Public Health Funding and Health Service Delivery-A Case Study of the Gauteng Province, South Africa

Abstract

In South Africa, the provision of health care services by public institutions has been reported to be under tremendous funding constraints. This paper reports the findings of an exploratory study to determine the funding process as well as factors which influence funding of the public health sector in Gauteng South Africa by interviewing relevant officials in the province, as well as outpatients at certain public hospitals, since the funding will eventually impact the level of health-care service delivered. It became evident that allocating funds to the Gauteng Department of Health (GDoH) with specific conditions attached thereto, is an acceptable way of funding national policies and ensuring that such funds are ‘protected’ and spent only for the purposes as stipulated in the accompanying grant framework. There is need for the GDoH and the Gauteng Provincial Treasury (GPT) to ensure that the well-established provincial budgeting processes are followed, which should be accompanied by building technical capacity to ensure that all areas of spending are well funded, information is communicated to all the public health institutions, and that every unit adheres to the budget limitations to avoid overspending. Keywords: public health service; health service financing; budgeting;