Business Monitor International

Understanding South Africa's Regional Healthcare Markets

Published 14 March 2014

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Understanding South Africa's Regional Healthcare Markets

BMI View: Th e majority of the South African population reside s in the north east and south w est parts of the country. While the number of hospitals in each province tends to be roughly proportional to regional population figures , the degree of public and private healthcare provision varies depending on a province 's level of economic development (gross state product per capita) and , to some extent, the burden of HIV/AIDS and other infectious diseases . This report gives a picture of healthcare trends and forecasts within South Africa ' s nine provinces.

More than half of South Africa's population resides within the north east provinces of Gauteng and Kwa-Zulu Natal and the coastal province of the Eastern Cape. As such these regions have the largest number of hospitals, a pattern we observe across the country. Gauteng is the most densely populated province, and as the business hub of the country, boasts the highest absolute and per capita gross state product. Gauteng is bordered by provinces whose economies are weaker and are driven by agriculture and mining, and tends to attract those seeking commercial employment opportunities and higher incomes. Healthcare infrastructure is highly concentrated in this densely populated area and, correspondingly, the increase in population and the rise in incomes have made the private sector viable, providing some relief to public sector hospitals. Meanwhile, in the south west of the country the Western Cape follows in second place as the next wealthiest province. Although attractive, it does not attract as much inward migration, as it is bordered by the sparsely populated Northern Cape and the economically underdeveloped Eastern Cape.

We note that government healthcare expenditure is likely to be highest in the Eastern Cape, where hospital provision is greatest and personal spending power lowest. On the other hand, government provision for healthcare is somewhat lacking in the wealthiest...

With a new National Health Insurance system being implemented, what will the effects be on the under-resourced public sector and the expensive private sector? And what changes can be seen at the varied regional and provincial levels?

Any assessment of South Africa must consider the potential variations across Eastern Cape, Free State, Gauteng, KwaZulu-Natal, Limpopo, Mpumalanga, North West, Northern Cape and Western Cape, as well as down to provincial levels. Geographical diversity will impact on medical services and this report answers those key questions that will arise:

  • How is the population distributed? How is healthcare divided?
  • Health funding: How is the Government expenditure vs. private expenditure indicated?
  • What are the long-term macroeconomic forecasts?
  • Which regions are better provided for and which still need investment?

Identifying opportunities in South Africa’s growing health economy requires detailed knowledge of the economic performance and health infrastructure at a regional and province level. Being able to see that in the context of neighboring provinces and the national picture brings focus to areas of opportunity.

Rich in statistics and charts, this newly updated report from Espicom, Understanding South Africa’s Regional Healthcare  Markets  is part of a series on major markets; taking you further into understanding the growing regional health environments.

Our valued expert views from our analysts provide you with key opinions not found anywhere else:

A two-tiered healthcare system currently operates in South Africa, compromised of the under-resourced public sector (which supports the majority of the population) and expensive private sector (which attracts the wealthy minority). This divergence is attributed mainly to disparity in the provision and standard of healthcare services, infrastructure and resource allocation between the public and private sectors.Against this backdrop,  despite high expenditure on healthcare (8.8% of GDP in 2012), health outcomes remain poor in comparison with similar middle-income countries. To abolish this inequality, the African National Congress (ANC) is in the process of implementing National Health Insurance (NHI) to realize its goal of universal healthcare in the country, aiming to provide the population with the required health services while making financial contributions according to an individual’s ability to pay. This report gives a picture of the current state of regional healthcare systems, trends and forecasts within the nine provinces of South Africa.

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