oa South African Health Review - Health care financing : core health issues

Volume 2006 Number 1
  • ISSN : 1025-1715



Public sector health care funding continues to stabilise, with provincial expenditure growing by 5.6% annually above inflation (i.e. real terms) from 2002/03 to 2008/09. The main areas which have benefited from funding growth are primary health care (8.5% annually), HIV and related illnesses (30.1%), infrastructure (14.3%) and emergency medical services (14.3% annually). With the exception of capital expenditure, hospital funding, particularly for central hospitals, has been constrained for a decade. Spending in under-resourced provinces such as Limpopo and Mpumalanga is growing strongly.

Improved funding has supported an increase in primary care visits by 20 million since 2000 and public sector health personnel numbers have recovered by almost 20 000over the past two years to reach 235 000. However despite various funding, service and public health improvements, mortality is increasing largely driven by the HIV epidemic and resultant TB. Greater attention to improving effectiveness and outcomes is required.
Private medical scheme beneficiary numbers increased marginally, by 2.7% in 2005. This is associated with lower than usual contribution increases, given the high solvency margins that have now been achieved by schemes.

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