Introduction

This chapter examines the nature of health policy and the challenges of healthcare delivery in South Africa. It argues that although the government of South Africa has been preparing to adopt universal health coverage that could ensure access to affordable healthcare, the challenges of racial and economic disparities in the country may prevent the attainment of the proposed goal of the policy initiatives. Further, since 1994, the government of South Africa has enacted health policies such as the National Health Policy, and National Health Insurance Policy and has recently proposed to formulate Universal Health Coverage without focusing on how to de-escalate the challenges of mixed success. Thus, equitable, affordable, and high-quality health coverage cannot be accomplished in the future without solving the current healthcare disparities predicament. The research method adopted for this research involved interviews and the administration of a questionnaire to 1,648 respondents such as public sector staff, nongovernmental organizations employees, traders, academic staff, law enforcement personnel, unemployed citizens, and community and provincial health practitioners. Interviews with 273 respondents, including officials of public and private sectors as well as foreign NGO stakeholders were conducted. The secondary research methods adopted included the review of the reports of the National Department of Health in South Africa, the World Health Organization white papers, the United Nations Human Development annual report, the Center for Disease Control, and academic as well as professional journal articles. Data were analyzed using SPSS to determine the effectiveness and challenges facing the health policy and quality of the healthcare delivery system in South Africa. The finding of this research reveals that despite the new policy initiatives adopted by the government of South Africa, health services are still falling below the basic standards of patients’ expectations because they are highly fragmented with discriminatory effects and disparities between urban and rural regions. Moreover, there are glaring differences even between urban and peri-urban areas that are usually attributed to South Africa's apartheid-derived racial and socioeconomic inequalities. In addition, improvement initiatives were not able to produce the expected high-quality healthcare services that citizens or patients desired due to a lack of resources, and enough trained medical doctors as well as avoidable errors, shortage of resources in medicine and medical technology, and poor record keeping.