In 2015 the infant mortality under-five rate in the Republic of South Africa was 40.5 for every 1000 births, a 6.5 decrease from 2011. While infant mortality has decreased in recent years, the Government of the South Africa continues to take important steps to provide access to health care for all citizens. In 2011 it introduced the National Health Insurance (NHI) pilot scheme designed to provide all citizens and residents of South Africa with essential health care regardless of employment status or ability to contribute to the scheme. The NHI will remain in pilot phase for the first 14 years of implementation with the first five years focused on building processes and preparations for increased usage. After 2014 the NHI will be established as an autonomous public entity reporting to Parliament as well as the Ministry of Health, which manages 4,200 pubic health facilities in the Country.
The NHI is designed to increase access to both public and private health care facilities through the scheme’s agreements with public and private hospitals and specialists. As part of the package, NHI entitles free access to full health care coverage at public clinics for all citizens and legal residents. NHI is funded through tax revenues and mandatory contributions from those with income over USD 5,450 per year. NHI is currently in pilot phase in 11 sites covering 11 million people, or about 2 per cent of the total population. The NHI’s universal coverage excludes short-term residents, but includes refugees and asylum seekers in accordance with provisions of the Refugees Act of 1998, which entitles refugees to the same basic health services and education as citizens.
The Government of the Republic of South Africa has made achievements in promoting equal access to health care since 1994. The NHI represents a continuation of this progress. The NHI has been realised through a consultative process including health care administrators and professionals, academia and civil society, and through international dialogue among countries moving toward health insurance schemes such as the NHI. Health insurance schemes such as the NHI represents a significant move toward universal coverage, creating part of a national social protection floor that is essential in promoting equality in social services.
Further Reading:
Matsotso M.P. and Fryatt R. (2013). ‘National Health Insurance: The first 18 months’. In Padarath A., English R., editors. South African Health Review 2012/13. Health Systems Trust, Durban. Accessed from https://www.health-e.org.za/wp-content/uploads/2013/04/SAHR2012_13_lowres_1.pdf PAGE 21 on December 2016.
Republic of South Africa. Department of Health (2011). National Health Insurance: Healthcare for all South Africans. Accessed from https://www.health-e.org.za/wp-content/uploads/2015/12/National-Health-Insurance-for-South-Africa-White-Paper.pdf on December 2016.