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Reinvigorating South Africa's Universal Health Reforms

LSE Principal Investigators: Elias Mossialos and George Wharton
LSE team: Robert Yates and Stephanie Winitsky
Start Date: 27 January 2025
End Date: 31 December 2025
Funder: UK Foreign, Commonwealth and Development Office (FCDO)
Region(s): Africa
Countries: South Africa
Keywords: Universal Health Coverage, National Health Insurance, health reforms

South Africa is at a critical juncture in its pursuit of Universal Health Coverage following the enactment of the National Health Insurance (NHI) Act, which establishes a framework for a publicly financed universal health system. Progress on implementation has taken place in a complex political and economic context, shaped by coalition government dynamics, legal challenges, fiscal constraints, and differing stakeholder views on the design and sequencing of reform.

This project provided targeted technical assistance to support the Government of South Africa in strengthening political dialogue, public communication, and technical understanding of National Health Insurance implementation. Drawing on international experience and comparative evidence, the project supported constructive engagement between government, policymakers, health professionals, civil society, and global partners.

Activities and outputs

  • High level policy dialogue with senior government and health system stakeholders on NHI implementation
  • Public engagement events to strengthen understanding of Universal Health Coverage reforms and international experience
  • Strategic advice informed by global best practice on governance, financing, and phased implementation of universal health systems
  • Communications and media engagement to support evidence informed public discussion of National Health Insurance reforms

Contribution

The project contributed to clearer and more consistent reform narratives, strengthened stakeholder engagement, and improved alignment between South Africa’s NHI reforms and international Universal Health Coverage experience. It concluded in December 2025, having delivered all planned activities and outputs.