Africa's middle class women bring entrepreneurial opportunities in breast care medical tourism to South Africa

Ahwireng-Obeng, Frederick; Loggerenberg, Charl van

doi:10.1002/hpm.1034

Cited by 12 publications

(14 citation statements)

References 22 publications

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“…The doctors here are arrogant and uneducated (85, p. 283).” Also in Indonesia, patients from West Kalimantan travelling to Kuching, Malaysia praised the professionalism of Kuching doctors and expressed disdain for the prevalent hierarchical medical culture at home that places patients as passive recipients of care rather than as active consumers [ 83 ]. Other common sources of dissatisfaction and mistrust included outdated technology and diagnostic capacity, substandard facilities, uncaring staff and poor quality/counterfeit pharmaceuticals [ 66 , 68 , 71 – 74 , 79 , 83 , 84 ]. As with the other mechanisms described above, activation of this mechanism requires knowledge of healthcare providers abroad and economic capital.…”

Section: Resultsmentioning

confidence: 99%

A realist synthesis of cross-border patient movement from low and middle income countries to similar or higher income countries

Durham

Blondell

2017

Global Health

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Patient travel across borders to access healthcare is becoming increasingly common and widespread. Patients moving from high income to middle income countries for healthcare is well documented, with patients seeking treatments that are cheaper or more readily available than at home. Less well understood is when patients move from one low income country to another or from a low income country to a higher income country. In this paper, a realist review was undertaken to explore why, in what contexts and how patients from lower income countries travel to countries with the same, or more advanced, economies for planned healthcare. Based on an initial scoping of the literature and discussions with key informants, we generated an initial theory and set of propositions about why, how, who and in what contexts people cross international borders for planned healthcare. We then systematically located and synthesized (1) peer-reviewed studies from the Scopus, Embase, Web of Science and Econlit databases; (2) non-indexed reports using key informants and Google; and (3) papers from the reference lists of included documents, to glean supportive or contradictory evidence for our initial propositions. As we reviewed the literature and extracted our data, we drew on the work of Pierre Bourdieu to understand the interplay between material and non-material capital and cognitive processes in decisions to cross borders for healthcare. Patient travel was largely undertaken due to a lack of services in the home country and/or unacceptability of local services, with decisions on when, and where, to travel, usually made within the patient’s social networks. They were able to travel via use of multiple resources, including social networks, economic and cultural capital, and habitus. Those patients with greater volumes of the aforementioned factors had greater healthcare options; however, even those with limited resources engaged in patient travel. Patient movement challenges traditional ways of thinking about public health and the notion of health systems contained within the nation state. Further research is needed to better understand the effects of patient travel, and how to harness the benefits of patient travel without exacerbating existing health inequalities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12992-017-0287-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

A realist synthesis of cross-border patient movement from low and middle income countries to similar or higher income countries

Durham

Blondell

2017

Global Health

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“…Of the 191 articles assessed for eligibility for full screening, 19/ 191 (less than 10%) articles focused specifically on MT in Africa [4,5,7,13,27,28,36–48]. …”

Section: Resultsmentioning

confidence: 99%

“…From outside Africa, long waiting-lists for certain procedures in some countries, and medical under- or non-insurance are motivations for travel, mostly from developed countries [6]. Lack of good quality hospitals and health professionals in most African countries cause some patients to travel internationally or regionally to other African countries, like South Africa, Tunisia, Egypt and Mauritius for medical care [4,7]. Some countries adopt restrictive regulations on certain treatments, such as some stem cell therapies, surrogate pregnancy, organ transplantation and sex determination for the unborn, thereby causing patients who want or need these treatments to travel to where they are either legal, unregulated or less restricted [1,2].…”

Section: Introductionmentioning

confidence: 99%

Ethical issues associated with medical tourism in Africa

Mogaka

Mupara

Tsoka-Gwegweni

2017

Journal of Market Access & Health Policy

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Global disparities in medical technologies, laws, economic inequities, and social–cultural differences drive medical tourism (MT), the practice of travelling to consume healthcare that is either too delayed, unavailable, unaffordable or legally proscribed at home. Africa is simultaneously a source and destination for MT. MT however, presents a new and challenging health ethics frontier, being largely unregulated and characterized by policy contradictions, minority discrimination and conflict of interest among role-players. This article assesses the level of knowledge of MT and its associated ethical issues in Africa; it also identifies critical research gaps on the subject in the region. Exploratory design guided by Arksey and O’Malley’s (2005) framework was used. Key search terms and prior determined exclusion/inclusion criteria were used to identify relevant literature sources. Fifty-seven articles met the inclusion criteria. Distributive justice, healthcare resource allocation, experimental treatments and organ transplant were the most common ethical issues of medical tourism in Africa. The dearth of robust engagement of MT and healthcare ethics, as identified through this review, calls for more rigorous research on this subject. Although the bulk of the medical tourism industry is driven by global legal disparities based on ethical considerations, little attention has been given to this subject.

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“…But, in sharp contrast, local patients are forced to experience similar long queues in oversubscribed and underfunded local health systems. 9 33 35–38 …”

Section: Discussionmentioning

confidence: 99%

“…Some African countries are said to have invested in or attracted ample pool of specialist physicians in quality private hospitals whose medical facilities are similar to the ones in developed countries. 9 Costs associated with these MT infrastructure are substantial. 11 Similarly, MT is said to cause competition for best local resources including qualified medical professionals 11 12 and transplant organs.…”

Section: Introductionmentioning

confidence: 99%

Role, structure and effects of medical tourism in Africa: a systematic scoping review protocol

et al. 2017

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IntroductionSome patients travel out of, while others come into Africa for medical care through a growing global phenomenon referred to as medical tourism (MT): the travel in search of medical care that is either unavailable, unaffordable or proscribed at home healthcare systems. While some castigate MT as promoting healthcare inequity, others endorse it as a revenue generator, promising local healthcare system strengthening. Currently, however, the understanding of this component of healthcare in Africa is inadequate. This study seeks to determine the level of knowledge on the role, structure and effect of MT in Africa as it relates to healthcare systems in the region.MethodsConduct a systematic scoping review to outline the role, structure and effect of MT in Africa. Databases: Academic Search Complete, Business Source Complete. Studies mapped in two stages: (1) mapping the studies based on the relevance of their titles and subject descriptors; (2) applying further inclusion criteria on studies from stage 1. Two reviewers will independently assess study quality and abstract data. Both quantitative and qualitative data analysis will be performed, using STATA V.13 and NVIVO, respectively.Ethics and disseminationThe study results will be disseminated by publication in peer-reviewed journals and findings presented at academic and industry conferences related to MT, public health, health systems strengthening and tourism.DiscussionMT spurs cutting-edge medical technologies, techniques and best practices in healthcare delivery. The two-tier healthcare landscape in Africa, however, presents an exceptionally unique context in which to situate this study. Much has been written about MT globally, but not much is known about the phenomenon in Africa; hence the appropriateness of this scientific assessment of MT in the region. By elucidating the role, structure and effect of this phenomenon, this study hopes to contribute to health systems strengthening in Africa.PROSPERO registration numberCRD42016039745.

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Africa's middle class women bring entrepreneurial opportunities in breast care medical tourism to South Africa

Cited by 12 publications

References 22 publications

A realist synthesis of cross-border patient movement from low and middle income countries to similar or higher income countries

A realist synthesis of cross-border patient movement from low and middle income countries to similar or higher income countries

Ethical issues associated with medical tourism in Africa

Role, structure and effects of medical tourism in Africa: a systematic scoping review protocol

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