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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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Listed:
  • 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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    Citations

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    Cited by:

    1. Steven F Koch & Naomi Setshegetso, 2020. "Catastrophic health expenditures arising from out-of-pocket payments: Evidence from South African income and expenditure surveys," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-14, August.
    2. Steven F. Koch & Naomi Setshegetso, 2021. "Progressivity of out-of-pocket payments and its determinants decomposed over time," Development Southern Africa, Taylor & Francis Journals, vol. 38(5), pages 731-749, September.
    3. Morné Oosthuizen, 2019. "Inequality and the generational economy: Race-disaggregated National Transfer Accounts for South Africa, 2015," WIDER Working Paper Series wp-2019-24, World Institute for Development Economic Research (UNU-WIDER).
    4. Laura Rossouw, 2015. "Poor Health Reporting: Do Poor South Africans Underestimate Their Health Needs?," WIDER Working Paper Series wp-2015-027, World Institute for Development Economic Research (UNU-WIDER).
    5. Zoë 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.
    6. Laura Rossouw, 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).
    7. Bell, Griffin J. & Ncayiyana, Jabulani & Sholomon, Ari & Goel, Varun & Zuma, Khangelani & Emch, Michael, 2022. "Race, place, and HIV: The legacies of apartheid and racist policy in South Africa," Social Science & Medicine, Elsevier, vol. 296(C).
    8. Ahmed Shoukry Rashad & Mesbah Fathy Sharaf, 2015. "Who Benefits from Public Healthcare Subsidies in Egypt?," Social Sciences, MDPI, vol. 4(4), pages 1-15, November.
    9. 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.

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