THE HEALTH CARE SYSTEM IN THE REPUBLIC OF SOUTH AFRICA: ANALYSIS OF REFORMS, NON-COMMUNICABLE DISEASES, AND THE IMPACT OF THE COVID-19 PANDEMIC

Kacper Wrzosek; Kacper Ponikowski; Paulina Gumółka; Emilia Kamizela; Eliza Kuchta; Karina Udrycka

doi:10.31435/ijitss.2(50).2026.5265

Authors

Kacper Wrzosek Student Research Circle at the Chair and Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, 20-093 Lublin, Poland https://orcid.org/0009-0009-6215-2134
Kacper Ponikowski Student Research Circle at the Chair and Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, 20-093 Lublin, Poland; https://orcid.org/0009-0008-4052-0410
Paulina Gumółka Student Research Circle at the Chair and Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, 20-093 Lublin, Poland; https://orcid.org/0009-0007-7571-2917
Emilia Kamizela Student Research Circle at the Chair and Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, 20-093 Lublin, Poland; https://orcid.org/0000-0001-9364-6764
Eliza Kuchta Student Research Circle at the Chair and Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, 20-093 Lublin, Poland; https://orcid.org/0009-0009-2408-4900
Karina Udrycka Medical University of Lodz, 90-419 Lodz, Poland https://orcid.org/0009-0003-8577-4100

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5265

Keywords:

Republic of South Africa; Health System Reform; National Health Insurance; Non-Communicable Diseases; COVID-19; Primary Care

Abstract

Since the end of apartheid in 1994, the Republic of South Africa has implemented multiple reforms to improve equity and quality within its healthcare system. This paper provides a comprehensive review of the current state of these reforms, focusing on the implementation of National Health Insurance (NHI), the growing burden of non-communicable diseases (NCDs), and the systemic impact of the COVID-19 pandemic. Based on a systematic review of 32 scientific papers published between 2017 and 2025, a qualitative analysis was conducted to identify recurring trends, structural barriers, and strategic recommendations. The findings reveal that healthcare reform is progressing unevenly, hindered by limited financing, weak intersectoral coordination, and persistent disparities between the public and private sectors. Furthermore, the rising prevalence of NCDs, such as diabetes and cardiovascular diseases, poses a significant threat to system stability. While the COVID-19 pandemic exposed the fragility of existing organizational structures, it also served as a catalyst for digital health innovation and telemedicine. To achieve Universal Health Coverage, South Africa must transition toward an integrated, community-based model. Key priorities include strategic investment in the health workforce, improved public financial management, and effective public-private integration. Ultimately, the lessons learned from the pandemic and the NCD crisis should drive the development of a more resilient, equitable, and technologically advanced healthcare system.

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