How does the healthcare system work in South Africa?

What is the quality of healthcare in South Africa?

• Healthcare in South Africa consists of a heavily subsidized public healthcare system and a smaller but high-quality private system. Although the country offers excellent private healthcare, public healthcare faces many challenges. For example, 79% of doctors in South Africa work in the private sector.
• About 80% of the population uses the public healthcare system, while the wealthy 18-20% mainly use private healthcare. Although public healthcare is often very cheap for people on low/no income, expats still often have to pay a lot.
• Good medical care is available in urban areas, but the situation varies outside the cities.
• There is no public insurance system yet. Many treatments have to be paid for in cash.
• There are two large pharmacy chains; Clicks and DisChem. There are also many independent pharmacies. Pharmacists are generally well-trained. Hospital pharmacies are often open 24 hours a day. Availability of medicines is comparable to Western countries. Life expectancy in South Africa is on average much lower than in the West. In 2021, life expectancy was 59 years for men and 64 years for women.
• The emergency number for public ambulances is 10177, and the general emergency number is 10111. There are also private ambulance services.
• The government is working on a National Health Insurance System (NHI), but it is not clear when this will come into effect.
• The provision of mental health care is very limited, despite the fact that many people experience mental health problems.
• Traditional medicines still play a major role in South Africa. About 80% of the population report using them. Traditional healers are regulated by the 1982 Associated Health Service Professions Act.

How does the public healthcare system work in South Africa?

• South Africa's public healthcare system is available to all residents, but the system is often underfunded and overburdened.
• Although doctors are generally well trained, they are limited by limited or outdated resources, medication shortages and insufficient staff. Public hospitals often have long waiting times and can be very busy, especially in rural areas.
• The best public hospitals are often associated with major universities.
• Much is being done to improve health. Various initiatives have been launched, from hygiene advice to immunisations and the construction of new hospitals. The National Health Insurance Scheme has made public health care more accessible.

How does the private healthcare system work in South Africa?

• The private health care system is world-class, with modern facilities, advanced equipment and highly qualified doctors.
• There are over 200 private hospitals in the country, offering the best quality healthcare in Africa.
• Only a small part of the population has financial access to private hospitals. Although apartheid has been abolished, the consequences are still visible, especially in healthcare.
• Private healthcare can be expensive, so it is essential to take out comprehensive private insurance. If you are not properly insured, there is a good chance that you will end up in a public hospital.
• In recent years, there has been criticism of private healthcare, due to the very high costs and the monopolisation by large healthcare providers.

How is the general pracitioner arranged in South Africa?

• General Practitioners (GPs) are often the first point of contact for non-urgent medical care and refer you to a specialist.
• You can visit a GP without a referral, even for minor procedures and advice.
• In private clinics, appointments are often available quickly, while in public centres this can take longer.

How is the dentist arranged in South Africa?

• Dentists in South Africa are well trained, and the quality of private practices is high. Many dentists work in modern, well-equipped clinics.
• Public sector dental care is limited and often only offered for serious cases and basic care.
• Private care offers quick access but can be expensive. A consultation costs on average ZAR 500-1,500 (€25-75), excluding treatments such as crowns or root canals.
• Make sure you have insurance that covers dental care, as specialist treatment can quickly add up.

How is pregnancy care arranged in South Africa?

• Antenatal care is provided in public hospitals, but quality and experience can vary. Although skilled professionals are available, these hospitals often suffer from overcrowding and long waiting times.
• Expatriates often choose private hospitals and clinics for their personal attention and modern facilities. Private care offers regular check-ups, ultrasounds and support during pregnancy and childbirth.
• South Africa offers specialised prenatal care and 4D ultrasounds in many private clinics. Some private hospitals have luxury facilities, such as maternity suites and optional doula services.
• Contraceptives are widely available in South Africa, but you must have a prescription from your GP. The emergency contraceptive pill is freely available.
• Abortion is legal up to 12 weeks, and later in certain medical cases. It is also free through the public health system, but most expatriates choose private care.

How safe or unsafe is a trip or stay in South Africa?

What should you pay attention to in terms of safety in South Africa?

• The country is safer to travel than many might think, but South Africa does face crime challenges, especially in urban areas. This does not mean you are in constant danger, but awareness and precautions are important.
• Street muggings, burglaries and car thefts are common, especially in larger cities such as Johannesburg, Pretoria, Cape Town and Durban.
• Avoid remote areas, especially at night.
• Keep valuables such as phones, jewellery and wallets out of sight.
• Use secure parking and keep your car doors locked while driving.
• The use and possession of (soft) drugs is prohibited.
• Many expats live in gated communities or apartments with 24/7 security. These areas offer extra security and peace of mind.
• Be careful about sharing personal information with strangers. Rely on official bodies or local guides for advice.

What should you look out for in terms of diseases in South Africa?

• South Africa has one of the highest rates of HIV infection in the world. For foreigners, the risk is low, but it does highlight the importance of education and safe practices.
• Malaria is present in certain areas, especially in the summer months and around national parks such as Kruger.
• Tropical diseases are present in parts of the country. Be up-to-date on the latest vaccination advice.
• Tap water is generally safe to drink, but be careful in remote areas. This is not always the case here.
• Rabies is present in wild animals in rural areas. Avoid contact with stray animals and seek immediate treatment for a bite or scratch.

What should you pay attention to when it comes to traffic in South Africa?

• South Africa has a left-hand drive system, which can take some getting used to. Roads in urban areas are generally well maintained, but in rural areas roads can be poorly lit or unpaved.
• Avoid driving after dark in rural areas due to the risk of animals on the road or poor visibility.
• Traffic accidents are common, partly due to reckless driving and failure to comply with traffic laws. Always wear your seatbelt and be alert to other road users. Minibuses, which are used by many locals, are often overloaded and unsafe. Foreigners are advised to use private transport or apps such as Uber in urban areas.
• Many expatriates rent or buy a car. Make sure you have an international driving permit and that your vehicle is properly insured.
• Use secure parking spaces and avoid leaving valuables in the car.
• Cycling on public roads is not recommended due to unpredictable traffic.

What work and travel insurance policies are suitable for short and long stays in South Africa?

• Is the trip to South Africa and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for South Africa if you are going to live there for a while?

• When applying for your visa, you are usually required to be able to prove that you have valid health insurance.
• If you have private insurance, you can choose your own doctor in South Africa.
• Read more about insurances for abroad on Expatinsurances.org.