South African Healthcare System.ppt

South African Healthcare System Elizabeth Chester Lecture 15 HSCI 609 Comparative International Health Systems South Africa Republic of South Africa Capital: Pretoria Style of Government: Republic Administrative divisions: 9 provinces Middle-income, emerging market, vast natural resources, high unemployment Population Statistics 44.1 million (2006, CIA) Poverty levels: 71% rural/ 50% urban Unemployment: 38% People living with AIDS: 23.5% More than 6 million HIV/AIDS deaths expected by 2012 Macro Health Statistics Total health expenditure as % GDP: 8.4 (2003) Life expectancy: 43.25 male/ 42.19 female Infant Mortality: 60.6 per 1000 Population 65 yrs: 5.3% The impact of AIDS cannot be ignored Higher infant mortality Lower life expectancy Negative population growth rate (-0.4%) Organization Decentralized and participatory at the lowest levels Department of Health—Federal level Sets user fee schedule, nation legislation (i.e. free health care for certain groups: women, children, AIDS, TB) Provincial Departments of Health— maintain operational decision-making authority in health care delivery and finance provide hospital and primary healthcare Further divisions into Health Regions Districts Funding the System 18% of population has private insurance Private health expenditures per person are 7.1 times higher than public health expenditures per person (2003) (.za) Federal gov’t contributes 40% of total health expenditures for 80% of population Public health consumes 11% of federal budget From the South Africa home page “Aids and other poverty-related diseases like tuberculosis and cholera are placing a tremendous strain on South Africas health care system, eroding attempts to improve the general health of South Africas people.” Accessed 26 May 2006 /ess_info/sa_glance/health/923087.htm Social and Historical Impact on Health and the Health System Under Apartheid hospitals were assigned to particular racial groups concentrated in white areas. When Apartheid ende