Uptake of health services among truck drivers in South Africa: analysis of routine data from nine roadside wellness centres

Abstract

BackgroundLong-distance truck drivers are occupationally susceptible to poor health outcomes. Their patterns of healthcare utilisation and the suitability of healthcare services available to them are not well documented. We report on truck driver healthcare utilisation across South Africa and characterise the client population of the clinics serving them for future service development.MethodsWe analysed anonymised data routinely collected over a two-year period at nine Roadside Wellness Centres. Associations between services accessed and socio-demographic characteristics were assessed using univariable and multivariable logistic regression models.ResultsWe recorded 16,688 visits by 13,252 individual truck drivers (average of 1.26 visits/person) who accessed 17,885 services for an average of 1.07 services/visit and 1.35 services/person. The mean age of truck drivers was 39 years. Sixty-seven percent reported being in stable relationships.The most accessed services were primary healthcare (PHC)(62%) followed by HIV (32%). Low proportions (≤6%) accessed STI,TB and malaria services. Most visits were characterised by only one service being accessed (93%, n = 15,523/16,688). Of the remaining 7% of visits, up to five services were accessed per visit and the combination of TB /HIV services in one visit remained extremely low (<1%, n = 14/16,688). Besides PHC services at the beginning of the reporting period, all service categories displayed similar seasonal utilisation trends(i.e. service utilisation peaked in the immediate few months post clinics opening and substantially decreased before holidays). Across all service categories, younger truck drivers, those with a stable partner currently, and those of South African origin were the main clinic attendees.Older truck drivers (≥40 years) were more likely to access TB and PHC services, yet less likely to access HIV and STI services. Those with stable partners were less likely to access STI and TB services but more likely to access malaria and PHC services. South African attendees were more likely to access PHC, while attendees from other nationalities were more likely to access HIV and malaria services.ConclusionsThis utilisation analysis shows that tailored services assist in alleviating healthcare access challenges faced by truck drivers, but it underscores the importance of ensuring that service packages and clinics speak to truck drivers’ needs in terms of services offered and clinic location.Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2595-3) contains supplementary material, which is available to authorized users.

Cross-sectional study of the health of southern African truck drivers

“…While traditional public health facilities are available to truck drivers across the country, truck drivers hardly access these services as they cannot take leave or clinics are not reachable by large trucks. In order to reduce barriers to access, mobile HIV clinics and roadside wellness clinics have been established to accommodate all drivers at no cost 9 10. The North-Star Alliance (NSA) clinics, for example, use trained clinical and outreach teams to provide primary healthcare services, HIV prevention and screening for other infectious diseases in converted shipping containers.…”

“…These initiatives have shown successes with the general uptake of healthcare, including HIV counselling and testing (HCT) for truckers,10 11 however, most of the focus is on preventing communicable diseases and very little is known about long-term health trends within this group. Current findings have come from studies and interventions that examine individual factors or conditions, but they do not incorporate a comprehensive health approach that includes NCDs 12 13.…”

Utilization of HIV and Sexually Transmitted Infections Prevention Services, and Associated Factors among the Long-Distance Truck Drivers along the Northern Corridor Highway, Kenya

“…Long-distance truck drivers (LDTDs) are central to the challenges faced in the fight against HIV and sexually transmitted infections (HIV/STIs) in large part due to escalated risk of new infections arising from the nature of their career [1] [2]. Moreover, the risk of HIV and STI infection outcomes among the LDTDs is partly attributable to sub-optimal access and underutilization of HIV/STI preventive services [3]. These two factors (heightened risk and underutilization of HIV/STI preventive services) have placed the LDTDs among at-risk populations that need targeted interventions for effective control of HIV [1].…”

Working nights and lower leisure-time physical activity associate with chronic pain in Southern African long-distance truck drivers: A cross-sectional study

“…Roadside Wellness Centres (RWC) and mobile HIV clinics have been set up along driving routes in South Africa to provide such services. An analysis of the up-take of RWC services recommended that the services provided at the RWC needed to be designed for the needs of truck drivers [ 27 ]. In order to design services for long-distance drivers that promote health and quality of life, factors that associate with chronic pain need to be determined.…”