Healthcare in South Africa: What Determines Access to Medical Services

This study investigates disparities in access to healthcare in South Africa. The first part of the study provides a detailed review of the existing literature, which highlights various demographic and socio-economic factors of access to healthcare. However, previous works on South Africa are based on surveys prior to 2012 and do not account for recent changes, including the shock caused by the COVID-19 pandemic and the worsening energy crisis in South Africa in 2022–2024. This study includes data from General Household Surveys of South Africa from 2002 to 2024. Factors such as gender and race, education level, place of residence (province and city/village), and income level are considered. The study presents the main results for assessing the physical accessibility of healthcare. Overall, there is a positive trend, although the values of 2024 still reflect the shock of the pandemic and the energy crisis, showing worse results than in 2019. The study also presents the assessment for inequality in financial affordability of healthcare. Socio-economic factors (race, education, and income level) have a much greater impact on financial accessibility. Comparison with previous literature shows that in 2024, the healthcare access landscape in South Africa remained largely similar to the situation in 2012: the same population groups remained vulnerable (black Africans, poor people, rural residents, and people with low education level), and the level of inequality in financial access to medicine remained high.