Healthcare Market Insights for South Africa

Healthcare System

South Africa currently runs a two-tiered healthcare system, comprising the public and the smaller, but fast-growing private sector. The country spent 9.0% of its GDP on healthcare in 2017 - higher than the 5% the World Health Organisation (WHO) recommends for a country of its socio-economic status. However, despite this high expenditure, health outcomes remain poor in comparison with similar middle-income countries. This poor performance is attributed mainly to the inequities between the public and private sectors.

According to a 2018 report by South Africa’s Competition Commission, when it comes to the private healthcare sector, South Africa faces a problem of over-servicing and oversupplying. The report gives three examples to illustrate this:

  • Firstly, hospital admission rates are extremely high. South Africa’s rate was higher than all but two of 17 other OECD countries used as comparisons in the report.
  • The Commission also looked at seven different surgical procedures. In four, South Africa had the highest usage rates.
  • Lastly, the Commission looked at the number of people that get admitted to intensive care units. It found that South Africa had higher admission rates than eight other countries with comparable published data.

Health Insurance


In order to obtain universal healthcare in the country, the African National Congress is in the process of implementing National Health Insurance (NHI), which aims to provide all South Africans with health services they need while making financial contributions according to their ability to pay. In August 2018, South Africa’s Department of Health announced that the new National Health Insurance (NHI) plan would guarantee the provision of quality healthcare for more than 60% of the population unable to afford medical aid cover.

On 26th July 2019, the Government released the NHI Bill creating an NHI Fund paves the way for a comprehensive overhaul of South Africa’s health system.