A Health Care System Divided

How Apartheid's Lingering Effects Harm South African Maternal Health

Abstract

From 1948 to 1994 South Africa was under the repressive Apartheid regime. Among many other actions taken to ensure white South Africans maintained power, the regime put in place discriminatory health policies that deprived black South Africans of equitable health care. As the apartheid era came to an end in 1994, the newly elected African National Congress sought to prioritize equity by creating the National Health Act. Despite this, major disparities in health care persist. Te purpose of this case study is to shed light on such disparities in the South African health system by using maternal health as a proxy. Mothers living in rural areas continually contend with barriers to access, afordability and availability. Rural areas account for about 46% of South Africa’s population but service provision is only 12% and 19% of the nation’s doctors and nurses respectively. The lack of medical professionals in these areas make it difcult for mothers to receive vital procedures, such as emergency obstetric care, without traveling unmanageable distances. Moreover, high transport costs ofset progress made by the elimination of out-of-pocket expenses and continues to make the cost of accessing care prohibitively expensive, accounting at times for 51.4% of household income.