Alcohol addiction treatment in Cape Town: Exploratory investigation of the public-private mix

Master Thesis


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University of Cape Town

Public health and safety are compromised by the effects of alcohol addiction. Some of the consequences include transmission of infectious diseases, disproportionate use of medical and social services, traffic accidents, and street crimes. Additionally, when dealing with alcohol addiction, many expenses are incurred by public services such as the criminal justice system, emergency medical care centers, foster home placement centers, employee assistance programs and family violence centers. The clinical and economic benefits of addiction treatment are therefore clear. The aim of this study was to investigate Cape Town's alcohol addiction treatment center public-private mix and to determine quality of care and access. Document review and semi-structured interviews were the methods used. Provider reporting on quality of care and the limited number of sites interviewed were the main research limitations. Nevertheless, the thesis reached its objectives and contributed to the limited information on alcohol addiction treatment public-private mix, quality of care and access in South Africa. It is notable that there were few differences in the quality of care reported by public, public-private mix, private registered and private unregistered facilities. Quality of care was found to be good across sectors. Public and public-private mix facilities provided superior access in terms of income. Private facilities had the shortest wait-time. Geographic access was a pronounced issue for the poor population that resides in the Southern suburbs, far from affordable primary care alcohol addiction treatment services. Both horizontal and vertical inequities were identified in terms of access to primary care alcohol addiction treatment services in the Cape Town metropole. A strong case is made for involving more of the private sector in public-private partnerships in order to scale up alcohol addiction treatment within the South African setting. This will allow quality of care to be maintained while improving access.

Includes bibliographical references.