Are you planning to build or restructure or venture in any healthcare venture in South Africa? Looking for information about the major healthcare players in government, private diagnostic centers that are available in South Africa? Are you looking to find out which part of the cities is best to venture in or what all facilities are available and what all should be planned for new setup? In this article Hospaccx Healthcare Consultancy has mapped all on major players in terms of medical facilities and healthcare scenario of South Africa.
This is the superficial and macro level survey if you need a refined market and financial feasibility or any other study related to healthcare is required you can contact Hospaccx Healthcare business consulting Pvt. ltd on info@hhbc.in or Hospaccx.India@gmail.com or you can visit our website on www.hhbc.in
SOUTH AFRICA – HEALTHCARE SCENARIO
INTRODUCTION:
South Africa has an estimated population of 54,956,900, the majority of whom access health services through government-run public clinics and hospitals. The health system comprises the public sector (run by the government) and the private sector. The public health services are divided into primary, secondary and tertiary through health facilities that are located in and managed by the provincial departments of health. The provincial departments are thus the direct employers of health work force while the National Ministry of Health is responsible for policy development and coordination.
There is overwhelming evidence that the quality of healthcare in South Africa has been comprised by various challenges that impact negatively on healthcare quality. Improvement in quality care means fewer errors, reduced delays in care delivery, improvement in efficiency, increased market share and lower cost. Decline in quality healthcare has caused the public to lose trust in the healthcare system in South Africa. Huge efforts has been made to improve the quality of healthcare delivery in South Africa since 1994 elections, but several issues has been raised by the public regarding public institutions.
SOME OF THE ISSUES ARE DISCUSSED BELOW:-
Prolonged waiting time because of shortage of human resources:
A major weakness in sub-Saharan African health systems is inadequate human resources. Africa is said to have less than one health worker per 1000 population compared to 10 per 1000 in Europe. Barron and Padarath noted that health problems in South Africa are worsened by unequal distribution of health professionals between the private and public sectors, coupled with unequal distribution of public sector health professionals among the provinces. In a study, participants affirmed the insufficiency and inadequacy of health workers which they described as leading to physical and mental exhaustion, and in some cases to further deterioration of their medical condition.
Poor hygiene and poor infection control measures:
Public healthcare facilities exhibit numerous shortcomings such as long waiting times, poor-quality healthcare delivery, old and poorly maintained infrastructure and poor disease control and prevention practices. According to South African medical Association, most facilities have problems such as poor waste management, lack of cleanliness and poor maintenance of grounds and equipments. In a study, patients and staff confirmed that some departments had an unacceptable physical environment (e.g. dirty toilets) for delivery of quality health care.
Poor record-keeping of patients:
Poor record-keeping causes unnecessary delays for patients. Sometimes patient’s folders are missing or lost, and instead of healthcare workers explaining this to the patient, they simply let the patient wait. In worst scenarios, the medical history of the patient is lost, which can create further complications leading to incorrect diagnosis and in some cases death of the patient.
SOCIO-ECONOMIC OVERVIEW:
The economy of South Africa is the second largest in Africa, after Nigeria. As a regional manufacturing hub, it is the most industrialized hub, it is the most industrialized and diversified economy on the continent. South Africa is an upper-middle income economy – one of only eight such countries in Africa. At the end of over twelve years of international sanctions, South Africa’s GFP almost tripled to peak at $400 billion in 2011, but has since declined t roughly #386 billion in 2019. In the same period foreign exchange reserves increased from $3 billion to nearly $50 billion creating a diversified economy with a growing and sizable middle class, within two decades of ending apartheid.
South African state owned enterprises play a significant role in the country’ s economy with the government owning a share in around 700 SOEs involved in a wide array of industries. In 2016 the top five challenges to doing business in the country were inefficient government bureaucracy, restrictive labour regulations, a shortage of skilled workers, political instability, and corruption, whilst the country’s strong banking sector was rated as a strongly positive feature of the economy. The nation is among the G20, and is the only African member of the group.
HEALTH OUTCOMES IN SOUTH AFRICA:
While the patient perspective on healthcare quality is revealing it is important to measure quality of care in other ways too. For example, health outcomes such as mortality rates can be measured and reported, as can adverse events such as hospital-acquired infections.
While there are some statistics available on health outcomes, these are not consistently reported across both sectors. For example, there are reports of a large number of avoidable maternal, neonatal and child deaths in public sector, a substantial proportion of which are related to failure in the health system. Unfortunately, maternal deaths in the private sector are not assessed in the same way.
In the private sector, the three large hospital groups all publish key quality measures in their annual financial statements, albeit at a group-wide level. However, the choice of measures and the detail on how they are defined differ between the groups.
POLICY IMPLICATIONS:
Quality differentials are both a symptom of structural inequity in South African healthcare system, and an obstacle to planned health reforms. While it is essential to alleviate inequality, it is likely to be a challenging process for South Africa to bring the two sectors closer together. In particular, those with access to private care are likely to resist giving that up if quality differences between the two sectors persist. In2009, Mclntyre et al. found that individuals were willing to contribute to the public system only if they could be assured of the quality of the system. Merely purchasing care from the private sector is unlikely to be a viable solution, given the urban concentration of private facilities and, by implication, the absence of these facilities in rural areas.
If the National Health Insurance fund were to purchase care from the private sector, and quality differences were to persist, careful thought would have to be given to which patients are able to access private care. Unless this is done carefully, pluralistic purchasing is likely to raise equity concerns.
THE GROWTH OF MEDICAL TREATMENT IN SOUTH AFRICA:
South Africa has been making medical advances, with statistics showing that in 2012, between 300,000 and 350,000 tourists from all around Africa travelled to South Africa for medical treatment. In addition to shorter travel times than India, South Africa advertises the added allure of the safaris and spas.
African travelers coming to South Africa for medical treatments do so less for cost savings and more because of South Africa’s advanced infrastructure and medical technology, as well as its doctors, whose skills are on par with international standards.
For Europeans and travelers from the Americas and Asia, South Africa offers an affordable alternative for many cosmetic procedures. For example, a breast augmentation procedure that costs US$8,000 in the UK would cost about $3,600 in South Africa, according to medical tourism SA, a consultancy firm that offers total health care information for medical travelers.
American patients who pay about $12,400 for in vitro fertilization, a procedure that helps women become pregnant, can expect to pay a third of that in South Africa.
It is for this reason that the number of African medical tourists going to South Africa. While medical tourism will continue as people shop around for prices and countries view to improve their offerings, solving the health system challenges in Africa will likely reduce the amount spent on medical tourism. In turn, savings from medical tourism can be used to finance or subsidize health insurance for the poor.
NUMBER OF HEALTH CARE CENTRES AVAILABLE IN SOUTH AFRICA:
There are more than 400 public hospitals and more than 200 private hospitals. The provincial health departments manage the larger regional hospitals directly. Smaller hospitals and primary care clinics are managed at district level.
AVAILAIBLE HOSPITAL BEDS IN SOUTH AFRICA:
| Province | Public hospital beds | Private hospital beds | Total hospital beds |
| Eastern cape | 13200 | 1723 | 14923 |
| free state | 4798 | 2337 | 7135 |
| Gauteng | 16656 | 14278 | 30934 |
| KwaZulu-Natal | 22048 | 4514 | 26562 |
| Limpopo | 7745 | 600 | 8345 |
| Mpumalanga | 4745 | 1252 | 5997 |
| North west | 5132 | 1685 | 6817 |
| Northern cape | 1523 | 293 | 1816 |
| Western cape | 12241 | 4385 | 16626 |
| South Africa | 85362 | 31067 | 119155 |
POULATION IN SOUTH AFRICA:
| South Africa | Year 2018 |
| Population | 55,380,210 |
AGE STRUCTURE IN SOUTH AFRICA:
| Age structure | Male | female | % |
| 0-14 years | 7,815,651 | 7,793,261 | 28.18% |
| 15-24 years | 4,711,480 | 4,837,897 | 17.24% |
| 25-54 years | 11,782,848 | 11,503,831 | 42.05% |
| 55-64 years | 1,725,034 | 1,992,035 | 6.71% |
| 65 and above | 1,351,991 | 1,866,182 | 5.81% |
| Population growth rate | 0.97% (2018 est.) |
HEALTH INFRASTRUCTURE:
In 2015, it was estimated that vacancy rates for doctors were 56% and for the nurses was 46%. Half the population lives in rural areas, but only3% of newly qualified doctors take jobs there. All medical training takes place in the public sector but 70% of doctors go in to the private sector. 10% of medical staff is qualified in other countries. Medical student numbers have been increased by 34% in past few years.
PUBLIC HOSPITALS IN SOUTH AFRICA:
There are more than 400 public hospitals in South Africa. According to the National Health Act, section 4(3), certain healthcare services should be provided free for people who do not have medical aid. The South African healthcare system allows all nursing mothers and children less than six years to access free healthcare services in any public hospital.
PRIVATE HOSPITALS IN SOUTH AFRICA:
There are around 215 private hospitals in South Africa, with three major hospital groups accounting for 63% of private-sector beds.
TOP FIVE HOSPITALS IN SOUTH AFRICA:
- Chris Hani Baragwanath Hospital:
It is the largest hospital in Africa. It has 6,760 staff members. It is 3,400 bedded hospital and occupies 170 acres. The hospital is located in Johannesburg.
- Ethekwini Hospital and Heart Centre:
The hospital prides itself on being one of the few in the country where heart, lungs and kidney transplants are performed. It is 373 bedded hospital with four major operating theatres. There are 42 bed intensive care units. It is the only hospital that offers much needed services for Pediatric Cardiac surgery.
- Life Bay View Private Hospital:
It is a 147 bedded hospital with combination of high-quality treatment, excellent facilities and focus on personal needs. The hospital has state-of-art diagnostic and monitoring technology which includes five OTs, an intensive care unit, neonatal ICU and maternity wing.
- Busamed Gateway private hospital:
This hospital is ideally positioned to meet the growing demand for surgical services in the province. Boasting 160 beds, two ICU units, a high-care unit, and the highest standard patient accommodation in dedicated specialty unit.
- Life Rosepark Hospital:
It is a 251 bedded hospital which has an excellent reputation for quality and clinical excellence. The hospital is known for particularly for its state-of-art maternity, orthopedic, cardio and neurosurgical units.
LIST OF TOP 10 MAJOR DIAGNOSTIC CENTRES IN SOUTH AFRICA:
- National health laboratory service
- Scan for life
- Pathcare Fontana healthcare
- Lancet laboratories
- Align corrective chiropractic Durban
- Akeso crescent clinic randburg
- life Pasteur hospital-life rehabilitation centre
- Kenilworth clinic
- Cipla
- Witpoort care centre
VARIOUS DISEASES AND HEALTH SITUATION IN SOUTH AFRICA:
Based on civil registration data, statistics South Africa indicates the main causes of deaths as tuberculosis (8.8% of total deaths), influenza and pneumonia (5.2%), HIV (5.1%), cerebrovascular diseases ( 4.9%), diabetes (4.8%), other forms of heart disease (4.6%), and a hypertensive disease (3.7%). South Africa faces a quadruple burden of disease resulting from communicable diseases such as HIV/AIDS and TB; maternal and child mortality; NCDs such as hypertension and cardiovascular diseases, diabetes, cancer, mental illness and chronic lung diseases like asthma; as well as injury and trauma.
Some of the water borne diseases that pose a high risk to South Africans includes gastroenteritis, cholera, viral hepatitis, typhoid fever, and dysentery. Malaria is endemic in small areas within the provinces of Kwazulu-Natal, Limpopo and Mpumalanga.
INFANT MORTALITY RATE IN SOUTH AFRICA:
| Infant mortality rate | 2018 est. |
| Male | 33.2 deaths/1,000 live births |
| Female | 26.5 deaths/1,000 live births |
| total | 29.9 deaths/1,000 live births |
LIFE EXPECTANCY AT BIRTH IN SOUTH AFRICA:
| Life expectancy at birth | 2018 est. |
| Male | 62.7 years |
| Female | 65.6 years |
| Total | 64.1 years |
| Total infertility rate | 2.26 children born/women (2018 est.) |
| Contraceptive prevalence rate | 54.6% (2018 est.) |
| HIV/AIDS adult prevalence rate | 20.4% (2018 est.) |
| HIVE/AIDS deaths | 71,000 (2018 est.) |
CONCLUSION:
It is clear that quality improvement in the public-hospital sector is a vital part of the journey to universal coverage. Public-sector quality improvement is necessary for greater trust in the public-hospital system. Changing the financing of the system alone is likely to be insufficient to achieve universal access to quality care.
Related Team Members
