Understanding South Africa’s healthcare system

SOUTH Africa’s healthcare system stands at a crossroads, where ensuring quality of care is not just a goal—it's a necessity for long-term sustainability.

- DIEKETSENG MALEKE

The way patients are treated, screened, and monitored impacts everything from health outcomes to service efficiency. If we want a system that truly serves its people, we need to pay attention to the data. Fortunately, HQA, a non-profit organisation, provides an annual review of how well medical schemes are performing in clinical quality of care.

This latest report, which assesses over 84% of insured beneficiaries, paints a picture of how primary care, maternity services, chronic disease management, and hospital-based care stack up. What makes HQA’s review particularly valuable is its independent nature — now in its 21st year, it offers unbiased insights into where healthcare is improving and where it’s falling short.

“These indicators give us a snapshot of how well we are doing—not just in treating illness, but in preventing it,” says Louis Botha, CEO of HQA. “They also highlight where healthcare providers, funders, and patients alike can take more proactive steps.”

This year, four key areas have been highlighted: diabetes care, flu vaccination for older adults, colorectal cancer screening, and breast cancer screening. Let’s unpack what the numbers reveal.

According to the report, diabetes is one of South Africa's fastest-growing health challenges, fuelled by poor diets and increasingly sedentary lifestyles. A 2025 health report estimated that nearly two-thirds of South African women are overweight or obese, putting them at high risk of developing diabetes.