This report is a case study of the Partnerships for Health Reform Project's empirical work on
equity in health care financing in South Africa. The study uses government-supplied data on health
spending and household survey information to analyze private and public sector health care delivery.
This paper will contribute to the larger equity study which will provide more in-depth analysis.
Section 2 of the paper presents an overview of the health sector in South Africa; Section 3 provides
basic information on government health care financing in the country; Section 4 describes the
household survey used in the analysis; and Section 5 presents the results and implications for policy.
Despite substantial economic resources relative to other African countries, South Africa suffers
substantial inequalities of health care spending and delivery and has relatively high poverty levels.
Approximately 60 percent of health care expenditure is attributable to the private sector, however
only 23 percent of the population have regular access to private sector health care in terms of
coverage by a third-party payer mechanism. Closing the gap in health care spending and access will
require policy innovations that reallocate financial and human resources, improve access to care,
especially for residents of rural area; and improve quality of primary, maternal and pre-natal care. To
make informed decisions, a more detailed analysis of the public/private health sector mix, health
sector revenue allocation, and service delivery reform is recommended.