SOPH-UWC’s Comments to the South African National Treasury on the Proposed Sugary Drinks Tax29 January 2017
Vancouver Statement for the Fourth Global Symposium on Health Systems Research Vancouver, Canada 18 November 201629 January 2017
Case Study of PHC in South Africa: progress but still some way to go
South Africa is a middle-income country of around 55 million people, two thirds of whom live in urban areas.
South Africa is a middle-income country of around 55 million people, two thirds of whom live in urban areas. Public primary health care (PHC) is provided through a nurse-based, doctor-supported infrastructure of over 3500 clinics and community health centres, available within 5 kms to more than 90% of the population, and free at the point of use. It is supported by an emerging system of community-based outreach teams consisting of community health workers. This PHC system has enabled access to antiretroviral therapy (ART) to more than 3 million people, and reduced mother-to-child transmission of HIV to 1.5%. In parallel, primary care is also provided by private, fee-for-service general practitioners as well as traditional healers.
PHC progress has been achieved in South Africa despite a backdrop of significant health system, social and economic challenges. South Africa has one of the highest levels of income inequality in the world, with a Gini co-efficient of 0.69. In the health sector, these inequalities are visible as stark differences between two realities: A well-resourced, insurance-based private sector serving only 16% of the population, but consuming half the total funds flowing through the health sector in the country; and the tax-funded, public health system providing care for the remaining 84%.