Health System in South Africa

This document provides an overview of the health system in South Africa, including the provision of primary care services by the state and the role of private and public sectors. It discusses major health issues such as tuberculosis, obesity, and suicide rates. The document also explores the historical developments in the country's healthcare system and analyzes its performance in key health indicators.

Health System in South
Africa

Table of Contents
SECTION A.....................................................................................................................................1
SECTION B.....................................................................................................................................2
SECTION C.....................................................................................................................................4
REFERENCES................................................................................................................................7

Table of Figures
Figure 1: South Africa Suicide Rate 2
Figure 2: Life expectancy in South Africa 4
Figure 3: Infant mortality rate in South Africa 5

SECTION A
The population of South Africa is 59,62 million. 7.8 per cent of the population comprises
of white south Africans. The status of healthcare in the country is varied. The most basic primary
health care services are provided by the state while the hi- tech services are provided by both
private and public sectors. However, there ae places where the public healthcare sector is under –
resourced.
With 450000 cases per year, Tuberculosis has become one of the serious public health
issues in South Africa. It is also a leading cause of death in the country. According to World
Health Organization, a total of 58000 people died of TB in the year 2019 (TB in South Africa -
Burden, strategic plan, key populations, 2021). 80 percent f [people dying from TB are those that
are also infected with HIV. Majority of the TB patients are those that carry a latent infection.
Only 5 per cent of the total TB patients are those that develop active TB within 18 months.
According to World Health Organization (WHO) the incidence of TB in 2019 in South Africa
was 360,000. The highest incidence was fond in KwaZulu-Natal, The Eastern Cape AND THE
WESTERN Cape. The government introduced TB testing with Genexpert that provided test
results within hours. National Strategic Plan on TB 2017- 2022 was also launched by the
government of South Africa (TB in South Africa - Burden, strategic plan, key populations, 2021)
Increased earning and rapid urbanization have acted as drivers for increased rate of
obesity in South Africa. Then western lifestyle that includes consumption of high levels of
animal fat leads to high incidence of obesity in the country. In the western Cao, 62 per cent of
women and 25 per cent of men are obese (Obesity: Is your waistline killing you?, 2020). The
prevalence of obesity is high in Black Africans in the country. The obesity is not limited to the
adult population but is also increasing in adolescents and children.
Suicide is a critical health issue that is covered under intentional injuries in the country. It
ranks at 8th number in terms of suicide rates in the world. Every year, 6000 to 8000 people
commit suicide in South Africa making it as the third greatest cause of unnatural death in the
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country. Every day, an average number of 23 people commit suicide in South Africa (Tlhabye,
2020). The suicide rates in men are three times higher as compared to women.
Figure 1: South Africa Suicide Rate
(Source: South Africa Suicide Rate 2000-2021, 2021)
As per the graph above, the rate of suicides in females is less as compared to males. Further,
the gap between the male and the female suicide rates has widened over the past 10 years as
there has been a sharp rise in the suicide rates of males.
SECTION B
Considering the history of key health events in South Africa, the colonial subjugation
period, apartheid disposition and post – apartheid period can be analyzed. There has been
widespread incidence of poverty related illnesses in the country including maternal death,
infectious diseases and malnutrition. 31 per cent of the total disability adjusted life years of the
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country are comprised of HIV/ AIDS. Another major cause of premature deaths were violence
and injuries.
The health outcomes in south Africa are worse when compared to other lower income
countries, despite it being a middle income country.
In the history, 17th century was marked by various health challenges such as epidemics of
small pox, malaria and schistosomiasis. His was the period of British colonialism. During the
years of 1910- 1948, known as the period of segregation, the key health challenges were poor
urban working and diseases such as syphilis and tuberculosis. There was a high rate of maternal
mortality and malnutrition. In the apartheid period ranging from the years 1948 to 1994, there
was a rise in the incidence of non- communicable diseases and infant and child mortality. The
population also suffered from apartheid related mental disorders. Further, in the urban areas,
there was high incidence of tuberculosis and deaths in the black and colored populations. The
post – apartheid period was characterized by burden of diseases associated with poverty such as
perinatal and maternal diseases. This period also saw a rise in the communicable as well as non
– communicable diseases. The reason behind mortality and loss of healthy years of life was
violence and injury.
During the period of the Dutch colonialism and British Colonialism, the hospital care
was provided by the colonial government and the Dutch East India Company. In the year 1807,
first health legislations were implemented. Further, the Supreme Medical Committee was
established. In response to Small pox, Public Health Act was notified. In the Mid 1800s,
hospitals were established in the major centers. Further, preventive and curative care was
separated by Public Health Amendment Act. Following this, during the period of segregation,
Union of South Africa was established and fragmentation of health services was done among the
four provinces. Further, first, Union wide Public Health Department was established and a
unitary national health service was advocated.
During the apartheid years, the black students were provided segregated medical schools.
The missionary hospitals were taken over by the state. As South Africa was increasingly isolated,
there was no effect of Alma Ata Declaration. In the year 1994, the principles of primary health
care were given importance and African National Congress Heath plan was established. The
period of Post – Apartheid Democracy was characterized by provision of free care for children
and pregnant women. A right based approach to youth sexuality was promoted. In the year 2002
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mental health Care Act was brought into action to check discrimination against users of mental
health care. Further, in the year 2004, National Health Act was passed to development healthcare
system that incorporates public and private sectors and assisted in provision of health care
services in an equitable manner.
Currently, majority of the population of South Africa access health services with the ID OF
Public Clinics and hospitals that are government run. The health care system incorporates both
the public and the private sectors. According to WHO, health care services are accessed by the
patients through District Health System of the public sector.
SECTION C
The performance of South Africa can be analyzed through various indicators. Life
expectancy in the country is 64 years. There has been an increase in the life expectancy over the
past years. in the year 2000, life expectancy was 59 years from birth.
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Figure 2: Life expectancy in South Africa
(Source: Life expectancy at birth, total (years) - South Africa, 2021)
The graph above shows the rise in the life expectancy in South Africa over the years from
1960 to 2018. From the graph it can be analyzed that there was a steep increase in the life
expectancy from the year 1960 to 1990. This was followed by a sharp decrease till the year 2005
when the life expectancy was below 54 years. following it, the line graph shown another phase of
rise in the life expectancy which rose to 64 in the year 2018. This indicates that the health of the
population in the country has improved.
In order to analyze the performance of South Arica, infant mortality rate can be studied
over a period of 10 years from 2009 to 2019.
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Figure 3: Infant mortality rate in South Africa
(Source: South Africa: Infant mortality rate from 2009 to 2019, 2021)
The above graph shows infant mortality rate in South Africa from the years 2009 to 2019.
From the graph, it can be analyzed that there has been a decline in the infant mortality rate within
the country. As opposed to 36.5 deaths per 1000 births in 2009, the current infant mortality rate
is 27.5 deaths per 1000 births. This decline indicates the improvement in the healthcare system
which has prevented infant deaths and led to a decline in the infant mortality rate.
Millennium Development Goals (MDG) comprise of targets that aim at bringing
improvements in the life of people living in poorer conditions. In order to accomplish the MDG,
South Africa introduced various institutional and legislative frameworks. However, the country
was not on track to meeting the MDGs. The situations related to the goals can be regarded as
sensitive and are characterized by weak macroeconomic performances. Major success was
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achieved in relation to the goal of achieving universal primary education. However, in the area of
improving maternal health, least progress was recorded (Africa’s Millennium Development
Goals, 2021). In this regard, 17 sustainable development goals (SDG) were adopted by all the
member states of United Nations in the year 2015. The 2030 Agenda for Sustainable
Development was adopted by South Africa. It can be analyzed that great progress has been
achieved by South Africa in the critical areas such as electricity, provision of clean water,
sanitization and health (South Africa, 2021). From this it can be analyzed that the health status of
the country has improved.
REFERENCES
Online
Africa’s Millennium Development Goals. 2021. [Online]. Available Through:
<https://www.sahistory.org.za/article/africas-millennium-development-goals>. [Accessed
on 31 March 2021].
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Life expectancy at birth, total (years) - South Africa. 2021. [Online]. Available Through:
<https://data.worldbank.org/indicator/SP.DYN.LE00.IN?
end=2018&locations=ZA&start=1960&view=chart>. [Accessed on 31 March 2021].
Obesity: Is your waistline killing you?. 2020. [Online]. Available Through:
<https://www.westerncape.gov.za/general-publication/obesity-your-waistline-killing-
you>. [Accessed on 31 March 2021].
South Africa Suicide Rate 2000-2021. 2021. [Online]. Available Through: <
https://www.macrotrends.net/countries/ZAF/south-africa/suicide-rate>. [Accessed on 30
March 2021].
South Africa. 2021. [Online]. Available Through: <
https://sustainabledevelopment.un.org/memberstates/southafrica>. [Accessed on 30
March 2021].
South Africa: Infant mortality rate from 2009 to 2019. 2021. [Online]. Available Through: <
https://www.statista.com/statistics/807744/infant-mortality-in-south-africa/>. [Accessed
on 30 March 2021].
TB in South Africa - Burden, strategic plan, key populations. 2021. [Online]. Available Through:
<https://tbfacts.org/tb-south-africa/>. [Accessed on 30 March 2021].
Tlhabye, G., 2020. Up to 23 suicides a day in SA, says Sadag. [Online]. Available Through: <
https://www.iol.co.za/pretoria-news/news/up-to-23-suicides-a-day-in-sa-says-sadag-
ac124a68-b7a3-48a6-b560-d823eb936238>. [Accessed on 30 March 2021].
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