Day 3: The South African Health System

Activity 8: The South African health system: From apartheid to today

Day 3: The South African Health System

Activity 8: The South African health system: From apartheid to today

2 hours 30 minutes

Aims | To help us to:

  • Broaden our understanding of the South African healthcare system, looking at its trajectory from Apartheid to today
  • Build a timeline of the key events that have shaped health in South Africa
  • Work out how race, gender, class and other structural and systemic dynamics have shaped the country’s health system 

Task 1 Group work

Reading for an overview of South Africa’s health history

(1 hour)

We will have four (4) reading groups, with each assigned a period in our South African history as indicated below. Each group will receive Reading Resources to explore one period in South Africa’s health history. We also have a guest facilitator to draw on when you have gaps and need advice or help.  

Remember to refer back to the ‘Deepening our Critical Reading Skills’ guidance at the end of Activity 6 before you begin this task. Collectively agree how your group wants to approach this ‘rapid research’ that needs quick skimming of the readings in search of your period’s focus. You will also have access to laptops with wifi for quick online searches where you have gaps or feel the need.     

You have a maximum of 45 minutes to do your rapid research and then, depending on how long your skim-reading took, the remainder of your 1 hour (around 15 minutes) for a short discussion to share the key ideas that you have found for the period that you are assigned. You will see below each reading below, some pointers to the dates covered by that reading. Feel free to mark the readings (they are take home copies) and to use highlighter markers provided, to pick out key points for sharing within your group: 

Group 1: Apartheid – 1994

Group 2: 1994 – 2004 (two elections)

Group 3: 2004 – 2014 (20 years of the ANC in power)

Groups 4: 2015 – today

For the period that you are assigned, scan the documents you are given and use the internet to search for answers to the following questions: 

  1.  What was happening in the political context at this time? 
  2.  What were the critical health policy interventions and critiques of these during this period? 
  3.  What social justice organising was happening around health? What was being demanded? What were the popular slogans and/or images? 
  4.  Were there any victories or critical achievements for public health during this period? 



1. Coovadia et al (2009) ‘The health and health system of South Africa: historical roots of current public health challenges’, The Lancet, Vol 374, 5 Sep 2009, 817-834
     • Covers 1948 – 2008 with helpful Timeline Log for two periods of 1948 – 1994 and 1994 – 2008 (pages 820-21) 
2. Maphumulo, W.T. & Bhengu, B.R., (2019) ‘Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review’, Curationis 42(1), a1901. 10.4102/curationis. v42i1.1901
    • Covers 1948 – 1993 and 2010 – 2016
3. Brauns, M & Stanton, A, (2015) ‘Reforming the health sector in South Africa – post 1994’ in Virtus Interpress – Risk governance & control: financial markets & institutions / Volume 5, Issue 3, 2015, 167-179
    • Covers 1994 – 2014 – see policies listed page 176 
4. African National Congress (1994) ‘A National Health Plan for South Africa 
    • Covers 1994 policy proposal of ANC and commissions of inquiry proposals (Medical Aid sector and Standards & Conditions of Service)
5. Mayosi, B.M. & Benatar S.R., (2014) ‘Health and Health Care in South Africa – 20 Years after Mandela’, Special Report, New England Journal of Medicine, 371. 14. 1344-1353
    • Covers 1999 – 2005 and with the Mbeki presidency 1999-2008, it covers some aspects to 2012 is HIV/TB focus
6. Spotlight Editors (2020) ‘Health in 2020: Eight questions facing South Africa’ by Section  27 and the Treatment Action Campaign (TAC) in Daily Maverick, 13 Jan 2020 
    • Covers 2018 – 2019 (references TB Prevalence Survey 2018) 
7. Wikipedia (2019) ‘Timeline of healthcare in South Africa 

Task 2 Group work

Timeline Poster-making on South Africa’s health history

45 minutes

Now it’s time to get creative in your group and to collectively make a colourful and educative Timeline Poster that you can use to teach the other groups about the period that you were assigned. You will have magazines, cards, pastel crayons, paints, brushes, glue, scissors to use on huge brown-paper sheets and other such creative resources available to help in creating your poster. 

You have 45 minutes to complete your timeline poster and be ready to present your posters to the other groups in plenary.  Design your poster to answer the questions above that are four angles: 

In creating the Timeline Poster, remember that it must speak to the questions above under Task 1. These are the features the poster should have. Consider how race, gender, class and other structural and systemic dynamics have shaped the particular period when drawing out the:     

  • Political context of this time period
  • Health policy interventions and critiques
  • Social justice organising 
  • Victories or key achievements 

Task 3 Plenary:

Group presentations of our History of Health in South Africa from 1948 to date

45 minutes

Each group will have a maximum of 10 minutes to present their Timeline Poster in plenary. There will be time for questions of clarity. 

[The guest facilitator’s engagement will take place in the next session.]