Promoting Equitable Healthcare Access for Marginalized Populations: A Comprehensive Framework for Men Who Have Sex With Men (MSM) in South Africa

Abstract

Men who have sex with men (MSM) across South Africa face significant health disparities rooted in stigmatization due to their sexual orientation, which negatively affects their health. Toward curbing sexually transmitted diseases and ensuring equitable distribution of access to health services for MSM, this study developed a framework capable of providing equal health for MSM in South Africa. The study aims to develop a framework that promote equitable health among MSM in South Africa. This study adopted a qualitative method with in-depth consented interviews targeted at MSM in Umlazi township, South Africa. A total of 25 MSM were interviewed, and their responses were analyzed using Nvivo 11, supported by content analysis. The Equitable Health Access Framework (EHAF) was developed using the study findings, guided by the WHO framework for social health determinants, and underpinned by the systems theory. The framework was structured around three factors: input, processes and output. The key finding depicted that the implementation and collaboration of the input and process will result in an output of equitable health access for MSM. Based on the study findings, the processes and key factors to be considered are sensitization training, community engagement and support, MSM empowerment program, and health promotion. At the same time, the input are finance, human resources, infrastructure, medical equipment and consumables. The “framework” could guide policymakers and health professionals by providing structured processes and key elements to ensure better health space and equal healthcare delivery to MSM in the research setting and similar settings in developing countries.