National Health Context

National health picture

The national health budget increased from R192 billion in 2017, to R205 billion in 2018, constituting 12% of the total national budget. More than R90 billion was allocated to district health services and R73 billion was allocated to central and provincial hospital services.  According to Statistics South Africa’s (Stats SA) General Household Survey 2016, only 17 in 100 South Africans have medical insurance. As many as 45 million South Africans are dependent on public healthcare. 

The same survey found that the Northern Cape spent the most on healthcare in 2015/16, at R 4082.00 per person, followed by the Western Cape and Free State. Limpopo, the North West and Mpumalanga all spent below R 3000.00 per person.   The Office of Health Standards Compliance inspected 696 public hospitals, clinics and community health centres in the 2016/17 financial year. According to its Annual Inspection Report, released in June 2018‚ only five health establishments were found to be compliant; 168 were conditionally compliant with serious concerns; 240 were non-compliant; and a shocking 172 were critically non-compliant.  

According to consulting firm, Econex, in 2013 South Africa had an average ratio of 60 doctors per 100 000 people, compared with the global average of 152 doctors per 100 000 people.   Tuberculosis, diabetes and heart conditions remain the top causes of natural death in South Africa, according to Stats SA’s latest Mortality and causes of death in South Africa report.   The Fifth South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2017, conducted by the Human Sciences Research Council, reported that approximately 7.9 million people were living with HIV in South Africa in 2017. HIV prevalence among adults aged 15 to 49 years was 20%; among females was 20% and among males was 15%. Among people living with HIV aged 15 to 64 years, 71% were on antiretrovirals.  

According to research from the Institute for Race Relations, new HIV/Aids infections declined by 39% countrywide between 2009 and 2016, from 437 705 to 266 931.   The South African Demographic Health Survey 2016 reported that 27% of children under five were stunted – a statistic which has remained largely unchanged in the last 20 years. Affected children experience chronic malnutrition which influences physical growth, brain development, the ability to function at school and in a work environment, and increases the risk of obesity, heart disease and diabetes in adulthood, with an estimated cost of R62 billion per year, according to the South African Child Gauge 2017.

*Information gathered from the Trialogue Business in Society Handbook 2018, Pg 97