H.C.J. van Rensburg

Slow to share: social capital and its role in public HIV disclosure among public sector ART patients in the Free State province of South Africa.

Abstract HIV serostatus disclosure to community members has been shown to have potential public and personal health benefits. This study examined the impact of bonding and bridging social capital (i.e. close and distant ties) on public disclosure and described the complex relationship between bonding and bridging social capital in the context of serostatus disclosure among AIDS patients enrolled in South Africas public sector antiretroviral treatment (ART) program. Data were collected from a cohort of patients enrolled in the public sector ART program in the Free State province of South Africa. Semi-structured, face-to-face interviews were conducted with a random sample of 268 patients at three points in time (<6 months of ART, 6–12 months of ART, and 18–24 of months ART). The relationship between bonding and bridging social capital and the impact of different forms of social capital on public disclosure were determined using a fully cross-lagged regression model. The impact of bonding social capital (treatment and emotional buddy) on public disclosure was positive and invariant across time. The results from the cross-lagged regression indicated that bridging social capital (community health worker and support group) only encouraged public disclosure in the second year of treatment. At the start of treatment, bivariate analysis showed a strong negative association between bonding and bridging social capital, which diminished at follow-up and eventually disappeared in the second year of treatment. This study identified bonding social capital as a leverage to maximize potential benefits and minimize potential risks in order to shift the balance toward consistent public disclosure. Furthermore, the importance of bridging social capital initiatives is demonstrated, especially for the most vulnerable patients, those who cannot capitalize their bonding social capital by disclosing their HIV serostatus to family and friends at the start of treatment.

The legacy of apartheid in health and health care

Abstract This contribution analyses and systematiscs apartheid as a phenomenon and as a problem in South African health and health care. It is assumed that apartheid is one of the most decisive forces moulding the South African health care system as well as the health of the people, resulting in grave race-related disparities, inequalities, fragmentation and discrimination on the one hand, and divergent, race-related health outcomes in the health indices and health statuses of the different ‘colour’ groups. The material presented. is systematised within a fourfold framework, differentiating between a structural/institutional component and a consequential/outcome component of apartheid, The former refers to both the racially segregated supply system and the racially divided clientele; the latter applies to both structural outcomes in the form of race-related deformities in the organisation and allocation of health care supply and racerelated inequalities and disparities in the health and health status of t...

Sosiologie in Suid-Afrika: Profiel van die huidige

Abstract South African Sociology: Profile of the present Profile of the present is an exploration of the manifestation of Sociology in the South Africa of the 1980s. The material for the theme is arranged and dealt with in three parts. In the first part South African Sociology is considered in the context of world Sociology. It is assumed that similar characteristics, tendencies, and problems are displayed by South African Sociology as by Sociology in a global context. These refer to the extensive diversity of theoretical and methodological orientations; the extensive diversity of areas ot specialization (specialties); the thrust towards the application and practical serviceableness of Sociology; and the many tasks and expectations imposed upon Sociology and sociologists from outside as well as from their own ranks. As a matter of fact, these characteristics and tendenCies in many respects have favoured Sociology and sociologists, but in the same measure have had serious effects on the discipline and its ...

South African health care in change

Abstract This article presents an overview of the nature, direction and depth of change in the South African health care system since the European settlement in 1652 up to the present The main argument is that in reality there were, despite much dynamics and slight changes, no fundamental changes at all; rather a structural drift of the health care system in the same direction throughout As a result a typical pluralistic system was eventually established, and with it the numerous structural problems characteristic of this type of health care system. Despite this dominant structural drift, significant markers of fundamental change presented itself, including the Gluckman Report, the Freedom Charter and more recently pleas for fundamental restructuring of the current system. All these markers distinctly point in the same direction, and that is towards increasing socialisation of South Mrican health care. However, a precondition for any fundamental change in South African health care remains fundamental chan...

Simboliese interaksionisme: 'n mikrososiologiese oriëntasie

Abstract Symbolic Interactionism: a micro sociological orientation. Symbolic interactionism has become one of the most prominent theoretic sociological approaches; it is certainly comparable to structural functionalism and conflict theory. This article focuses on the nature and unique character of this typically American trend of thought which originated in the work of R.E. Park, W.I. Thomas, C.H. Cooley, and especially G.H. Mead. An exposition of the basic assumptions of symbolic interactionism is presented, which reveals its micro sociological orientation and the specific emphasis on the individual, his subjective stance, and such micro elements and micro processes as are found in interaction. The particular nature of symbolic interactionism is elaborated upon in terms of central characteristic conceptual constructs, including the nature of symbols and symbolic interaction; role-taking, self-objectivation and self-interaction; the definition of the situation; the self and personality; self development; ...

Deur 'n alternatiewe sleutelgat: Kritiek op die vryemarkmedisyne in Suid-Afrika / A criticism of free-market medicine in South Africa from an alternative perspective

South African free-market medicine is viewed, evaluated, and criticized from an alternative perspective in terms of the built-in shortcomings of this model of health care services. Despite the many positive qualities of free-market medicine, the author argues that this model of health care is not the most suitable for the South African situation and the total population of the country; that it indeed aggravates the central problem, namely that there is a marked lack of synchronization between the health care supply on the one hand, and the actual health care needs of the total population on the other. This leads to serious discrepancies, inequalities and deprivation in South African health care, resulting from the prevailing policy, priorities and organization of South African health care delivery. Fact is that some population groups and sectors of the clientele are favoured more than others by the present system. The contention of the author is that—and in spite of the well-known problems accompanying he...

Die mediese sosioloog en gesondheidsorgnavorsing: die dilemmas van toeganklikheid en orientasie tot die navorsingterrein

Abstract The medical sociologist and health care research: The dilemmas of accessibility and orientation to the research field. Sociologists working in medical settings are confronted with the dual task of, on the one hand, producing basic research for the development of sociological knowledge and theory-building and, on the other, providing medicine with applied research suitable for practical problem solving. This double role confronts the medical sociologist with two related problem areas. The one is the problem of interdisciplinary co-operation between the medical sociologist and his counterpart in the medical profession, and the other is the restrictive effect that the growing tendency towards applied medical sociology has on sociological theory-building. The problems of co-operation are all, in one way or another, related to either the profound difference in research approach between the medical and social model of health and illness or the institutional aspects such as the position and status of so...

Privatisering van gesondheidsorg: 'n Skeptiese stellingname

Abstract Privatization of health care: A sceptical viewpoint. The privatization of health care is implemented nowadays as a policy measure with high priority. It is propagated generally as a remedy for problems in the field of health care in South Africa. In this article privatization, and especially the privatization of health care, is analysed and evaluated as a concept and a social phenomenon. Besides defining the concept, the different sectors and subsectors, as well as the many forms and mechanisms of privatization are identified. Furthermore, the rationale, objectives, and underlying interests of privatization are identified, followed by the analysis of the disadvantages and side-effects of this policy measure on different levels and for different interest groups. A synoptic description of the manifestation of the privatization phenomenon in a global and more specifically in the South African context of health care is also given. In conclusion it is argued that the privatization of health care in So...

Mediese sosiologie by Marburg: Spieëlbeeld van 'n subdissipline in Wes-Duitsland / Medical sociology at Marburg: Mirror image of a subdiscipline in West Germany

Medical sociology has displayed phenomenal growth in West Germany during the last two decades. Although this subdiscipline was introduced in 1958 it was only recognized formally and institutionalized by law in 1970, with the purpose of being incorporated into the syllabus of medical students. Since the middle seventies teaching thereof has been gradually replaced by research therein. Medical sociology in the FRG has developed its own unique characteristics, the most important of which is its close association and even integration with medicine, especially regarding institutional placement and objectives. This development has its advantages as well as its disadvantages for the subdiscipline. These include not only greater recognition by and more relevance for the medical profession as well as a more applied and interdisciplinary character, but also estrangement from sociology, professional dominance, and selective accentuations in both research and teaching. The Institut fur Medizinische Soziologie at Marb...

Mediese sosiologie by Marburg: Spieëlbeeld van ’n subdissipline in Wes-Duitsland

Medical sociology at Marburg: Mirror image of a subdiscipline in West Germany. Medical sociology has displayed phenomenal growth in West Germany during the last two decades. Although this subdiscipline was introduced in 1958 it was only recognized formally and institutionalized by law in 1970, with the purpose of being incorporated into the syllabus of medical students. Since the middle seventies teaching thereof has been gradually replaced by research therein. Medical sociology in the FRG has developed its own unique characteristics, the most important of which is its close association and even integration with medicine, especially regarding institutional placement and objectives. This development has its advantages as well as its disadvantages for the subdiscipline. These include not only greater recognition by and more relevance for the medical profession as well as a more applied and interdisciplinary character, but also estrangement from sociology, professional dominance, and selective accentuations ...