10 important things expats need to know about healthcare in South Africa

With a beautifully warm climate, stunning beaches, strong sense of culture, and low cost of living, it is no surprise that the Republic of South Africa is a popular choice for UK and US expats looking for adventure. South Africa also offers plenty of job opportunities for those who fancy a career change. In fact, the country was included in the Top 10 Most Job Searched Countries (Since Jan 2013).

While the country has plenty to offer in terms of lifestyle, business and culture, there is a striking divide between the rich and the poor in South Africa and this is fully reflected in the construction of its healthcare system. With this in mind, here are 10 important things expats need to know about healthcare in South Africa.

1. Public healthcare

One of the first things to mention about healthcare in South Africa is that, just like other African nations, there is a huge difference between the standards of public and private healthcare. Many public facilities are dealing with overcrowding, a lack of staff, a shortage of resources, and low levels of hygiene. About 80 percent of the population relies upon the public system as poverty is high and people simply cannot afford to pay for private healthcare. Most expats in South Africa choose to use private facilities instead, as these offer better standards of care.

2. Private healthcare

In comparison to the public system, the private healthcare sector offers some of the best medical facilities available, even rivaling the standards of healthcare in some European cities. Its plastic surgery and dental treatments are particularly well regarded, and people travel from around the world for these services.

There are more than 200 private hospitals in South Africa, and most towns and cities will have a local medical facility that private patients can visit. Private medical schemes, regulated by the Medical Schemes Act, are also widely available, and are usually jointly paid into by employers and employees. Expats may of course also choose to take out their own personal health insurance before relocating, to ensure they are covered from the moment they arrive.

3. Free healthcare for all

In response to the rapidly diminishing health of South Africa’s poorest communities, the government introduced its ‘free healthcare for all’ policy in 2006. The idea is that all South Africans can access basic healthcare for free, across all of the country’s public medical facilities. This has resulted in more people seeking regular medical help, a greater use of prescription medication, and a population that is gradually becoming healthier.

4. National Health Insurance (NHI)

South Africa’s National Health Insurance (NHI) system aims to generate funds that will enable all South Africans to access high-quality and affordable healthcare services based on their needs, at local facilities, using an NHI card. The first phase was implemented in 2012 and it will be rolled out over a 14-year period, using various pre-payment sources for funding.

5. Costs

While essential treatment on the public system is currently free, prices can be high for expats receiving private healthcare. Patients can pay for each treatment on an as-needed basis and make a co-payment for things like visits to a GP (General Practitioner) or family doctor, but expats may decide to take out private health insurance to help cover medical costs.

6. Standard of care

Improvements in medical facilities in South Africa’s major towns and cities mean that, in general, the population is getting healthier and living longer. However, in poorer rural areas of the country, healthcare facilities are not as efficient: hospitals are often overcrowded, the standard of treatment is lower, and there are fewer resources available.

7. Health risks

There are certain health risks in South Africa, but these are more widespread in rural parts of the country. While tap water is generally clean in built-up areas and cities, it may be unsuitable for drinking in less well developed areas. There may be a risk of malaria in the northeast parts of the country too, so anti-malarial medicine could be considered if staying in these regions.

There is also a high rate of HIV/AIDS in South Africa, although measures are being introduced to tackle this issue. Under the government’s antiretroviral treatment (ART) program and prevention of mother-to-child transmission (PMTCT) initiative, more than 12 million people were tested for HIV in 2015, and nearly 170,000 babies were tested at six weeks old. According to the Department of Health (DoH), the HIV infection rate has dropped from 8 percent in 2008 to 1.5 percent in 2015.

8. Health insurance and visas

Expats are not required to have health insurance in place to apply for a general work visa, long-term temporary residence visa or permanent residency permit. However, they will usually need to provide a medical report to prove they are in good health (this can often include submitting a radiological report). If they have recently travelled through a country where there is a risk of yellow fever, they may also need to provide a yellow fever vaccination certificate with their application.

9. Pharmacies

There are several main pharmacies in South Africa, including Dis-Chem, Clicks and MediRite. These can be found in most towns and cities. One quirk to take note of about South African pharmacies is that drugs are dispensed in a metal cage, which is then opened when taken to the counter. Also, due to the country’s pricing policies, it is common for pharmacists to hand out low-cost drugs over more expensive branded options, as this can be more profitable for the pharmacist.

10. Emergencies

In the case of a serious medical emergency, dial 10177, unless you are calling from a mobile, in which case the number is 112. There are also two private ambulance services available: Netcare 911 (dial 082 911) and Mediclinic’s ER24 (dial 084 124).

In summary

Expats in South Africa have the choice between public and private healthcare, although there is usually a big difference in the quality. While the private sector offers some of the best medical facilities in Africa, the public sector is by contrast overcrowded and under-resourced. Visitors to South Africa do not need to have health insurance in place in order to apply for a work visa or residency permit, but many arrange for private insurance to ensure that they have access to better treatment and care for the duration of their stay.

Disclaimer: The information included in this article is provided for information purposes only and is not intended to constitute professional advice or replace consultation with a qualified medical practitioner. All information contained herein is subject to change.