title: Reflections on health-care reforms in South Africa.
abstract: We describe an economic framework, including demand- and supply-side factors, for approaching the analysis and planning of health system reform in South Africa, in order to avoid piecemeal debates. We argue that there is an urgent need to re-engineer the way health facilities are internally organized to achieve better productivity and responsiveness. We argue that funding is not the central problem of the South African public health system but rather the enormous inefficiencies in management and low productivity; and that separating the purchase from the supply side is a critical component of making significant efficiency gains. Finally, we suggest that income inequalities and a divided health system in South Africa are departure points for reform initiatives. We must build on the strengths of the South African health system as we plan for the eventual achievement of a more homogeneous health-care system across the public and private sectors.
authors: Discovery Health, 155 West Street, Sandton 2146, South Africa. brianr@discovery.co.za
authors: Brian
authors: B
authors: Ruff
authors: Mandi
authors: M
authors: Mzimba
authors: Simon
authors: S
authors: Hendrie
authors: Jonathan
authors: J
authors: Broomberg
mesh_terms: D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration / Q000592:standards; D018166:Health Care Reform; D006301:Health Services Needs and Demand; D006801:Humans; D013019:South Africa