South Africa
South Africa has mixed public and private healthcare systems. In the public sector, as with many public healthcare systems, medical services are subject to long wait times and quality is poorer, thanks to deficits in funding and staffing. However, this system still serves 80% of the population in South Africa. Meanwhile, 79% of doctors in South Africa work in the private sector, which serves the remaining 20% who can afford to pay for healthcare. Medical services in the private sector are not subject to the same wait times or poor quality, given the higher concentration of doctors and funding.
Healthcare Spending
Healthcare spending is moderately low in South Africa, compared to the rest of the world. The country spent 8.8% of the national GDP on healthcare costs in 2012, ranking South Africa 54th in the world on the percentage spent. However, since GDP is low in South Africa, total spending amounted to only $898 USD per person. For instance, Finland spends only 0.4% more of its GDP, but total spending per capita is $3,545 USD. However, across the African continent, where healthcare spending is extremely low, the total amount spent per capita by South Africa is close to nine times the regional average.
Availability of Care
Similarly, concentrations of doctors and nurses are much higher in South Africa when compared to the region, but low compared to the rest of the world. There are only 0.78 doctors per every one thousand people, a ratio of 1:1,282 doctors to people. Figures for nurses and midwives are slightly better, with approximately 4.9 nurses and midwives per one thousand people, a ratio of 1:204. Availability for hospital beds is also low, with 2.8 beds per one thousand people.
Life Expectancy & Mortality
South African life expectancy is among the lowest in the world. In 2014, the CIA World Factbook estimated that average life expectancy was 50.52 years for males and 48.58 years for females, for a combined average of 49.56 years. South Africa ranks 222nd in the world on longevity; life expectancy is lower only in Chad. In addition, South Africa is one of the only countries in the world where women have a lower life expectancy than men. Research has suggested that HIV/AIDS deaths are responsible for the drastic decrease in South African life expectancy, which was reported as 62 years in 1990.
Other Issues
Changes in health policy and delivery in recent years have initiated a more hopeful future for the South African healthcare system. Currently, policy changes have been made with respect to the four most concerning epidemics across the country: tuberculosis and HIV/AIDS; accidents, violence, and injury; mental health and chronic illnesses; and child and neonatal health. In fighting HIV, various education campaigns targeting prevention have attracted attention. Child mortality rates as a result of HIV are no longer as severe as they once were. In addition, a large program of antiretroviral therapy has been introduced. As with the other targeted health problems however, it will take some time before changes in policy and delivery are fully realized.