Healthcare in South Africa

Healthcare in South Africa is very much divided along socioeconomic lines. A massive quality gap exists between the private and public sectors, and, in practice, these systems cater to different populations. The public healthcare system mainly serves a lower income bracket, while those who can afford it use the private healthcare system.

It's strongly recommended that expats take out health insurance and opt for treatment in private facilities, which generally provide world-class levels of care.

Public healthcare in South Africa

Much of the South African population uses the public healthcare system, which is heavily affected by a lack of resources and funding. The South African government recently announced universal healthcare under the National Health Insurance (NHI) Bill. 

Due to funding challenges, the NHI is set to take several years to implement. Currently, fees are still charged according to a patient's income and number of dependents.

Though usually manned by highly qualified professionals, public hospitals are often poorly maintained. Expats will find minimal creature comforts, and will likely come across long queues, dingy exam rooms and overworked staff members.

Useful links

• South African National Department of Health

Private healthcare in South Africa

In contrast to the public health sector, South Africa's private health sector is excellent. Most cities and towns have a good selection of clinics, hospitals and general practitioners.

The standard of treatment in South African private hospitals is some of the most highly regarded on the continent, and in the opinion of many expats, on par with that of Europe. The medical tourism industry has grown steadily, and many foreigners travel to South Africa for plastic surgery and dental work.

That said, private healthcare in South Africa comes at a price, especially for local workers. Although paying per treatment is possible, medical costs can quickly add up.

Expats should take out private health insurance to protect against the hefty bills accompanying emergency situations, repeat consultations and specialist treatment.

Health insurance in South Africa

An assortment of local medical aid providers and international health insurance companies are available to expats in South Africa.

Local providers offer various schemes and charge progressive monthly premiums. Most local health insurance providers in South Africa require claims to be pre-authorised, which requires people to keep their medical aid cards in their wallets. Some medical aid schemes will have digital cards that you can simply keep on your phone. 

Insurance plans can either be comprehensive, covering a range of services, or more basic, serving as backup in the case of an emergency. While hospital plans cover the cost of ambulance transport and hospital stays, these are essentially emergency plans which don't cover day-to-day medical expenses such as doctor consultations and treatment, dental treatments, and prescription medications.

Expats interested in getting coverage for day-to-day expenses should compare the different packages offered by local insurance providers. Alternatively, you may opt to use international insurance providers. Emergency evacuation insurance is unnecessary, as private South African facilities are adequate.

Pharmacies and medicines in South Africa

Pharmacies are readily available in urban centres and are generally well stocked, but if you're travelling to outlying rural areas for extended periods, you should pack basic medications. Those living in rural areas may need to travel to larger towns to fill prescriptions.

Health hazards in South Africa

Contrary to popular belief, malaria is not a wide-scale problem in South Africa. That said, there is a narrow high-risk area that stretches across the extreme northeast of the country along the borders with Mozambique, Eswatini (formerly Swaziland) and Zimbabwe where taking anti-malarial medication would be wise in peak season. It should be noted that the Kruger National Park is considered a moderate-risk area.

The tap water in South Africa's cities and towns is typically safe to drink and often of good quality, but caution should be exercised in rural areas.

Though decreasing, prevalence rates remain high for HIV/AIDS, but expats who take appropriate precautions against the disease need not be concerned.

Vaccinations for South Africa

There are several routine vaccinations recommended for travelling to South Africa, including for measles-mumps-rubella (MMR), polio, and hepatitis B. There has been an increase in measles cases in South Africa, so a booster shot is essential for those who are already vaccinated. 

If you're from a country where Yellow Fever is endemic, a vaccination against the disease will be required. The rabies, influenza, and Covid-19 are recommended. It's recommended that older adults who have certain medical conditions like asthma get a pneumonia vaccine.

Emergency services in South Africa

Public ambulance services in South Africa are run provincially, and standards and response times vary. Although technically separate entities, fire and ambulance services cooperate closely. The government employs emergency paramedics and often work with volunteers, especially in outlying areas.

The South African Red Cross and St John's Ambulance are run by volunteers and supplement the national system. Two private, profit-making national ambulance services, ER24 and Netcare 911, are also contacted via their own emergency numbers. Health insurance providers will have a preferred ambulance service and provide their customers with the corresponding contact numbers.

Ambulance contact details

• Public ambulance services: 10177
• Netcare 911: 082 911
• ER24: 084 124