Find Health and Medical expertise in South Africa
South Africa has approximately 400 public and private hospitals, with people living in urban areas having better access to expert health care. In 2014 the government committed to building 43 new hospitals and 213 new clinics, as well as refurbishing some existing facilities, within the next five years.
There is a noticeable division between public and private health facilities, with current government policy aimed at closing the gap. Private facilities are largely aimed at middle- to high-income earners and funded through private health insurance, while public facilities are under-resourced. The private sector attracts the majority of health care professionals.
South Africa has an established pharmaceutical industry with operations spanning all stages of industry: manufacturing, wholesaling and retail. All the major global pharmaceutical names have offices in the country that act as a central base for many of their operations in the rest of the Southern African region.
South Africa’s two-tier system of public and private health care makes adequate health care inaccessible to a large number of South Africans, as public sector institutions are so stretched. Initiatives, such as free health care for children under six and for pregnant or breastfeeding mothers, were introduced in the mid-1990s as a step towards making quality care more affordable. A new scheme of National Health Insurance (NHI) is aimed at completely overhauling the health system. The aim of NHI is to improve access to quality health care services for the whole population and to provide financial protection against high health-related costs. The idea is that comprehensive health care will be provided through accredited public and private providers, including health promotion and prevention services at the community level. NHI is being phased in over a 14-year time frame, which started in 2012, and will eventually cover all South Africans.
Communicable diseases along with maternal, perinatal and nutritional conditions accounted for an estimated 48% of all mortality in South Africa in 2012. The prevalence of HIV, as a percentage of the people aged 15–49 years, stood at 19.1% in 2012. HIV prevalence in South Africa has remained high in the period 2004–12. In 2012 there were 5,629 reported cases of malaria in the country. The number of confirmed cases of malaria fell by more than half overall between 2001 and 2012. The number of deaths from malaria has seen a slight overall decrease since 2000; however, this decline was not consistent and the number of deaths almost doubled in the period 2007–12. Since 1990 there has been a significant increase in estimated incidence of and estimated mortality (when mortality data excludes cases comorbid with HIV) from tuberculosis (TB). Non-communicable diseases (NCDs) accounted for an estimated 44% of all mortality in 2012. The most prevalent NCDs in South Africa are cardiovascular diseases, which accounted for 18% of total deaths across all age groups in 2012. Cancer, diabetes and non-communicable variants of respiratory diseases contributed 7%, 6% and 3% to total mortality, respectively (2012).
Commonly diagnosed mental illnesses in South Africa include depression and anxiety disorders. The country also has a high rate of mental health conditions relating to psychoactive substance misuse. The impact of HIV/AIDS in South Africa has been connected with a significant increase in medical conditions, including depression and anxiety.
Infant mortality in South Africa was 34 deaths per 1,000 live births in 2014, with an under-five mortality rate of 44 deaths per 1,000 live births in 2012. The country’s under-five mortality rate increased from around 60 deaths to 80 per 1,000 live births between 1990 and 2003. The decline in under-five mortality in the period 2004–13 has resulted in the lowest rate in more than 20 years, 44 per 1,000 live births. While this decline is encouraging, the under-five mortality rate is not yet in line with the country’s target of 20 deaths per 1,000 live births as defined by Millennium Development Goal 4 (MDG 4).
Around half of all health care in South Africa (52%) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 8.8% of GDP in 2012, of which 48% (US$309 per capita) was covered by the government.
South Africa’s public spending on health was 4.3% of GDP in 2013. In the most recent survey, conducted between 1997 and 2012, there were 76 doctors, and 490 nurses and midwives per 100,000 people. Additionally, in the period 2007–12, 91% of births were attended by qualified health staff and in 2013, 66% of one-year-olds were immunised with one dose of measles. In 2014, 93% of people were using an improved drinking water source and 66% had access to adequate sanitation facilities. The most recent survey, conducted in the period 2000–11, reports that South Africa has 37 pharmaceutical personnel per 100,000 people.
South Africa has signed and ratified the International Covenant on Economic, Social and Cultural Rights, which includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination.