With nearly 80% of the population relying on public health services. NHI rollout looming, can the system cope?

MilisaD September 18, 2025 2 minutes read

South Africa’s public healthcare system is under a huge strain, due to high level of diseases, budget limitations and high patient capacity, this lead to resource scarcity and shortage of staff. Factors resulting to this include the shortage of qualified professionals and overworked staff, increasing chronic diseases and lifestyle diseases and infrastructure shortfalls.

The issues manifest as long waiting times, limited access to health care, low hygiene more especial in rural areas, despite efforts to strengthen primary healthcare services and support for HIV treatment.

Is the struggle new?

South Africa’s healthcare system is a long-standing issue rooted in the apartheid system worsened by ongoing management and resource and facing ongoing efforts for improvements. The National Health Insurance ( NHL) aims to provide an accessible quality healthcare to all residents of South Africa, with a defined package of comprehensive health services from primary healthcare to specialized and quaternary levels for all citizens and legal residents.

The National Health Insurance (NHI) Challenges

Training gaps: There are training gaps in medical staff training resulting into lack of sufficient human resources in the public sector and the loss of medical professionals to other countries is an outstanding challenge.
Workforce Strain: NHI requirements and the potential for increased demand may strain the existing healthcare workforce.
Unclear Funding Model: There is lack of a viable and clear funding model, with potential costs exceeding government estimates.
Corruption: Corruption remains a continuing issue, which can impact the implementation and success of the NHI.
Governance and Integration: Establishing effective governance structures and coordinating between the public and private sectors is one the biggest and ongoing challenges.

Solutions for National Health Insurance ( NHI) rollouts focus on improved digital systems, transparent and sustainable financing, robust collaboration between public and private sectors, strengthened governance and clear definitions of services.

View related content