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HEALTHCARE FOR THE YOUTH NEEDS STRATEGIC SHIFT TO PREVENTION, INNOVATION IN CARE AND BETTER DELIVERY OF SERVICES

Satish Antony, Executive Manager: Actuarial of the AfroCentric Group

The landscape of healthcare in South Africa is undergoing a profound transformation. While this transformation is largely focussed on the NHI and its implications we need not neglect everything else that is happening in the healthcare sector such as the state of health of our youth.

Perhaps we have been somewhat overwhelmed with election news throughout June, but a critical aspect of voting is visions for the future in which the health of today’s youth will be central to success.

Amid socioeconomic challenges like a 45.5% unemployment rate among 15–34-year-olds, a widening skills gap, and a perceived bleak economic future, the mental health and well-being of young people is under siege. 

With all the challenges the youth face, the obstacles may contribute to feelings of despondency and low morale which has a range of psychosocial implications especially for their health. This Youth month AfroCentric looked again at what the data is telling us in terms of trends, challenges and opportunities when it comes to the health of our Youth. 

Within the universe of Medscheme, an AfroCentric Group company, which encompasses a diverse demographic, the Youth account for 25% of the overall scheme population which is member base of about 4million lives under managed care. 

The youth population at Medscheme, numbering 1,000,455 individuals between the ages of 15 and 35, has an average age of 24 years with a gender split of 44:56 male: female respectively. Understanding the specific needs of different age groups within this population is essential for tailoring appropriate healthcare interventions. 

For instance, we are witnessing a significant shift in our population due to the growth observed in one of our big schemes. A larger portion of their members are now bringing an average of two children as dependents meaning, if they have 30,000 main members, we can expect to see an additional 70,000 children/youth as well. This trend is noticeably different from what we see in our other scheme populations. The changing demographics suggest that up to 50% of our beneficiaries could be children and youth. 

This necessitates a proactive approach, focusing on preventative care and innovative healthcare delivery methods tailored to the particular needs of this growing demographic and indicates a need for a strategic shift in our healthcare focus. 

This shift requires greater emphasis on primary healthcare to prevent chronic diseases before they develop, as well as a shift in healthcare delivery mechanisms to better cater to a younger population.

We need to re-evaluate our current healthcare strategies and focus on providing comprehensive care that addresses the needs of our evolving beneficiary population. This includes not only managing chronic diseases but also actively promoting preventive care and developing engaging healthcare solutions for a younger generation which will also be the approach in an NHI setting. 

Let us take a look at insights in other areas of youth heath. 

Early Pregnancies

Early pregnancies present significant health and socio-economic risks globally, and Medscheme is no exception. In the past 12 months, nearly 80% of pregnancies within the youth population were among those aged 26-35 years, while 4% occurred in individuals aged 18 or younger. The average age for pregnancy among the youth is 29 years. This data underscores the need for targeted healthcare and educational initiatives to address early pregnancies effectively.

HIV Prevalence

HIV remains a critical concern among pregnant youth beneficiaries, with a prevalence rate of 7.46%. This is higher than the overall Medscheme population rate of 6.07% but lower than the 12.16% observed in the overall pregnant population. These figures highlight the necessity for continuous HIV education, prevention, and treatment programmes.

Hospital Admissions

Hospital admissions provide insight into the prevalent health issues among different age groups within the youth population. Notably, the 15-18 age group has a higher prevalence of mental health-related admissions compared to other age groups. The top 10 admission categories in 2023 indicate varying health challenges across age groups, including major depression, oesophagitis, gastroenteritis, and asthma.

Chronic Disease Profile

Chronic diseases are a significant concern among the youth, with an overall chronic prevalence of 7.32%. This prevalence increases with age, with the 26-35 age group exhibiting the highest resource utilisation. Among chronic conditions, HIV is the most prevalent, followed by depression, diabetes, and hypertension. The need for effective disease management initiatives is evident to help beneficiaries manage these conditions better.

Mental Health Crisis

Mental health is a pressing issue within the youth population. While 12% of youth claim mental health-related benefits, only 3% are enrolled in chronic disease management programmes. This disparity indicates a significant gap in access to and utilisation of mental health services. Furthermore, hospitalisation rates for mental health conditions are higher among those not participating in disease management programmes, indicating the need for early intervention and comprehensive mental health support.

The health landscape of Medscheme's youth is marked by some challenges and opportunities. Early pregnancies, chronic diseases, mental health issues and the increasing number of child dependents require focused and tailored healthcare interventions. By addressing these areas with targeted strategies, we can ensure that our youth receive the best possible care, enabling them to contribute positively to their communities and society at large. Prioritising youth health is both a social and economic imperative.