Excluded Lives: Migrant Status and Access to Healthcare in South Africa

While South Africa’s Constitution guarantees the right to healthcare for all who live in the country, there are still inequities that affect vulnerable groups. Based on migration status, this paper examines how discrimination intersects with structural and institutional practices to produce unequal access to healthcare services for black foreign migrants and asylum seekers in South Africa. Desk reviews of policy frameworks, relevant academic literature, and documented case reports were used to analyze the disconnect that exists in South Africa’s rights-based legal commitments and the lived realities of foreigners in the country. Adopting a theoretical framework that integrates structural violence, intersectionality, and bureaucratic discretion, the findings are discussed by conceptualizing discrimination as a structural and interpersonal determinant of health. The findings suggest that the experiences of foreign nationals regarding access to healthcare services are not incidental but embedded within complex socio-political dynamics of scarce resources, institutional practices, and institutional ambiguity. The consequences of these inequities involve delayed care-seeking and increased vulnerability to preventable diseases among black immigrants, with a broader public health risk. Drawing from the study, policy clarity is recommended, and the strengthening of accountability mechanisms to ensure equitable access to healthcare in the country.