The moral determinants of health in South Africa: Diversity and inclusion in medicine

Abstract

Background: Diversity, inclusion, equity and access (DIEA) are fundamental principles deeply intertwined with South Africa’s historical narrative. Despite strides towards equality, the medical profession remains susceptible to challenges related to DIEA like the rest of society. Issues such as racial and gender bias, alongside covert discriminatory practices, persist within medical institutions. These concerns underscore the imperative for the medical community to prioritise diversity, inclusion and equitable access to opportunities throughout training and professional practice. Aim: This review aims to assess the current status of DIEA in South Africa, identify research and practice gaps and position South Africa within the global discourse on DIEA in medicine. Setting: Worldwide literature review was conducted to set a foundation for the analysis of the SA medical profession. Methods: A review of global literature was conducted to explore themes related to diversity, inclusion, access and equity in medicine. Results: Existing literature lacks sufficient focus on DIEA in the South African context, but highlights more United States-based discourse. There are limited empirical studies exploring systemic DIEA practices and its impact on access to opportunities and how it affects the well-being of underrepresented groups in medicine. These findings underscore the critical need for inclusive practices to drive both individuals and institutions to create a safe and just culture in medicine. Conclusion: Prioritising implementation and monitoring of inclusive policies and practices within the medical profession is imperative and should aim beyond numerical representation. Progress will be achieved through collaboration with bioethicists. Contribution: Providing insights and recommendations to advance DIEA in the South African field of medicine contributes to creating a more equitable and just medical profession

Keywords

• diversity
• inclusion
• belonging
• equity
• medical practitioners
• discrimination
• south africa
• justice