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Table 2 Participants’ perceptions on quality of medicines and healthcare services

From: Parents’ and guardians’ perceptions on availability and pricing of medicines and healthcare for children in eThekwini, South Africa – a qualitative study

  Public sector Private sector
Quality of medicines “I think this medication that we purchase over the counter that we pay for in the pharmacy is really good. It helps even if it’s very expensive for us. It’s good compared to the clinic, it’s really good. Even the clinic does have Panado, I know they always have Panado® and Allergex® but sometimes they add water and sometimes it’s not strong. Sometimes it’s expired and we can’t go to the clinic and return it because it’s expired, but over the counter at the pharmacy I can return it and say it’s expired. So I think the pharmacy is very good”. (‘Poor’ group)
“The medication from the private pharmacy is really good. It helps. You can see it all the time, even the expiry date, you can check the expiry date. Sometimes in the clinic you don’t even see the expiry date. Sometimes the Panado is open, they give you with water and it is weak. So you have to go to the pharmacy. The pharmacy medication is really good.” (‘Poor’ group)
“The ones that I’m buying I think they are very good. The quality is perfect because first the medication is served and it really helps. If you buy Panado®, you give the child, you monitor the child, the temperature will go down. So the medicine is very, very good. It is better than what you get from the clinic because sometimes they add lots of water. The medication that I buy from pharmacy is 100% good than the medication I get from the clinic.” (‘Poor’ group)
“What am I going to judge the quality against? It’s hard to judge because we only know the medicines here, we can’t compare it to anything, but generally I think it sorts the problem out”.(‘Upper middle class’ group)
“Way better, my brother from London, whenever he comes down he takes a travel kit back up, so our medication is pretty good. The quality is good”. (Upper middle class’ group)
“Considering my kids, the medicines do work because I have one that’s chronic, asthmatic, so I can’t say that the medication doesn’t work, it does”. (‘Realised middle class’ group)
“Sometimes I have to go back to my pead (paediatrician) because it’s not working…average”. (‘Realised middle class’ group)
“I think the generic is better than the original, generic is sometimes, when it comes to her, it works better”. (‘Realised middle class’ group)
Quality of services “the quality of the health care I can say for the public clinic it’s not very bad except for the fact that they don’t have medication and stuff, because you don’t leave the clinic without your child being examined, they tell you exactly what is wrong with your child and they give a prescription if they don’t have that medication, but they don’t let your child just go out without trying to help him. Since it’s the government, I think they really try, it’s not very bad”. (‘Poor’ group) 
“The quality of the clinic is really, really good, we go there sometimes, but the only reason we end up buying it is because they out of stock”. (‘Poor’ group) 
“The care is excellent between both public and local GP’s… I should say public is a bit slow but we still receive the care, the best of care. It is time consuming to go publicly but we still receive excellent care”. (‘Low emerging middle class’ group) 
“The resources in public are very bad. There is a lot of shortages as well as there is a lot of room for improvement with regards to the caregivers itself. Due to the over population at the hospitals and the stress of the job itself, working under pressure, short staff…what happens is that they give care that is sub optimal I would say because they’re dealing with a bulk of people. They can’t give the quality care that you get in a private hospital”. (‘Low emerging middle class’ group) 
“Sometimes you find the nurses shouting but you don’t know what’s the problem”. (‘Poor’ group)
“But some of them shouting at the people who are taking their children to the clinic, some children are missing immunization they didn’t get it, ja (yes) they used to shout” (‘Poor’ group)
“I would like to see the doctor explain more about the medicine he’s giving you and the side effects. I don’t like reading pamphlets. I like to know from them. Because very few of them explain what the ingredients are or ask you, are you allergic to it”. (‘Realised middle class’ group) 
“You going to top specialist, it’s the best, but you paying”. (‘Emerging affluent’ group)
“I’ve always had good service from them. Never really had a problem with time or appointments or getting treatment on time and things… and off course in pharmacies”. (‘Realised middle class’ group)
“I normally wait…It’s just that if I go for the emergency, maybe like for my kids, I normally wait at the hospital, at the Netcare”. (‘Realised middle class’ group)
“Okay right now it’s a private clinic and I must say I was very disappointed, it was bad experience that I had in Private. I had to change doctors as a result, my kid (child) was misdiagnosed and I was thinking, this is a specialist doctor who should know what she should be doing and we ended up being hospitalised. They were carrying out different expensive procedures for a simple problem and eventually the person who ended up solving that problem came from a public clinic. So I was very disappointed in that…what I think private health care does is, they offer you the most expensive option and they don’t take time to really investigate the condition because each child is different. It’s just a ticking, ticking thing, you walk in, yes it’s a numbers thing, you find you have 20 of you waiting for the doctor and you don’t get that personal connection”. (‘Realised middle class’ group)