The critical issues of violence against women, prison reform, the plight of South Africas former guerrilla fighters, the vast Zimbabwean exile community in South Africa, South African rugby and the role of the post-apartheid church all come under the spotlight in the section on society.
The volume concludes with an analysis of the growing involvement of South African banks and financial institutions on the African continent, while another chapter looks at our long involvement in the complex search for peace and stability in the Democratic Republic of Congo.
The Promise and the Practice of Transformation: the state of South Africas health system written by
Sharon Fonn, Helen Schneider and Peter Barron
This chapter provides an overview of developments in South Africas health system over the past 12 years, using the WHOs assessment framework. While this framework has good health is an obvious goal, broader social objectives such as responsiveness to the needs of citizens and promotion of equity are also measured.
Despite the largely successful efforts to shrug off the legacy of a racially divided health system and to generate numerous transformation initiatives, the reality is that the current system is as problematic as it was 12 years ago.
As it stands, the amalgamation of numerous fragmented authorities and changes to the gender, racial and professional profile of the health administration are the most significant achievements of the post-apartheid era. Beyond this, many of the structural problems remain.
It is suggested that this is partially explained by changes in economic policy with the shift from the RDP to GEAR political failings such as weak local government specific health system factors (such as the overwhelming nature of the HIV epidemic) and a continuing human resource crisis, among other reasons.
Although the health system in South Africa is facing a number of serious crises, it would be an over simplification to say it is in a state of collapse. There are some positive signals:
- Recognition that much more needs to be done
- Large investments in HIV treatment and the general health system
- An incremental process of regulating the private sector
Additionally, the Health Act of 2004 offers the potential for all role-players to be coordinated under a common framework.
The conclusion poses a major question as to whether the Ministry/Department of Health has sufficient legitimacy and willingness to reinvent itself as a strong steward of the health system, including an (altered) management of HIV/AIDS.
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