddell

Kvalsvig

Qotyana

Shabalala

(1994). Community violence and youth South African children's involvement in aggression. International Journal of Behavioural Development, 17, 613–628

17.

Luthar

S. S.

Goldstein

(2004). Children's exposure to community violence: Implications for understanding risk and resilience. Journal of Clinical Child and Adolescent Psychology, 33, 499–505

18.

Markowitz

F. E.

(2003). Socioeconomic disadvantage and violence: Recent research on culture and neighborhood control as explanatory mechanisms. Aggression and Violent Behavior, 8, 145–154

19.

Mathews

Abrahams

Martin

Vetten

Van der Merwe

Jewkes

(2004). Every six hours a woman is kicked by her intimate partner: A national study of female homicide in South Africa. Cape Town, RSA: Medical Research Council

20.

Matzopoulos

Bowman

Butchart

Mercy

J. A.

(2008). The impact of violence on health in low- to middle-income countries. International Journal of Injury Control and Safety Promotion, 15, 177–187

21.

Matzopoulos

Bowman

Mathews

Myers

(2010). Applying upstream interventions for interpersonal violence prevention: An uphill struggle in low- to middle-income contexts. Health Policy, 97, 62–70

22.

Medina

A. M.

Margolin

Gordis

E. B.

(2002). Violence, children's exposure to: General effects. (Ed). Encyclopedia of Education, second edition, pp. 2623–2627. New York: MacMillan Reference

23.

Shields

Nadasen

Pierce

(2008). The effects of community violence on children in Cape Town, South Africa. Child Abuse Neglect, 32, 589–601

24.

Seedat

Niekert

A. V.

Jewkes

Suffla

Ratele

(2009). Violence and injuries in South Africa: Prioritising an agenda for prevention. Lancet, 374, 1011–1022

25.

Shisana

Rehle

Simbayi

L. C.

Zuma

Jooste

Pillay-Van-Wyk

, … SABSSM III Implementation Team (2009). South African national HIV prevalence, incidence, behaviour and communication survey 2008: A turning tide among teenagers? Cape Town: HSRC Press

26.

United Nations Children's fund (UNICEF) (June 2000). Domestic violence against women and girls. Innocenti Research Centre Florence, Italy.Innocenti Digest, No. 6

27.

United Nations Population Fund (UNFPA). (n.d.). Gender Equality: Empowering Women. Retrieved from http://www.unfpa.org/gender/empowerment.htm

28.

United Nations Development Programme (UNDP) (2010). South Africa Millennium Development Goals (MDG) Report 2010. Retrieved from http://www.undp.org.za/remository/MDGs/South-Africa-MDG-Report-2010/

29.

Vetten

(2005). Addressing domestic violence in South Africa: Reflections on strategy and practice. Retrieved from http://www.un.org/womenwatch/daw/egm/vaw-gp-2005/docs/experts/vetten.vaw.pdf

30.

Van der Merwe

Dawes

(2000). Prosocial and antisocial tendencies in children exposed to community violence. Southern African Journal of Child and Adolescent Mental Health, 12, 19–37

31.

Vlachova

Biason

(Eds.). (2005). Women in an insecure world. Geneva Centre for the Democratic Control of Armed Forces DCAF, Geneva, Switzerland

32.

Vogelman

Lewis

(1993). Gang rape and the culture of violence in South Africa. Centre for the Study of Violence and Reconciliation (CSVR). Retrieved from http://www.csvr.org.za/wits/papers/paplvsl.htm

33.

World Bank. (2007). What is a health system? The World Bank strategy for HNP results. Retreived from http://www.worldbank.org/

34.

WHO (World Health Organization). (2000). World health report 2000: health systems: improving performance. Retrieved from http://www.who.int/whr/2000/en/

35.

WHO (World Health Organization). (2003). Multi-country study on women's health and domestic violence Against Women. Retrieved from http://www.who.int/gender/violence/who_multicountry_study/en/