Health Systems Philosophy

The South African health system is fragmented, there is a public health system which is underfunded which serves a large majority of the population and a private health system which serves a minority of the population but has plenty of resources (Day et al., 2021).  I credit the source of this fragmentation to Apartheid, when the then ruling government would divide health system according to race. There was the formation of Bantustans which had their own departments of health specifically for people with African heritage.  Due to the intentional lack of resources healthcare delivery in Bantustans was not up to standard (Maphumulo and Bhengu, 2019). Simultaneously, the Apartheid government ensured that hospitals had accessibility to the need resources (Solomon et al., 2020). Additionally, the apartheid government encouraged the development of the private health (Whyle and Olivier, 2023). I believe that due to the continued fragmentation there is a lack of equity in the care that people for different socioeconomic statuses are able to access. Consequently, I believe that a universal health system is necessary. A universal health system would ensure that all people have access to the care they need without financial barriers (Fisher et al., 2022).

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However, there are many problems that need to be addressed in South Africa before a UHC such as the need for human resources in public hospitals, infrastructure development, the establishment of an honest and responsible leadership and government, etc. When the government is addressing these problems during the monitoring and evaluation stage, Health System Scientist should be incorporated. Broad health systems thinking coupled with the knowledge that experts have about components of health systems, would help illuminate the areas where strategies fail.