Policy Brief: How pro-poor is the South African Health System?
Stellenbosch Working Paper Series No. WP06/2007Publication date: 2007
Author(s):
This chapter investigates how effective recent changes in the South African public health care system have been in transforming the inequitable system inherited from the apartheid-era government. How has post-apartheid budget reallocations, decentralisation, the elimination of primary health care user fees and expansion of the network of clinics changed the incidence of spending and the quality of services provided? Have these changes benefited the poor? The results from research conducted indicate that the distribution of health spending on hospitals and clinics is driven by utilisation patterns. The decision by the affluent to opt-out of the public health system means that the most affluent receive a dramatically smaller proportion of the budget than the rest. There is, however, not much evidence of pro-poor targeting for the rest of the income distribution. However, in terms of spending equity, South Africa compares well with other developing countries. It is clear that health services have become more accessible and more affordable for the poor. Yet, the government is still far from achieving universal access and the desired degree of equity. In addition, there are concerns regarding the quality of services provided by public sector clinics and hospitals. Dissatisfaction among users of public sector services has increased and complaints include long waiting times, staff rudeness and problems with the availability of drugs.
JEL Classification:H51, I18
Keywords:Fiscal incidence, South Africa, health
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16 May 2025 Trade truce lifts markets, SA braces for winter load-shedding and budget reckoningThis week, data showed that South Africa’s unemployment rate rose in 2025Q1, with net job losses compared to 2024Q4. Meanwhile, mining output improved in March but declined overall for the quarter. In the US, inflation eased to a four-year low, while Germany’s economic sentiment rebounded sharply. The UK economy posted impressive growth in Q1; however,...
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Upcoming Seminars
Monday 26 May 202512:00-13:00
Prof Simon Franklin: Queen Mary University In London
Topic: "No Place Like Home? The Causal Effect of Housing Clearances in Central Addis Ababa"
12:00-13:00
Dr Dawie van Lill: South African Reserve Bank & Stellenbosch University
Topic: "TBC"
12:00-13:00
Prof Hylton Hollander: University Of Cape Town
Topic: "TBC"
BER Weekly
16 May 2025 Trade truce lifts markets, SA braces for winter load-shedding and budget reckoningThis week, data showed that South Africa’s unemployment rate rose in 2025Q1, with net job losses compared to 2024Q4. Meanwhile, mining output improved in March but declined overall for the quarter. In the US, inflation eased to a four-year low, while Germany’s economic sentiment rebounded sharply. The UK economy posted impressive growth in Q1; however,...
Read the full issue