SIHMA | Scalabrini Institute For Human Mobility In Africa

Health Access for Non-South African Nationals

Prepared by Vhuthuhawe Ramatsitsi

 Photo  by Owen Beard on Unsplash

The rights of non-nationals to access the South African healthcare system is a complex matter. There is a clash between policies/laws and the actual implementation on the ground.  The South African healthcare system struggles to provide sufficient medical care to any person, regardless of their nationality or status (Maphumulo & Bhengu, 2019). Although this is a fact, the government strives to provide health care access to people in South Africa, despite this, non-nationals continue to face challenges with access (South African Government, 2023).

 The Constitution of the Republic of South Africa which is the supreme law of the nation states that all people in South Africa, regardless of status or nationality, have the right to have access health care services, and that ‘no one’ may be refused emergency medical treatment (South African Government, 1996). In support of this, the National Health Act stipulates that, state run primary health care facilities must provide free health care to everyone in South Africa, including migrants and refugees (South African Government 2006). Furthermore, the National Health Act confirms that all people in South Africa can access primary health care at clinics and community health centres. Pregnant or breast-feeding women and children under the age of six are entitled to free health care services at any level South African Government 2003).

Refugees in South Africa have the same right to access healthcare as South African citizens, as set out in the Constitution and the Refugees Act of 1998. This right is also considered to include asylum-seekers (South African Government, 1996; South African Government 1998). The Department of Health Circular confirmed that refugees and asylum seekers, with or without permits, can access the same basic health care services as South African citizens - including treatment for HIV. The laws above are clear on refugees and migrants’ rights to access health care. Data from a report compiled by Scalabrini Centre of Cape Town and Sonke Gender Justice (2019) indicates that the Immigration Act is different: it states that staff at clinics and hospitals must find out the legal status of patients before providing care (except in an emergency).

Although South African laws clearly stipulates the right to primary health care access for migrants and refugees, medical xenophobia perpetuated by medical providers towards migrants and refugees continue to be common. This is informed by the idea that they are outsiders and therefore undeserving the care in the public facility (Vanyoro, 2022). Scalabrini Centre of Cape Town and Sonke Gender Justice prepared an infographic highlighting ways in which the health care system in South Africa is structured, what the laws stipulate, healthcare services non-nationals can access in terms of the law and issues of medical xenophobia. For more information on the infographic, please refer to the following link:




Maphumulo, W. T., & Bhengu, B. R. (2019). Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review. Curationis, 42(1), 1-9.

Scalabrini Centre Cape Town., & Sonke Gender Justice. (2023). Migrants & Refugees: Health Access. Available at:

South Africa, Government. (1996). Constitution of the Republic of South Africa. Republic of South Africa: Pretoria. Available at:

South African Government. (1998) Refugees Act 130 of 1998. Available at:

South African Government. (2003). National Health Act 61 of 2003. Available at:

South African Government. (2023) Health. Available online:,National%20Health%20Insurance,financial%20barriers%20to%20healthcare%20access.

Vanyoro, K. (2022) Migrants in South Africa have access to healthcare: why it’s kicking up a storm. Available online:'s%20Refugee%20Act%20of,the%20Southern%20Africa%20Development%20Community.


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