Timeline of healthcare in South Africa

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This is a timeline of healthcare in South Africa, focusing especially on modern science-based medicine healthcare. Major events such as policies and organizations are described.

Big picture[edit]

Year/period Key developments
17th–18th centuries Hospital care is provided by the Dutch East India Company, colonial governments, and Christian missions. Traditional healers, European trained doctors, missionaries, and other health providers offer a mix of services.[1]
19th century Medically trained doctors become mainstream. Indigenous and traditional healers are marginalized. Orthodox medicine becomes a professional practice with training of nurses and doctors. By mid-century, hospitals are present in most major centers. Epidemics of syphilis, tuberculosis, bubonic plague, yellow fever, typhus, cholera, soil parasites, and malnutrition hit South Africa.[1]
1910–1948 The Union of South Africa is established. Health services are fragmented among the four provinces. Poor urban working and living conditions with diseases are caused by overcrowding, poor sanitation and diets, stress, and social disintegration follow consolidation of racial segregation. Syphilis, tuberculosis, malaria and venereal diseases continue to spread.[1]
1948–1994 Apartheid years. Non-communicable diseases rise in white people and poverty-related diseases persist in black people. Tuberculosis rates and deaths are much higher in black and coloured populations than among whites. Health services in bantustans are systematically underfunded.[1]
1994–present Post-apartheid democracy. Today, the public system serves the vast majority of the population, but it still remains underfunded and understaffed. The wealthiest 20% of the population use the private system and are far better served.[1] Diseases of poverty, non-communicable diseases and HIV/AIDS comprise a huge burden for South Africa.

Full timeline[edit]

Year/period Type of event Event Location
1807 Policy The first health legislation is enacted. A Supreme Medical Committee is established to oversee all health matters.[1]
1830 Policy Ordinance 82 allows for regulation of all health practices in the Cape Colony. Other three colonies follow.[1]
1855 Organization Grey’s Hospital is established.[2] Pietermaritzburg, KwaZulu-Natal
1881 Organization Frere Hospital is established.[3] East London, Eastern Cape
1883 Policy Public Health Act makes notification and inoculation of smallpox compulsory in response to smallpox epidemic.[1]
1890 Organization Valkenberg Hospital is founded.[4]
1892 Organization Weskoppies Psychiatric Hospital is founded. It is the first psychiatric institution established in the Zuid-Afrikaansche Republiek.[5] Pretoria, Gauteng
1897 Policy Public Health Amendment Act is launched. It separates curative and preventive care.[1]
1919 Organization Health Act establishes the first Unionwide Public Health department in South Africa.[1]
1933 Organization Umlamli Hospital is established.[6] Sterkspruit, Eastern Cape
1938 Organization Groote Schuur Hospital is founded. It is the chief academic hospital of the University of Cape Town's medical school.[7] Cape Town
1940 Report There's an overall ratio of one doctor per 3600 population. There's one doctor for every 308 white people in Cape Town compared with one doctor for 22,000 to 30,000 people in the reserves.[1]
1942 Organization Chris Hani Baragwanath Hospital is founded. It is the largest hospital in the southern hemisphere and the third largest in the world.[8] Johannesburg
1942–1944 The National Health Service Commission (also called Gluckman Commission) is carried out. It advocates for a unitary national health service in South Africa.[1]
1951 Organization Segregated black medical faculty is created at the University of Natal (UNB).[9] KwaZulu-Natal
1955 Organization Fort Grey TB Hospital is founded.[10] East London, Eastern Cape
1959 Organization Madwaleni Hospital is founded.[11] Elliotdale, Eastern Cape
1966 Organization Jose Pearson TB Hospital is founded.[12] Port Elizabeth, Eastern Cape
1967 Achievement South African cardiac surgeon Christiaan Barnard performs the world's first human heart transplant operation at Groote Schuur Hospital.[13] Cape Town
1972 Organization Kalafong Hospital is founded. The University of Pretoria uses the hospital as a training institution for the Faculty of Health Sciences.[14]
1976 Organization Tygerberg Hospital is founded. It is the second largest hospital in South Africa.[15] Bellville, Western Cape
1977 Organization Second training site for black medical students is created at the Medical University of South Africa (MEDUNSA).[9] Pretoria, Gauteng
1977 Policy Health Act is passed, perpetuating the fragmentation with curative services being a provincial responsibility and prevention a local government responsibility.[1]
1983 Policy Tricameral Parliament further fragments health services with white, coloured, and Indian own affairs departments.[1]
1994 Policy First democratic elections in South Africa are held. The country's race-based health system begins dismantling. A policy on universal access to primary healthcare is introduced.[16]
1996 Policy Choice on Termination of Pregnancy Act is passed. This legislation legalizes abortion and allows for safe access to it in both public and private health facilities.[16]
1996 Policy Free care for children younger than 6 years and pregnant women, and free primary health care for all South Africans is instituted.[1]
1998 Program A National Telemedicine Project Strategy is adopted by the South African Department of Health. The system facilitates frequent contact between doctors in underdeveloped and developed areas.[16]
1998 Policy Medical Schemes Act is passed. This legislation regulates the medical schemes industry to prevent it from discriminating against "high risk" individuals like the aged and sick.[16]
1999 Policy Tobacco Products Control Amendment Act is passed. This legislation limits smoking in public places and makes the public aware of the health risks of tobacco by placing restrictions on tobacco advertisements.[16]
2000 Policy Pharmacy Amendment Act is passed. This legislation allows non-pharmacists to own pharmacies, with the aim of improving access to medicines.[16]
2001 Policy Free Basic Water Strategy defines water as a social and developmental good and basic human right.[1]
2002 Policy Mental Healthcare Act is passed. This legislation introduces a process to develop and redesign mental health services so as to grant basic rights to people with mental illnesses.[16]
2003 Program The South African government launches the Hospital Revitalisation Programme, with a total budget of R 1.9 billion, in an attempt to improve the public health system. Under the program, hospital infrastructure, procurement of the necessary equipment and management skills are improved.[16]
2003 Organization The National Reference Centre for African Traditional Medicines is launched to research African herbs and to evaluate their medicinal value.[16]
2004 Program The South African government launches the Community Health Worker Programme to develop community-based generalist health workers. Their training combines competencies in health promotion, disease prevention, primary healthcare and health-resource networking, as well as coordination. 40,000 such workers are estimated to be in South Africa.[16]
2004 Policy National Health Act is passed. Under this legislation, both the district health system and primary health care are defined as provincial responsibilities.[1]
2005 Policy Nursing Act is passed. This legislation provides for the introduction of mandatory community service for nurses.[16]
2006 Program The National Human Resource Plan is launched by the South African Department of Health in an attempt to make up for the skills shortfall and to compensate for the loss of experienced health professionals from rural to urban areas, from the public to private sector, and from South Africa mainly to developed countries.[16]
2006 Study The Medicines Research Council (MRC) initiates toxicology studies to further study selected indigenous plants.[16]
2006 Program The Accelerated Prevention of HIV/Aids Initiative is launched as part of an extensive initiative regarding prevention by the member states of the Africa region of the WHO. More than 1 060 health professionals are recruited to support the program. Some 7 600 health professionals are trained in the management, care and treatment of HIV/AIDS. 213 000 patients initiate on antiretroviral treatment by the end of September 2006, and an estimated additional 90,000 to 100,000 patients initiate in the private and nongovernmental sector.[16]
2007 Program The South African government enters into an agreement to recruit 2,000 Tunisian doctors to combat long standing shortage of doctors in rural areas. The Department of Health also employs 450 doctors from Cuba and Iran.[16]
2007 Program A new cadre of health professionals called clinical associates is introduced to lighten the workload at health facilities. Graduates are expected to work under the supervision of medical officers in district hospitals and primary healthcare level.[16]
2007 Campaign The South African Department of Health launches a nationwide Polio and Measles Immunisation Campaign. It is aimed at boosting the immunization coverage in the country.[16]
2010 Report 150,509 qualified health practitioners in both public and private sectors are registered with the Health Professions Council of South Africa. This includes 30,006 doctors and 5,185 dentists.[16]
2016 Report Life expectancy in South Africa is estimated at 49.99 years, being ranked 228th out of 228 political subdivisions.[17] South Africa is reported to have the lowest life expectancy in the world.[18]

See also[edit]


  1. ^ a b c d e f g h i j k l m n o p q "The health and health system of South Africa: historical roots of current public health challenges" (PDF). Retrieved 4 October 2016.
  2. ^ "GREY'S HOSPITAL". Retrieved 10 October 2016.
  3. ^ "Frere". Retrieved 20 November 2016.
  4. ^ "Valkenberg". Retrieved 20 November 2016.
  5. ^ "HISTORY OF MEDICINE" (PDF). Retrieved 4 October 2016.
  6. ^ "Umlami". Retrieved 20 November 2016.
  7. ^ "Groote Schuur Hospital: Overview". Retrieved 6 October 2016.
  8. ^ "The Chris Hani Baragwanath Hospital". Retrieved 3 October 2016.
  9. ^ a b Digby, A (2013). "Black Doctors and Discrimination under South Africa's Apartheid Regime". Med Hist. 57 (2): 269–90. doi:10.1017/mdh.2012.106. PMC 3867842. PMID 24070349.
  10. ^ "Fort Grey TB Hospital". Retrieved 20 November 2016.
  11. ^ "Madwaleni Hospital". Retrieved 6 October 2016.
  12. ^ "Jose Pearson TB Hospital". Retrieved 20 November 2016.
  13. ^ "Dr Chris Barnard performs the world's first human heart transplant". Retrieved 6 October 2016.
  14. ^ "Kalafong Hospital". Retrieved 4 October 2016.
  15. ^ "Tygerberg Hospital: Overview". Retrieved 4 October 2016.
  16. ^ a b c d e f g h i j k l m n o p q r "Healthcare in South Africa". Media Club South Africa. Retrieved 25 November 2017.
  17. ^ "Life Expectancy". Retrieved 10 October 2016.
  18. ^ "South Africa has the lowest life expectancy in the world". Retrieved 10 October 2016.