Health Financing Progress Matrix assessment, South Africa 2025: summary of findings and recommendations

This report presents the findings of South Africa’s 2025 Health Financing Progress Matrix (HFPM) assessment, WHO’s standardized qualitative analysis of a country’s health financing system. The report provides a detailed view of the strengths and weaknesses of health financing policies in South Africa, in relation to the performance goals of universal health coverage (UHC). Whilst South Africa has strong constitutional and legislative foundations in support of UHC further progress, in terms of equitable access to quality health services, is constrained by persistent fragmentation in the health system, particularly between public and private financing arrangements. Inequitable allocation of resources across the system, weaknesses in strategic purchasing, and inefficiencies in budget execution are some of the findings which need to be addressed.

Overall, the report concludes that South Africa has established the foundations for advancing UHC but requires sustained political commitment, institutional reform, and strategic investment to translate policy ambitions into improved health system performance for the entire population.