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Brenna Marshall

Gligorije Rakocevic

Ahmed Alhashmi

Mohammed Al Khalifa

Saif Alhajry

South Africa: Weekly Report #3

Currently, South Africa boasts the highest standards of healthcare in the continent. The country has over 200 well-established private hospitals that serve only about 20% of the population explaining why the country has a two-tier health care system. Around 80% of the population access public hospitals while only 20% accesses health care services from the quality private facilities (Katuu, 2018). There is a huge gap between the two tiers as quality between the two tiers vary. This has seen a move enrolled in 2017 that aims at putting in place a national health insurance in South Africa (Katuu, 2018). This will see the government fund the various forms of healthcare accessed by the low-income earners who make up the majority.

Based on the move enrolled by the government, the type of healthcare system can now be said to be National Health Insurance Model where services are normally paid through high taxation. It was estimated that after enrolling the new move, taxation would be higher especially for the middle and higher level income earners. The healthcare costs in the country are still high due to low quality life of a majority of South African who have been found to live below the poverty level. This makes health costs remain high as the population is highly vulnerable (Katuu, 2018). When it comes to the said model, patients are normally free to choose hospitals and doctors they wish to be served by. The South African government has not been able to achieve this due to the large number of patients accessing healthcare and the limited number of healthcare professionals in the public facilities. However, it is estimated that in the next few decades, the system will catch up with those in other countries such as Japan.

The health care system in South Africa faces the same problems faced by most countries in the world, with challenges in the full implementation of the system’s building blocks. According to a statement by the Deputy President, David Mabuza, the health system requires a systemic overhaul if the healthcare system is to be pulled out of the status quo (San News, 2018). Good service entails quality, access, safety and coverage. Service delivery in South Africa is still not up to the best level in terms of quality, access, safety and coverage. In a Health Summit in October 2018, the Vice President referred to the health service delivery to be in “crisis” and one that needs urgent attention (San News, 2018).

One of the challenges causing this situation is the lack of enough workforces. There has been a general outcry from all regions in the country about the shortages of workforce in the healthcare sector, and especially in the public sector. Also, a study conducted by Mahlathi and Dlamini (2015) revealed that the healthcare sector is experiencing a gap in its information system. The national health information system does not collect and keep all the needed information to keep the health sector functional in the right way.

The healthcare sector is also facing a challenge due to poor procurement and supply chain management practices (San News, 2018). These challenges have made it impossible for the healthcare sector to have adequate pharmaceuticals and other crucial health commodities. This is despite the fact that South Africa has one of the essential medical equipment and medication lists. However, inadequate maintenance of the equipment and lack of consistent supply of medicine has prevented effective implementation of this healthcare system block.

Financing of South Africa’s healthcare sector in inequitable. Most of the GDP is consumed by the private sector, but only 16% of the populations are served by the private sector (San News, 2018). The remaining 84% of the population is served by the public sector, which spends lower GDP than the private sector. Effective leadership to coordinate the healthcare sector is lacking. Effective leadership is needed to coordinate a publicly financed health system that ensures private and public facilities provide healthcare services that are up to the standards of care.

Cooperative for Assistance and Relief Everywhere (CARE) is a worldwide movement that is dedicated to ending poverty (CARE, 2017). They believe in quick action, innovation and transformation within the world. CARE’s main goal in improving health in South Africa is to focus on sexual and reproductive health and rights, child survival, access to water and HIV and AIDS. According to CARE, by addressing sexual and reproductive health and rights everyone benefits (CARE, 2017). They have seen a decline in maternal mortality, children are healthier and incomes are increasing. Child survival is very important to monitor as well. Almost 7 million children under the age of 5 die each year because of malnutrition, poor maternal health and diseases. CARE has trained workers that educate many parents and also hand out supplies that are needed to keep children healthy (CARE, 2017). Having access to safe water is extremely important because water can “change lives”. CARE helps communities access clean water and sanitation, which reduces the risk of illness and it saves time that can be spent on activities that improve livelihoods. They address the HIV and AIDS pandemic in South Africa by offering education, support, treatment and prevention services to help affected families (CARE, 2017).

CARE has a very big team extends across that United States. They works to educate and keep advocates updated on CARE's legislative agenda. They also hold local events to raise awareness for CARE's work and help advocates build local networks to give a voice to issues in the developing world (CARE, 2017).

It appears that CARE is adequately strengthening the healthcare system in South Africa because they seem to be addressing many of the system building blocks. They are providing services to many of the residents, have a huge healthcare workforce, use lots of educational services and information as a way to prevent illness and disease, have many treatment and medical products available to those who are affected by diseases, use their funds in a way that will best help people in need and they have leaders who make sure CARE helps people in need and can continue to help those people in need for a long time. One things that could be done differently than what CARE seems to do currently is spend slightly less money on “development” and more on “public information”. As of now, they spend 56% of their funds on development and only 1.7% on public information (CARE, 2017). Based on the information provided, CARE may have a bit more success in spreading the importance of what CARE does, which can lead to even more funding and support in the long run. Having more funding and support can then lead to assisting in even more development of countries in need.

Reference

CARE. (2017). Home. [online] Available at: https://www.care.org [Accessed 2 Feb. 2019].

Katuu, S. (2018). Healthcare systems: typologies, framework models, and South Africa’s health sector. International Journal of Health Governance 23(2), 134-148.

Mahlathi, P., & Dlamini, J. (2015). Minimum data sets for human resources for health and surgical workforce in South Africa’s health system. Retrieved from https://www.who.int/workforcealliance/031616south_africa_case_studiesweb.pdf

San News. (2018). Systemic reform necessary to cure SA health system. Retrieved from https://www.sanews.gov.za/south-africa/systemic-reform-necessary-cure-sa-health-system