Geography, marginalisation and the performance of the right to have access to health care services in Johannesburg

Résumé

This article aims to strengthen the theoretical case for geographical awareness in human rights work, by considering the performance of the right to have access to health care services in section 27(1)(a) of the 1996 Constitution, by particular inhabitants of Johannesburg. It shows how a performative understanding of the right to have access to health care services dovetails with the international law approach to assessing compliance with the right to health, and points to certain features of South African socio-economic rights jurisprudence that enable such an understanding of the right.
Thereafter, the article considers some of the geographic aspects of access to health care services in Johannesburg, with a particular focus on the experiences of marginalised groups. Current health system reforms and urban development initiatives in Johannesburg, that relate to the geographical features of access to health care in the city, are then assessed. It is shown that, while many of these measures will have very positive consequences for the progressive realisation of the right to have access to health care services, the interaction of geographic factors with other determinants of access (notably, affordability and quality of care, as well as stigmatisation of certain care seekers) may nevertheless continue to frustrate access to care by marginalised groups.

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