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Policy Briefs

Has South Africa’s Investment in Public Healthcare Improved Health Outcomes?

Lucas Bidzha, Talita Greyling and Jugal Mahabir
Since 1994, the South African government has invested significantly in public healthcare. This invested intended to improve access to quality health services to the majority of the population that were previously disenfranchised under the apartheid regime. In addition, access to improved healthcare services would consequently improve health outcomes, which is not only a key social objective but also contributes to long term economic growth. South Africa’s total public health expenditure equate to around 9% of its gross domestic product, which is above the average of other countries classified as middle-income countries. However, when compared to these very same countries, South Africa’s indicators of health outcomes remain relatively lower. This holds true when one considers the country’s infant mortality rate and life expectancy at birth in 2014, which stands at 37% and 57 years respectively. Given these trends, one needs to question the actual impact of healthcare expenditure on health outcomes in South Africa. Given the current tight fiscal framework and the growing needs and priorities, the South African government needs to ensure that limited funds are prioritised in areas that are contributing to social and economic welfare. In addition, the success of the country’s investment in social services need to be scrutinised in order to assist policy makers in improving the effectiveness of spending priorities. This study answers these key questions by undertaking a panel data analysis for South Africa’s nine provinces over the period from 2005 to 2014 to ascertain the impact of healthcare spending on health outcomes.
Aug 2017
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Black living standards in South Africa before democracy

Bokang Mpeta, Johan Fourie and Kris Inwood
The history of living standards in South Africa is a complex and incomplete picture. We know much more about the pre-1994 living standards of white South Africans – the descendants of European immigrants since the 17th century – than of black South Africans, the indigenous, Bantu-speaking population that had inhabited most of modern-day South Africa before the arrival of Europeans and have since formed the majority of the population. The reason for this dearth of knowledge is the lack of source material: whereas meticulous records were kept on white living standards from the beginning of settlement, the colonial and apartheid-era records often neglected to record the wages or incomes of black South Africans at the individual level. A different approach is thus necessary to provide a more complete picture of the evolution of South Africa’s living standards before the advent of democracy.
Aug 2017
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Human capital inequality and electoral outcomes

Biniam Bedasso and Nonso Obikili
Inequality is a problem which has beset South Africa for a long time with the country being on record as having one of the highest levels of inequality in the world. However, little is known about horizontal inequality between different groups in South Africa. Given the level of racial and ethnic diversity in South Africa, it is important to have a good grasp of the dynamics of group inequality in the country.
Aug 2017
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The impact of Home and Host Country Institutions in the Internationalization of an African Multinational Enterprise

Johh M. Luiz, Dustin Stringfellow and Anthea Jefthas
We demonstrate that firms can exploit their knowledge of ‘weak’ institutional settings and turn it into a source of advantage as they internationalize into locations with similar institutional ‘weaknesses.’ Using the case of one Africa’s most successful multinational enterprises we illustrate the...
Aug 2017
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Shaping macroeconomic outcomes

Chris Loewald
By early 2016, financial market participants had become increasingly critical of unsustainable current account deficits and low, unbalanced growth in many emerging economies. In response, adjustments have occurred (or are in process) in a wide range of countries – including Russia, Brazil, Mexico, Colombia, Ghana – gradually guided by policy in some instances and much more abruptly forced by recession in others. South Africa’s trajectory lies somewhere between – with some decline in the current account deficit in late 2016 and into 2017, but few clear steps to shift the composition of economic growth to something more sustainable. The recent current account moderation has fallen on the private sector, resulting in very weak investment and economic growth.