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Have public health spending and access in South Africa become more equitable since the end of apartheid?

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  • Ronelle Burger
  • Caryn Bredenkamp
  • Christelle Grobler
  • Servaas van der Berg

Abstract

This study investigates whether health spending and access to services in South Africa have become more or less pro-poor over time. We find that over the post-apartheid period health spending has become significantly more pro-poor. In addition to the rising share of the health budget allocated to public clinics, there has been an increase in the share of public clinic and hospital spending going to the poor and a rising share of the health budget allocated to public clinics. In addition, between 1993 and 2008 there were improvements in both financial access to public health services -- as measured by the incidence of catastrophic costs -- and physical access to public health facilities -- as measured by reduced travel time. Given that substantial progress has been made with fiscal equity and access to health, problems that users complain about -- rude staff, long queues and lack of medicine -- have moved higher on the policy agenda.

Suggested Citation

  • Ronelle Burger & Caryn Bredenkamp & Christelle Grobler & Servaas van der Berg, 2012. "Have public health spending and access in South Africa become more equitable since the end of apartheid?," Development Southern Africa, Taylor & Francis Journals, vol. 29(5), pages 681-703, December.
  • Handle: RePEc:taf:deveza:v:29:y:2012:i:5:p:681-703 DOI: 10.1080/0376835X.2012.730971
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    References listed on IDEAS

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    1. Thurlow, James, 2006. "Has trade liberalization in South Africa affected men and women differently?:," DSGD discussion papers 36, International Food Policy Research Institute (IFPRI).
    2. Murray Leibbrandt & James Levinsohn & Justin McCrary, 2005. "Incomes in South Africa since the fall of Apartheid," Working Papers 536, Research Seminar in International Economics, University of Michigan.
    3. Murray Leibbrandt & Laura Poswell & Pranushka & Matthew Welch & Ingrid Woolard, 2004. "Measuring recent changes in South African inequality and poverty using 1996 and 2001 census data," SALDRU/CSSR Working Papers 084, Southern Africa Labour and Development Research Unit, University of Cape Town.
    4. Ardington, Cally & Lam, David & Leibbrandt, Murray & Welch, Matthew, 2006. "The sensitivity to key data imputations of recent estimates of income poverty and inequality in South Africa," Economic Modelling, Elsevier, vol. 23(5), pages 822-835, September.
    5. Paula Armstrong & Bongisa Lekezwa & Krige Siebrits, 2008. "Poverty in South Africa: A profile based on recent household surveys," Working Papers 04/2008, Stellenbosch University, Department of Economics.
    6. Servaas Van der berg & Megan Louw & Derek Yu, 2008. "Post-Transition Poverty Trends Based On An Alternative Data Source," South African Journal of Economics, Economic Society of South Africa, vol. 76(1), pages 58-76, March.
    7. Haroon Bhorat & Carlene van der Westhuizen & Pranushka Naidoo, 2006. "Shifts in Non-Income Welfare in South Africa: 1993-2004," Working Papers 06108, University of Cape Town, Development Policy Research Unit.
    8. Ranjan Ray, 2000. "Poverty and expenditure pattern of households in Pakistan and South Africa: a comparative study," Journal of International Development, John Wiley & Sons, Ltd., pages 241-256.
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    Cited by:

    1. Wagstaff, Adam & Bilger, Marcel & Buisman, Leander R. & Bredenkamp, Caryn, 2014. "Who benefits from government health spending and why? a global assessment," Policy Research Working Paper Series 7044, The World Bank.
    2. Zoƫ McLaren & Cally Ardington & Murray Leibbrandt, 2013. "Distance as a barrier to health care access in South Africa," SALDRU Working Papers 097, Southern Africa Labour and Development Research Unit, University of Cape Town.
    3. Rossouw Laura, 2015. "Poor Health Reporting: Do Poor South Africans Underestimate Their Health Needs?," WIDER Working Paper Series 027, World Institute for Development Economic Research (UNU-WIDER).
    4. Ahmed Shoukry Rashad & Mesbah Fathy Sharaf, 2015. "Who Benefits from Public Healthcare Subsidies in Egypt?," Social Sciences, MDPI, Open Access Journal, vol. 4(4), pages 1-15, November.

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