The financing and sustainability of free primary health care in South Africa

M.Com. (Economics)Access to health care is a basic human right in South Africa. Primary health care is viewed by the South African government as the means to improving access to health care in the country. The concept of primary health care is based on the importance of first contact with a primary health worker. The Department of Health introduced free primary health care because it believes that the most significant barrier to access to health care is poverty. When a service is provided for free there is no income generated from user fees and the issue of funding becomes very important. This study performs an analysis of the free primary health care programme in South Africa and how it is financed. An important feature that characterizes South Africa is high inequality which is reflected in the high level ofpreventable diseases as well as high incidents of chronic diseases. The implementation of free primary health care has led to improved access to health care and somewhat improved the health status of the South African population. In order to address the inequalities in the health sector there must be funding targeted towards the needs of the poor. Government's fiscal policy places limits on the expansion of public expenditure, which poses a strain on resources flowing to the health sector. In addition to that there has not been a significant shift of funds from higher levels of care to primary health care. The funding issue will need to be urgently resolved for primary health care to be sustainable..