Healthcare delivery is one of the added responsibilities that newly elected local governments will have to manage. In theory, decentralised health care can provide a better service, but if poorly managed can increase the gap between rich and poor.
A South African generic manufacturer recently won its case against pharmaceutical giant SmithKline Beecham allowing it to produce a generic of SKB's penicillin-based antibiotic.
As part of provinces' quest to put their scarce health resources to the best use, provincial health management recently held a workshop with the World Health Organisation (WHO) to plan what personnel they will need in future.
The problem of access has been sited as one of the reasons for the decline in the quality of healthcare in South Africa.
Despite the decision to transfer over 2 500 health workers from Gauteng province to Johannesburg once it becomes a unicity, no formal agreement exists between the city's management and the province on how this will happen. KERRY CULLINAN reports.
Phelophepa, Transnet's mobile health train that has bought primary health care to thousands of rural South Africans, is managing to reach almost 5 000 individuals every week. Within four years the train has managed to reach a total of 67 855 patients, who receive quality and in most cases, free health care. ANSO THOM reports.
Every afternoon at about 5pm a red van stops next to an open piece of land in Masoyi near the Kruger Park. A woman gets out and looks around, sometimes staring at the piece of land, other days "shoo-ing people who have erected shacks overnight". Behind this piece of land lies a dream. "I must dream, I must'¦," Lucy Ngobeni whispers.
A controversial new approach to rationing care for head-injuries is being developed at Groote Schuur hospital. The new policy, introduced because budget cuts mean that there are insufficient resources to give optimum care to all severe head injuries, will give doctors guidelines as to which patients should receive the most intensive care. Jo Stein reports.
Groote Schuur's medical centre for private patients is planning to open its doors in January next year while similar plans at Tygerberg Hospital have been put on hold.The University of Cape Town signed an agreement with a German partner, Rhoen-Klinikum earlier this year, to open a new UCT Medical Centre in Groote Schuur Hospital.
If the rich consume more health resources than the poor, any efforts to redress the gap between the haves and have-nots must include a commitment to equity and not just equality. Sue Valentine attended a recent international workshop in the North West Province aimed at developing efective equity gauges to measure the gaps in health spending and resource allocation.
When Health Minister Manto Tshabalala-Msimang assumed power last year, she promised a new health bill this year. But this has been delayed yet again, in a saga that is over five years' long.
Dr Marcus Mumakwe's wedding is giving the superintendent of Jane Furse Hospital a headache. Mumakwe wants two weeks' leave but as he is one of only four doctors at a hospital that should have 13, this is a difficult request.
Although too early to accurately determine, medical schemes are reporting a positive response to the newly promulgated Medical Schemes Act, which allows people to join schemes without being penalised on the basis of age or health status.
Ever since provinces were given the power to allocate their own budgets, provincial health departments have been battling to get enough funds. Three health economists propose that central government establishes national norms and standards for health services to ensure that provinces allocate enough money to health.
At the level of words and policies South Africa's health system is broadly on track towards a more effective and equitable service, but implementation and delivery still have a long way to go.
