Rural health advocates call for stronger investment in frontline healthcare services
South Africa’s constitutional right to healthcare means little if people living in rural communities cannot access the services they need.
This was one of the key messages emerging from a Health Advocacy Panel Discussion hosted by the Wits School of Public Health, where representatives from RHAP, Section27 and TAC reflected on the role of advocacy, litigation and community mobilisation in advancing health equity.
Speaking during the discussion, RHAP Director Russell Rensburg said health advocacy is ultimately about ensuring that constitutional rights translate into meaningful improvements in people’s lives, particularly for those living in underserved communities.
Drawing on his own experiences growing up in a disadvantaged community, Russell highlighted the inequalities that continue to shape health outcomes in South Africa.
“Talent is everywhere and opportunity isn’t,” he said, noting that many young people in rural and underserved communities continue to face barriers that limit their ability to reach their full potential.
Russell argued that addressing these inequities requires greater investment in the parts of the health system that serve the majority of South Africans. He stressed the importance of district health services, saying that “90% of health needs can be met there”, yet resources continue to be concentrated elsewhere in the system.
He warned that healthcare policy and budgeting decisions have real consequences for communities that already face significant barriers to care, including shortages of healthcare workers, under-resourced facilities and long travel distances to access services.
For RHAP, improving rural health outcomes requires a focus on health financing, human resources for health, governance and accountability. Russell said advocacy must continue pushing for the progressive realisation of the right to healthcare, particularly for communities that have historically been excluded from opportunities and services.
Section27’s Khanyisa Mapipa shared how the organisation combines legal action, research and advocacy to protect access to healthcare services. She reflected on a successful court challenge involving migrant women and children who had been denied healthcare services because of their documentation status, despite constitutional protections and existing health policies.
Khanyisa explained that advocacy extended beyond the courtroom, with community workshops and rights education helping women understand and assert their rights when seeking healthcare. “Women were actually emboldened to advocate for themselves and advocate for their children at health facilities,” she said.
Meanwhile, TAC’s Morongwa Ntini highlighted the value of community-led monitoring, describing how community members collect evidence from healthcare facilities and use that information to advocate for improvements in service delivery. The organisation uses data gathered from communities to identify gaps and shape campaigns aimed at improving access to care.
Throughout the discussion, panelists agreed that advocacy is about more than raising awareness. It involves building evidence, strengthening accountability and ensuring that the voices of affected communities influence policy and decision-making.
For rural communities, where access challenges remain some of the most severe in the country, the discussion reinforced the need for sustained advocacy and investment. As Rensburg reminded attendees, South Africa’s public health system remains a critical national asset, but ensuring it serves everyone fairly will require deliberate choices and continued commitment to equity.