Allopathic healthcare access challenges in Rural Ngwelezane, South Africa: A qualitative case study
Andile Nceka, Constance Simangele Cele & Samson Adewumi
Abstract
The study aims to investigate how residents of Ngwelezane community access allopathic medical services at Ngwelezane hospital located in KwaZulu-Natal. Allopathic health care challenges are rarely explored when interrogated in the rural setting in South Africa. The research intends to show this gap through an examination of structural and systemic problems which affect healthcare services in areas that lack adequate medical resources. The study employed a qualitative case study design. Participants were purposively selected based on their experience using the hospital’s services for at least three years. Semi-structured interviews were conducted, and thematic content analysis was used to analyze the data. The findings indicated that the critical challenges included staff shortages, inadequate infrastructure, limited access to healthcare services, and poor communication. These challenges were further compounded by sociocultural factors that constrained community members’ acceptance and utilization of allopathic healthcare services. The study suggests that a comprehensive approach is needed to improve healthcare delivery in rural areas. This approach should include increasing the healthcare workforce, investing in infrastructure, strengthening communication, and implementing community-based health strategies to achieve the desired quality of healthcare services and improve health outcomes in Ngwelezane.
Keywords
mainstream medicine, rurality, community, healthcare services, access to health services
Author information & Contribution
Andile Nceka. PhD Research Student, University of Zululand. Email: andilenceka96@gmail.com
Constance Simangele Cele. PhD. University of Zululand. Email: Smangamanga68@gmail.com
Samson Adewumi. Corresponding author. PhD. Associate Researcher, University of Zululand. Email: adewumis@unizulu.ac.za
"All authors equally contributed to the conception, design, preparation, data gathering and analysis, and writing of the manuscript. All authors read and approved the final manuscript.”
Disclosure statement
The authors declare that no conflict of interest exists in relation to the publication of this paper.
Funding
This work did not receive any funding.
Institutional Review Board Statement
This study was granted ethical clearance by the University of Zululand, South Africa with reference UZ-REC 0691-008/897 PGM 2023/46.
Data and Materials Availability
The data supporting the findings of this study are available from the corresponding author upon reasonable request.
AI Declaration
No part of this work was generated through artificial intelligence (AI).
Notes
Acknowledgement
References
Aruleba, K., & Jere, N. (2022). Exploring digital transforming challenges in rural areas of South Africa through a systematic review of empirical studies. Scientific African, 16(1), 11-90. https://doi.org/10.1016/j.sciaf.2022.e01190
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
Burger, R., & Christian, C. (2020). Access to health care in post-apartheid South Africa: availability, affordability, acceptability. Health Economics, Policy, and Law, 15(1), 43-55. https://doi.org/10.1017/s1744133118000300
Chandran, M., & Schulman, K. A. (2022). Racial disparities in healthcare and health. Health Services Research, 57(2), 216-218. https://doi.org/10.1111/1475-6773.13957
Combes, J.B., Elliott, R. F., & Skåtun, D. (2018). Hospital staff shortage: the role of the competitiveness of pay of distinct groups of nursing staff on staff shortage. Applied Economics, 50(60), 6547-6552. https://doi.org/10.1080/00036846.2018.1490000
Coovadia, H., Jewkes, R., Barron, P., Sanders, D., & McIntyre, D. (2024). The South African health system: progress and challenges. The Lancet, 394(10213), 817-834. https://doi.org/10.1016/s0140-6736(09)60951-x
Creswell, J.W., & Poth, C. N. (2023). Qualitative inquiry and research design: Choosing among five approaches (5th Ed). London: Sage Publications.
Diko, M. (2023). The ramifications of the neglect of Indigenous South African languages by the South African Government: COVID-19 as a case study. African Journal of Inter/Multidisciplinary Studies, 5(1), 1-12. https://doi.org/10.51415/ajims.v5i1.1148
George, E. P., Raabe, D., & Ritchie, R. O. (2019). High-entropy alloys. Nature Reviews Materials, 4(8), 515-534. https://doi.org/10.1038/s41578-019-0121-4
Gumede, L., Nkosi, P.B., & Sibiya, M.N. (2024). Allopathic medicine practitioners’ experiences with non-disclosure of traditional medicine use. Health SA Gesondheid 29(0), a2381. https://doi.org/10.4102/hsag.v29i0.2381
Gona, P. N., Gona, C. M., Ballout, S., Rao, S. R., Kimokoti, R., Mapoma, C. C., & Mokdad, A. H. (2020). Burden and changes in HIV/AIDS morbidity and mortality in Southern Africa Development Community Countries, 1990–2017. BMC Public Health, 20(9), 1-14. https://doi.org/10.1186/s12889-020-08988-9.
Gupta, M., Bell, A., Padarath, M., Ngui, D., & Ezekowitz, J. (2021). Physician perspectives on the diagnosis and management of heart failure with preserved ejection fraction. CJC Open, 3(3), 361-366. https://doi.org/10.1016/j.cjco.2020.11.008
Kjos, A. L., Binh, N. T., Robertson, C., & Rovers, J. (2016). Drug procurement, storage, and distribution models in public hospitals in developing countries. Research in Social and Administrative Pharmacy, 12(3), 371-383. https://doi.org/10.1016/j.sapharm.2015.07.007
Lagarde, M., & Blaauw, D. (2023). Levels and determinants of overprescribing of antibiotics in the public and private primary care sectors in South Africa. BMJ Global Health, 8(7), 23-74. https://doi.org/10.1136/bmjgh-2023-012374
Laleman, G., Kegels, G., Marchal, B., Van der Roost, D., Bogaert, I., & Van Damme, W. (2007). The contribution of international health volunteers to the health workforce in sub-Saharan Africa. Human Resources for Health, 5, Article 19. https://doi.org/10.1186/1478-4491-5-19
Mabunda, S. A., Sigovana, K., Chitha, W., Apalata, T., & Nomatshila, S. (2021). Socio-demographic associations of HIV among women attending antenatal care in selected rural primary care facilities in South Africa’s Eastern Cape province. BMC Infectious Diseases, 21(1), 1-11. https://doi.org/10.1186/s12879-020-05744-7
Makhavhu, E. M. (2024). Integrating traditional and allopathic child health: A healthcare transformation opportunity. Health SA Gesondheid, 29, Article 2501. https://doi.org/10.4102/hsag.v29i0.2501
Malakoane, B., Heunis, J. C., Chikobvu, P., Kigozi, N. G., & Kruger, W. H. (2020). Public health system challenges in the Free State, South Africa: A situation appraisal to inform health system strengthening. BMC Health Services Research, 20, 1-14. https://doi.org/10.1186/s12913-019-4862-y
Maphumulo, W. T., & Bhengu, B. R. (2019). Challenges of quality improvement in the healthcare of South Africa post-apartheid: a critical review. Curationis, 42(1), 1-9. https://doi.org/10.4102/curationis.v42i1.1901
Metiso, N. F., & Mbowen, S. H. (2025). Barriers and enablers of health services utilisation in rural communities of Nkomazi sub-district in Mpumalanga province, South Africa: a quantitative community survey. Health Services Insights, 18, 1 –11. https://doi.org/10.1177/11786329251356931
Mchunu, G. G., Harris, O., & Nxumalo, C. T. (2022). Exploring primary healthcare practitioners’ experiences regarding the coronavirus disease 2019 (COVID-19) pandemic in KwaZulu-Natal, South Africa. Primary Health Care Research & Development, 23(4), 67-68. https://doi.org/10.1017/s1463423622000536
Mngomezulu, K., Ndinda, C., Mazamane, Z., Sinyolo, S., & Adebayo, P. (2022). Gendered attitudes to fruit and vegetable consumption during the COVID-19 epidemic: Implications for policy and programming. Agenda, 36(2), 77-91. http://hdl.handle.net/20.500.11910/19463
Mntungwana, S., Khosa, N. V., Buso, A. E., & Sithole, N. (2025). Barriers to chronic disease healthcare access in rural Eastern Cape Province, South Africa. International Journal of Environmental Research and Public Health, 22(12), Article 1881. https://doi.org/10.3390/ijerph22121881
Modisakeng, C., Matlala, M., Godman, B., & Meyer, J. C. (2020). Medicine shortages and challenges with the procurement process among public sector hospitals in South Africa: findings and implications. BMC Health Services Research, 20(5), 1-10. https://doi.org/10.1186/s12913-020-05080-1.
Naicker, S. N., Norris, S. A., Mabaso, M., & Richter, L. M. (2017). An analysis of retrospective and repeat prospective reports of adverse childhood experiences from the South African birth to twenty plus cohort. PloS One, 12(7), 19-22. https://doi.org/10.1371/journal.pone.0181522
Ndlovu, S.L. (2021). An ethical leadership framework to curb corruption and promote good governance in South Africa: A case of selected KwaZulu-Natal municipalities’, Doctoral dissertation, University of KwaZulu-Natal. https://researchspace.ukzn.ac.za/items/9ff8578e-4052-4b07-8b6a-5ca31b130d9f
Ngwenya, N., Nkosi, B., Mchunu, L. S., Ferguson, J., Seeley, J., & Doyle, A. M. (2020). Behavioural and socio-ecological factors influencing access to and utilisation of health services by young people living in rural KwaZulu-Natal, South Africa: Implications for intervention. PLoS One, 5(4), 73-80. https://doi.org/10.1371/journal.pone.0231080
Nkosi, V., Haman, T., Naicker, N., & Mathee, A. (2019). Overcrowding and health in two impoverished suburbs of Johannesburg, South Africa. BMC Public Health, 19, Article 1358. https://doi.org/10.1186/s12889-019-7665-5
Nnabuike, C. N., Olive, P.K., & Moodley, J. (2023). Inequality in health care services in urban and rural settings in South Africa. African Journal of Reproductive Health, 27(5), 1-9. https://doi.org/10.29063/ajrh2023/v27i5s.11
Nnadozie, R. C. (2013). Access to basic services in post-apartheid South Africa: What has changed? measuring on a relative basis. The African Statistical Journal, 4(2), 25-30. https://library.au.int/access-basic-services-post-apartheid-south-africa-what-has-changed-measuring-relative-basis-4
Padayachee, H., Hoque, M. E., & Mutambara, E. (2020). Patient experience of primary health care users in KwaZulu-Natal. Africa Journal of Nursing and Midwifery, 22(1), 23-25. https://doi.org/10.25159/2520-5293/6317
Pillay, J. (2023). Psychological, social, and physical ecologies for child resilience: A South African perspective. Frontiers in Psychology, 14(1), 90-97. https://doi.org/10.3389/fpsyg.2023.1190297
Sanders, R., & Lehmann, J. (2019). An exploratory study of clients’ experiences and preferences for counselling room space and design. Counselling and Psychotherapy Research, 19(1), 57-65. https://psycnet.apa.org/doi/10.1002/capr.12202
Siedner, M. J., Kraemer, J. D., Meyer, M. J., Harling, G., Mngomezulu, T., Gabela, P. & Herbst, K. (2020). Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: an interrupted time series analysis. BMJ open, 10(10), 543-763. https://doi.org/10.1136/bmjopen-2020-043763
Sweileh, W. M. (2024). Research trends and patterns on international migration of health workers (1950–2022). SAGE Open, 14(4), 1–14. https://doi.org/10.1177/21582440241293190
van Rensburg, H. C. (2014). South Africa’s protracted struggle for equal distribution and equitable access–still not there. Human Resources for Health, 12(1), 1-16. https://doi.org/10.1186/1478-4491-12-26
Wieland, L. S., Manheimer, E., & Berman, B. M. (2011). Development and classification of an operational definition of complementary and alternative medicine for the Cochrane collaboration. Alternative Therapies in Health and Medicine, 17(2), 50-56. Available at: https://pubmed.ncbi.nlm.nih.gov/21717826/ (Accessed 12 May 2026).
World Health Organization. (2020). Laboratory testing of 2019 novel coronavirus (2019-nCoV) in suspected human cases: interim guidance. https://www.who.int/publications/i/item/10665-331501
Cite this article:
Nceka, A., Cele, C.S. & Adewumi, S. (2026). Allopathic healthcare access challenges in Rural Ngwelezane, South Africa: A qualitative case study. International Review of Social Sciences Research, 6(3), 104-125. https://doi.org/10.53378/irssr.353384
License:
This work is licensed under a Creative Commons Attribution (CC BY 4.0) International License.
Find this article in:
Most read articles
- Social media usage and the academic performance of Filipino junior high school students
- A narrative exploration of romantic experiences and ideal relationship standards among Filipino Gen Z
- Tiktok made me book it: The impact of Tiktok on tourism destination selection of generation Z and millennials in Manila
- Students’ exposure to social media and their radical involvement on the societal issues in the Philippines
- Exploring the factors influencing commuters’ satisfaction and the use of public utility buses in Quezon City, Philippines
- ChatGPT integration significantly boosts personalized learning outcomes: A Philippine study
- Life-saving skills in the community: An assessment of basic life support and first aid knowledge in a selected barangay in the Philippines
- The effects of static and dynamic stretching exercises on the lower extremity performance
- The influence of travel vlogs on tourists’ decisions to visit destinations in the Philippines
- Decoding love signs: The role of perceived relational red flags in mate selection criteria among Filipino young adults