Since attaining independence in 1994, the South Africa government has endeavored to improve its health services. It has built new health care centers and upgraded the one’s left behind by the colonial masters.
Though much progress has been achieved in the health care sector, challenges such as understaffing, lack of adequate medical equipments and poor management practices has profoundly affected the administration of health care services in the country.
Currently, the country has two lines of healthcare facilities. These are the public and private managed systems. More than 80 percent of the population seeks health care service from government run facilities whereas the wealthy, comprising of 20 percent use facilities which are better managed.
Types of South African Health Care Systems
Public Health care system
Public health care is the most common system embraced by 80 percent of the population. In this facility, basic health is disseminated free of charge to any person.
The public system is overstrained in the provision of health services this is due to factors such as underfunding, poor management and inadequate infrastructures (PNHP).
Other factors contributing to the poor delivery of service the scourge caused by HIV/AIDS, Tuberculosis and shortage of key medical.
Private Health Care Facilities
The private sector is practiced along commercial lines. Thus, it addresses the healthy needs of the wealthy, the middle class and high income earners.
Similarly, patients attending private health care facilities are members of medical schemes.
Also, the government is funding private health care through schemes such as; Road Accident Fund and Workmen’s Compensation Fund (Allianz).
Private health facilities spend 50 percent of the nation’s health care resources besides attracting many of the state’s medical experts.
Health Care Legislations
The South African government has established various regulations to control health care delivery. One of these regulations is the National Health Act, 61 of 2003. This legislation provides a benchmark governing a single health care facility in the country.
Similarly, the government has passed the National Health Amendment bill of 2010. The law ensures that health care facilities comply with health standards through an independent entity.
Also, the country has operationalized the Medical Schemes Act of 1998. This act is essential in regulating medical schemes in the country. It also protects people at “high risk” such as the sick and elderly against victimization during the provision of health care (PNHP).
Allianz note that South African government has regulated abortion through the Choice on Termination of Pregnancy Act (Allianz). The Act permits abortion procured legally.
Other laws, which have been legislated include; Nursing Act, 2005, Mental Health Care Act, 2002 and Pharmacy Amendment Act, 2000 among others.
Health Care Financing
The country’s National Treasury provides most funding for smooth running of health care facilities. However, private and non-governmental bodies are involved. Similarly, the members of the public also contribute to the operation of public hospital by paying a small amount of user fee.
The government is planning to launch the Social health Insurance (SHI). This scheme is intended to provide more insurance cover to majority of South Africans.
Public health care facilities consume 11 percent of the national budget. This budget is allocated to local, provincial and National health care facilities.
PNHP also cite that non-governmental organizations, NGOs have been prominent in financing health care. In most cases, their funds are channeled towards combating HIV/AIDS, mental disease, disability and cancer (PNHP).
National Health Insurance Scheme, NHIS
This scheme is focused on public health. It is managed through public expenditure monitoring and budget.
NHIS has established a “10-point plan”. This plan is geared towards supporting human resources management and other operations such as improving hospitals facilities and equipment’s.
Health Care Facilities
The country has about 4,200 public health care facilities. The average number of person’s per clinic is about 13,718. This figure outstrips the World Health Organization, WHO guidelines which mandate 10,000 persons per clinic (Simjee). However, in regard to the statistics gathered in 2009, an average of about 2.5 people visits these clinics per year.
The State has constructed 1,600 health care facilities and strengthened the old ones. The public health facilities have been mandated to treat pregnant and breastfeeding women and children free of charge.
Similarly, Simjee cites that the National Health Laboratory Service is the single entity providing pathology services in the country (Simjee). National Health Laboratory Service has 265 laboratories spread across the country. These laboratories are significant for serving 80 % of the nation’s population.
Primary Health Care
HIV and Tuberculosis
HIV/AIDS is a prevalent disease in South Africa. However, other poverty linked diseases such as Cholera and Tuberculosis are common. These diseases have strained the country’s health care system (Simjee). Based on the statistics gathered in 2011, Human Rights Watch indicate that the rate of HIV frequency was 10.6 percent, and about one-fifth of the country’s women in their productive ages were HIV positive (Human Rights Watch).
Similarly, the statistics shows that about 5.4 million people are living with HIV (WHO). However, this year (2012) the government has released a report showing that it has abridged mother to child HIV transmission rate from about 3.5 percent in 2010 to about 2 percent.
The figures below illustrate HIV/AIDS trends in South Africa (WHO). These figures are based on the statistics collected by WHO between 1990 to 2007.
South Africa is signatory to the Millennium Development Goals (MDG). MDG is an organization which addresses the specific needs of women and children.
Under this program, in conjunction with the country’s National prevention of mother- to- child program, an expectant mother is offered counseling and HIV testing (Human Rights Watch). When a mother is tested positive, she is put on anti- retroviral treatment to prevent further transmission to the child. She is also offered protection, support and continuous treatment for herself and the baby.
Similarly, the government has enhanced the Accelerated Reduction of Maternal Mortality in Africa (CARMMA) (Sidley). This is an African Union initiative aimed at decreasing maternal and infant mortality rates.
The ministry of health has increased immunization programs for children receiving their first vaccines. The objective is to safeguard children against infectious diseases. The government has also intensified deworming in schools and monitors growth of children in schools.
The health care system in South Africa faces human resource shortage. Health Care cites factors such as; undesirable work environment, poor distribution of health workers and global skill imbalances among others as the cause (Health Care).
According to PBS Newshour poor leadership is noted in resource distribution in both private and government run health care facilities (PBS Newshour).
Also, migration of health care workers as also posed a serious challenge to South Africa’s health facilities. This is attributed to factors such as lack of clear posts in the public sector, workload in the public sector, working conditions, personal safety, workplace security and HIV/AIDS among others.
Major health establishments in the country have embraced the power of technology in the dissemination of health services. Leading hospitals have rolled out mobile health technology.
This technology has helped improve access to health whereas reducing burdens on health systems. Mobile health technology uses ordinary cellphones as they are popular with most people.
The government has stepped up initiatives to include aspects such as cell life project. This will allow HIV testing campaign using donated phones and patient data collection.
Health Care cites that digital radiography is on the rise. The technology is primarily used in leading teaching hospitals (Health Care).
Response to the Challenges
Despite the challenges being faced in the health care system, the government has responded with far reaching reform strategies. These strategies have aimed at restructuring the healthcare system. One of the strategies being adopted is fast tracking the implementation of a National Health Insurance Scheme (Sidley). This plan is intended to cover all South Africans.
Similarly, the government in collaboration with the NGOs have stepped up campaign against HIV, injury TB and other non-communicable illnesses. Health System Trust note that the government is also improving efficiency in human resource management at government hospitals and strengthening coordination between private and public health care sectors (Health System Trust).
The State has deployed medical personnel in schools and at grassroots levels. This is aimed at strengthening access of health care across the country.
Also, the government has been drumming in cost regulation with a view of making healthcare affordable and accessible to all population.
Allianz. Healthcare in South Africa 2012. Web.
Health Care. Health care in South Africa 2012. Web.
Health System Trust. A leading Resource on Health Systems and Primary Health Care in Southern Africa 2011. Web.
Human Rights Watch. South Africa: Failing Maternity Care 2011. Web.
PBS Newshour. South Africa’s Health System and Challenges 2009. Web.
PNHP. International Health Systems 2010, Web.
Sidley, Pat. South Africa’s shattered healthcare dreams 2012. Web.
Simjee, Fathima. South Africa: Primary Healthcare Revolution 2012. Web.
WHO. Epidemiological Fact Sheet on HIV and AIDS 2008. Web.