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Pomona College

Publication Date

Fall 2016

Program Name

South Africa: Community Health and Social Policy


This project seeks to explore the realities of the emergency medical system in the Durban area, particularly relative to government policy. It contextualizes its findings within the literature on public policy. Data for the project was collected via nine in-depth interviews with various professionals working in the field of emergency medical services, as well as a survey of fourteen citizens conducted in the peri-urban township of Cato Manor. This data was analyzed using qualitative methods. While every participant had different views and a different perspective on emergency services, some recurring themes and trends became evident, allowing for conclusions to be drawn.

The government-run emergency services in the Durban area do not measure up to the standards laid out by official government policy, often responding significantly slower than the national benchmark for response times. Many private ambulance companies have stepped into the gap in the market that this discrepancy creates, and are often significantly faster than the government services. This public-private dynamic fits an established model in policy literature of hybrid governance, in which third parties provide some of the services that the state would usually provide. However, despite official regulations, even private services also often deliver low-quality care to patients, particularly the smaller, so-called “fly-by-night” companies. There are many different possibilities as to how the state could improve the system, such as devoting more resources to the government service, further enforcing regulations, or creating a unified emergency call center. Unfortunately, none of these possibilities is without problems, and many participants were skeptical of whether any intervention could improve the system.


African Studies | Critical Care | Emergency Medicine | Health Law and Policy | Health Policy | Health Services Administration | Other Public Health | Public Administration


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