Patterns of physical assaults and the state of healthcare systems in South African communities: findings from a 2008 population-based national survey

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.