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


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


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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    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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