South Africa: exploring and understanding how and why universal health coverage policy implementation gaps come about

South Africa is known for its progressive constitution, human rights record and efforts in ensuring its citizens’ access to quality health care. One recent progressive undertaking by the South African Government is the pursuit of universal health coverage (UHC). For policies to be effective, integration with primary health care and successful implementation of financing reforms are needed. The primary health care system in sub-Saharan Africa is nurse-led, the involvement of nurses at the frontline in policy development is fundamental for successful health reform implementation. The trust in the government to efficiently and effectively manage the health fund is a glaring challenge, against the backdrop of a flourishing and strong private health care sector. Leadership, time, context, resources for health and the reforms themselves are linked and interact. The three streams - policy, problem and political - have already collided and the policy window, in our view, is still open. South Africa has the potential to achieve health for all.