- Fewer than one-fifth (18%) of South Africans say they have medical aid coverage.
- More than half of Whites (65%) and economically well-off citizens (53%) have health insurance, compared to fewer than one in 10 among the moderately and very poor (6% and 9%, respectively).
- Among those who have medical aid, most (86%) rely on private health insurance. More than nine in 10 (94%) say they are satisfied with their coverage.
- Among those who don’t have health insurance, the largest share (84%) say it’s because they can’t afford it.
- An overwhelming majority (84%) of South Africans say they worry about obtaining or affording medical care when they need it, including 50% who say they worry "a lot."
- More than six in 10 citizens (62%) say the government should ensure universal access to health care, even if it means higher taxes.
- About half (49%) of citizens say they or a family member went without medicine or medical treatment at least once during the preceding 12 months, including 14% who say this happened “many times” or “always.”
- Among respondents who had contact with a public clinic or hospital during the year preceding the survey: o More than half (57%) say it was easy to obtain the medical assistance they needed, though 8% say they had to pay a bribe to a staff member at least once to receive the necessary treatment. o Majorities report encountering long wait times (89%), absent medical staff (69%), inadequate medical supplies (66%), facilities in poor condition (62%), and high costs that prevented them from getting the medicines or care they needed (54%).
South Africa’s public health sector has been hit by a slew of recent scandals. In August 2021, then-Health Minister Zweli Mkhize resigned after a probe by the Special Investigations Unit (SIU) found that Mkhize, his family, and close associates improperly benefited from a R150 million (U.S. $9 million) contract awarded by the Department of Health to a communications company called Digital Vibes (Feketha, 2021).
In the same month, Babita Deokaran, acting chief director of financial accounting at the Gauteng Department of Health, died in a hail of bullets outside her home in Johannesburg. Just days earlier, Deokaran had halted R850 million (U.S. $50 million) in payments to Tembisa Hospital, citing suspicion of fraudulent procurement practices, and called for an urgent forensic investigation (Corruption Watch, 2025). Recently, an interim report by the SIU found that more than R2 billion (U.S. $120 million) allocated for health-care services at Tembisa Hospital was stolen over four years (Health-e News, 2025).
A report by Corruption Watch, an independent nonprofit organisation, reveals that the leading forms of graft in South Africa’s public health sector are employment corruption (39%), procurement corruption (22%), and the misappropriation of resources (16%). These practices result in regular stockouts of medicines and failing equipment, and they place pressure on people seeking health-care services to bribe staff to obtain help, with disproportionate effects on the most vulnerable in society, i.e. women, children, and the elderly (Ncala, 2020).
In May 2024, President Cyril Ramaphosa signed the National Health Insurance (NHI) Bill into law, paving the way for universal health coverage (UHC) (South African Government News Agency, 2024). Some observers warn that the NHI could turbocharge corruption, given that it will adopt a centralised-purchasing-power model. Others point out that funding the NHI in its current form would mean that between 33% and 44% of the national budget would have to be spent on health care, up from 11.5% currently (Neethling, 2025; National Treasury, 2025).
This dispatch reports on a special Afrobarometer Round 10 survey module focusing on health care. In South Africa, findings show that fewer than one-fifth of citizens have medical aid coverage. Among those who lack medical aid, most cite unaffordability as the main reason.
More than four-fifths of respondents say they worry about being unable to obtain or afford medical care when they need it, and a majority think that the government should ensure universal access to health care, even at the cost of higher taxes.
Concerning citizens’ experiences with the health care system, half of South Africans say someone in their family went without needed care during the past year. Among those who sought care at a public clinic or hospital, more than half say it was easy to get the services they needed, but majorities encountered problems such as long wait times, absent medical personnel, a lack of medicine or supplies, facilities in poor condition, and high costs that prevented them from getting the medicines or care they needed.
Although a majority think the government is doing a poor job of improving basic health care, about six in 10 citizens say they trust the Ministry of Health.
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