Health Systems

KZN: state of health

– KwaZulu-Natal state of health report published 

Each day in KwaZulu-Natal we hear reports of health system failures. Shortages of doctors, nurses and specialists that mean people wait hours, days or months for critical services. Broken equipment that mean cancer diagnostics and treatment are unavailable. Countless incidents of medical negligence. Pregnant women recount the fear and indignity they felt while giving birth in public hospitals. Healthcare workers without proper equipment get TB again and again. In emergencies people struggle to pay for private cars, knowing the ambulance will never arrive. Nurses shouting at vulnerable patients. Dirty, run down and broken infrastructure. The outcomes are clear – people are suffering and dying. We cannot turn a blind eye.

While the KwaZulu-Natal Department of Health is taking certain positive steps in addressing the HIV pandemic in the province, much more needs to be done to ensure everyone living with HIV gets on treatment, to reduce new HIV infections, to stop people getting TB and ensuring those who do are cured, and importantly to strengthen the public health system so that everyone can access decent free healthcare.

The Treatment Action Campaign (TAC) has been working in KwaZulu-Natal since the early 2000s and continues to represent users of the public healthcare system and campaign on critical issues related to the quality of and access to healthcare. We currently have a network of 44 branches in four districts in the province including eThekwini, King Cetshwayo, iLembe, and uMgungundlovu. Through these branches we monitor service delivery at a number of clinics and hospitals. Our members are the people who need the public health system to work, so they are the first to notice when it does not.

Each of our branches in the province has adopted a primary healthcare facility local to them and have been monitoring the state of services at these facilities since November 2017. The results highlight a number of critical concerns with regard to the state of services at clinics and community healthcare centres. A summary of the results of data collected to date is below.  

The monitoring tool used has 24 questions based on the services and quality of service that a primary healthcare facility should offer. The questions, developed in consultation with TAC members, are designed to address the key concerns for users of the public healthcare system – and as such should be seen as complimentary to the more systematic and operational monitoring conducted by the Office of Health Standards Compliance (OHSC). The monitoring was conducted by TAC members trained in the use of the tool. In addition to monitoring facilities, TAC branches engage with members of the community to understand the challenges and collect testimonies and complaints that relate to these concerns.

The data collected by our branches corresponds to the worrying picture of our public healthcare system painted by reports published last year by the OHSC. According to the OHSC report, facilities should score at least 80% to claim an acceptable level of care – yet in KwaZulu-Natal of 53 clinics inspected by the OHSC (not necessarily the same facilities as monitored by TAC) only 22.64% of the clinics are performing at 60% or above and 11.34% above 70%.

Fixing the health system in KwaZulu-Natal is an emergency. The many persistent challenges that plague the provincial health system require an urgent and comprehensive turnaround strategy by the provincial Department of Health. Poor people who depend on free public health services are being failed – often receiving inadequate, poor quality and undignified healthcare. As we speak to community members we hear a litany of stories of medical negligence that impact upon people’s lives forever. The provincial government is obligated by the Constitution of South Africa to provide decent and quality healthcare services to the people of KwaZulu-Natal. Instead we see severe dysfunction, that hits poor and rural communities hardest, costing people their dignity and at times their lives.

TAC will continue to monitor the state of healthcare delivery in KwaZulu-Natal and to seek solutions through all the means at our disposal. This report has been sent to the MEC of Health in the province. 




For more information contact:

Provincial Chairperson (Acting) | Bongiwe Ndlovu | | 072 995 9680

Provincial Manager | Mzamowenkosi Zondi | | 063 294 0534

(National media enquiries |Lotti Rutter | | 081 818 8493)