Social justice revolves around the concept of equality and human rights. It pertains to the opportunities, privileges, and wealth of people worldwide. The United Nations describes a health system as a structure that includes: All factors, organizations, institutions, and resources whose primary purpose is to improve health. Their primary goal is to promote, restore or maintain health, but they aim to be responsive to people’s legitimate expectations and financially fair.
Social justice in health care translates to delivering high-quality care to all individuals. Achieving social justice is critical in health care to ensure that all individuals can maintain their highest level of health and wellness.
Health care in Sub-Saharan Africa remains the worst in the world, with few countries able to spend the $34 to $40 a year per person that the World Health Organization considers the minimum for primary health care.
Healthcare systems in Africa pay little attention to the critical interface between health education and good health, especially regarding the education of women and mothers, who are the primary line of defense against childhood diseases and perform most domestic chores and critical agricultural activities simultaneously. And despite widespread poverty, an astonishing 50 percent of the region’s health expenditure is financed by out-of-pocket payments from individuals.
Homegrown doctors are moving abroad in search of higher wages and a better standard of living. Public health care does exist, but most experts will want to use the private sector or have international health insurance and funds to be evacuated to another country.
The social justice system is required to strengthen the health care system making it practical and efficient for rural and urban areas. The prescription for improvement of health systems in Africa, according to the WHO, the World Bank, USAID, the International Monetary Fund (IMF), and many other international organizations and foundations, such as the Bill and Melinda Gates Foundation, will have to include:
1) A more balanced, horizontal approach to disease; Focus on prevention, education, and awareness of the mode of transmission or exposure to both infectious and chronic diseases
2) An integrated approach to health, involving whole sectors of government, such as the ministries of health and the ministries of education; transportation and infrastructure; law enforcement; water and sanitation; food security and housing; the sharing of information while stressing the same general health goals and appropriate strategies.
3)Self-efficacy in managing disease; a scaled-down reliance on expensive medical equipment that only serves the rich and the families that can afford it, who often “overstretch the workforce”; more attention paid to the real needs of the people through proper retooling of the health personnel.
4) Accurate diagnosis of disease, Botswana monitors and screens for HIV (here, screening increased from less than 10% of the population in 2000 to 90% in 2014).
5) Increase children’s immunization against diphtheria, measles, and hepatitis.
6) Focusing on providing primary health care rather than on acute diseases, as Ethiopia has successfully done, reaching 80% of the population in 2014—a significant improvement over previous years.
7) Increasing mobile units to reach the people and not compelling all to come to the health centers; employing the workforce from neighboring countries, who might be paid salaries by their governments but provided with allowances and bonuses by the host state, as done in South Sudan.
8) Creating access to secondary care treatment in emergencies provided by specialized physicians; using, to the extent possible, the most modern technologies for the collection of accurate data, storage, and analysis.
9) Utilizing telemedicine to reach remote areas, as India has done recently, placing less reliance on private donors given the economic uncertainties and the fact that most tend to approach disease vertically.
10) Empowering women and communities.
11) Instituting universal insurance coverage.
12) Increasing local funding beyond the 15% recommended by the 2001 Abuja Declaration.
13) Empowering but also regulating local health care entrepreneurs and pharmaceuticals that would produce generic drugs locally, thus reducing the high cost of medicine. In Africa, drug costs have varied from city to city, region to region, and country to country, making it difficult to rationalize the system continentally.
