Geographic patterns of deprivation in South Africa: informing health equity analyses and public resource allocation strategies

Abstract

There is a growing interest in the use of small area analyses in investigating the relationship between socioeconomic status and health, and in informing resource allocation decision-making. However, few such studies have been undertaken in low- and middle-income countries (LMICs). This paper reports on such a study undertaken in South Africa. It both looked at the feasibility of developing a broad-based area deprivation index in a data scarce context and considered the implications of such an index for geographic resource allocations. Despite certain data problems, it was possible to construct and compare three different indices: a general index of deprivation GID;: compiled from census data using principal component analysis; a policy-perspective index of deprivation PID;: based on groups identified as priorities within policy documents; and a single indicator of deprivation SID;: selected for relevance and feasibility of use. The findings demonstrate clearly that in South Africa deprivation is multi-faceted, is concentrated in specific areas within the country and is correlated with ill-health