Fiscal space for health: assessing policy options in South Africa

South Africa’s health care system is at a crossroads. Health care reform is necessary and long overdue. If, within the next 14 years, the country wishes to strive towards universal coverage, public resources for health care will have to be freed up and used more efficiently. What budgetary room does South Africa have to sustain and expand its health services in the short to medium term? This paper outlines the results of a fiscal space analysis conducted for the South African health sector. It highlights the fact that a number of options are available to policy makers, as long as the political will exists to increase public resources for health. Since no such analysis has been conducted to date, such exercises fill a key research gap and contribute to current health care reform debates at a critical juncture in South Africa’s history.