HealthCare In South Africa
In South Africa, private and public health systems exist in parallel. The public system serves the vast majority of the population. Authority and service delivery are divided between the national Department of Health, provincial health departments, and municipal health departments.
In 2017, South Africa spent 8.1% of GDP on health care, or US$499.2 per capita. Of that, approximately 42% was government expenditure.About 79% of doctors work in the private sector.
History Of Healthcare In South Africa
The first hospital in South Africa, a temporary tent to care for sick sailors of the Dutch East India Company (the Company) afflicted by diseases such as typhoid and scurvy, was started at the Cape of Good Hope in 1652.
A permanent hospital was completed in 1656. Initially, convalescent soldiers provided to others whatever care they could, but around 1700 the first Binnenmoeder (Dutch for matron) and Siekenvader (male nurse/supervisor) were appointed in order to ensure cleanliness in the hospital, and to supervise bedside attendants.
The Company subsequently employed Sworn Midwives from Holland, who practiced midwifery and also trained and examined local women who wished to become midwives. Some of the early trainees at the Cape were freed Malay and coloured slaves.
From 1807, other hospitals were built in order to meet the increasing demand for healthcare. The first hospitals in the Eastern Cape were founded in Port Elizabeth, King Williamstown, Grahamstown and Queenstown.
Health Infrastructure In South Africa
In 2013, it was estimated that vacancy rates for doctors were 56% and for nurses 46%. Half the population lives in rural areas, but only 3% of newly qualified doctors take jobs there. All medical training takes place in the public sector but 70% of doctors go into the private sector. 10% of medical staff are qualified in other countries. Medical student numbers increased by 34% between 2000 and 2012.
National Health Insurance In South Africa
The current government is working to establish a national health insurance (NHI) system out of concerns for discrepancies within the national health care system, such as unequal access to healthcare amongst different socio-economic groups. Although the details and outline of the proposal have yet to be released, it seeks to find ways to make health care more available to those who currently cannot afford it or whose situation prevents them from attaining the services they need.
There is a discrepancy between money spent in the private sector which serves the wealthy (about US$1500 per head per year) and that spent in the public sector (about US$150 per head per year) which serves about 84% of the population. About 16% of the population have private health insurance.
The total public funding for healthcare in 2019 was R222.6 billion (broken down to R98.2bn for District Health Services, R43.1bn for Central hospital services, R36.7bn for Provincial hospital services, R35.6bn for other health services and R8.8bn for facilities management & maintenance). The NHI scheme is expected to require expenditure of about R336 billion.
How Many Doctors In South Africa
According to Comrie, South Africa has 28,000 registered doctors – not all practising – and produces around 2,500 doctors annually.