Development of the health system in the Western Cape: experiences since 1994

Abstract

Provincial governments in South Africa have a critical responsibility in terms of population health, yet few provincial-level analyses of health-system development have been undertaken. This chapter reports on research being conducted in the Western Cape to understand the province’s particular experience of health-system transformation since 1994, set against wider national experience. The research is being undertaken collaboratively by the authors of this chapter, a team of Western Cape provincial health managers and researchers. The chapter is structured to reflect the Western Cape’s 22-year experience. The situation that faced the province in 1994 is outlined briefly, followed by a description of key features of the three health strategies that have driven provincial health-system development over time. An assessment is then presented of the overall nature and patterns of Western Cape health-system change, and the achievements and limitations of this transformation are considered. The chapter concludes with some early lessons from this experience, and relevant, international experience is considered.

Description

Keywords

South Africa, Population health, Health-system development, Western Cape, Transformation

Citation

Gilson, L. et al. (2017). Development of the health system in the Western Cape: experiences since 1994. South African Health Review, 2017(1): 59 - 69