Infomedix International | 3 2016
One of the strongest economies in the African region, the Republic of South Africa is classified as a middle income emerging nation. With a progressive Constitution that guarantees the right to healthcare, it has dedicated substantial resources to health and human capital investments but its health outcomes remain poor when compared to similar middle-income countries.
The public sector is stretched and under-resourced in places. While the state contributes about 40% of all expenditure on health, the public health sector is under pressure to deliver services to about 80% of the population. The private sector, on the other hand, is run largely on commercial lines and caters to middle- and high-income earners who tend to be members of medical schemes. It also attracts most of the country’s health professionals. This two-tiered system is not only inequitable and inaccessible to a large portion of South Africans, but institutions in the public sector have suffered poor management, underfunding and deteriorating infrastructure. While access has improved, the quality of healthcare has fallen. The situation is compounded by public health challenges, including the burden of diseases such as HIV and tuberculosis (TB), and a shortage of key medical personnel. However, the South African government is responding with a far-reaching reform plan to revitalize and restructure the South African healthcare system, including: • Fast-tracking the implementation of a National Health Insurance scheme, which will eventually cover all South Africans. • Strengthening healthcare systems at primary health facilities. • Strengthening the fight against HIV and TB, non-communicable diseases, as well as injury and violence. • Improving human-resource management at state hospitals and strengthening co-ordination between the public and private health sector. • Deploying “health teams” to communities and schools. • Regulating costs to make healthcare affordable to all. • Increasing life expectancy. Health Expenditure The bulk of health-sector funding comes from the South Africa’s National Treasury. Despite the high expenditure from the government aimed at improving hospitals and strengthening public health ahead of the National Health Insurance scheme, health outcomes remain poor when compared to similar middle-income countries. This can largely be attributed to the inequities between the public and private sector.
market outlook
South Africa’s health system consists of a large public sector and a smaller but fast growing private sector, varying from the most basic primary healthcare, offered free by the state, to highly specialized, hi-tech health services available in both the public and private sector. The National Health Insurance Scheme (NHI) is the central means by which the government aims to achieve universal coverage, under the principles of social solidarity and equity elaborated in the National Development Plan.
Total population
54,490,000 (2015)
Population aged under 15
Population aged over 60
30%
(2013)
9%
(2013)
Population living in urban areas
Median age (years)
26
(2013)
64%
(2013)
Total expenditure on health per capita (Intl $, 2016)
Gross national income per capita (PPP intl. $, 2013)
12
(2013)
1,121
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