Africa’s healthcare systems face a dual challenge: expanding infrastructure and retaining skilled staff. Facilities alone cannot deliver care – doctors, nurses, and other practitioners are the backbone of any resilient system.
Globally, health systems are under pressure. Poland, for instance, has 3.5 doctors and 5.7 nurses per 1,000 people – below the EU average – yet South Africa’s ratios are far lower at 0.9 doctors and 1.3 nurses per 1,000. The rollout of National Health Insurance (NHI) and ongoing workforce challenges underscore an urgent need for sustainable solutions that directly address both staffing levels and system resilience.
Therefore, the core argument is that investment strategies must prioritise both infrastructure and the workforce. Unlocking sustainable, quality care for Africa demands capital that not only enhances facilities but, critically, supports the recruitment, retention, and empowerment of healthcare professionals.
The Role of Capital in Building Solutions
Workforce and infrastructure are interdependent: modern facilities improve working conditions, while skilled professionals ensure that those facilities have a meaningful impact. Financing strategies, therefore, matter as much as policy.
That’s why listed vehicles like RH Bophelo mobilise private capital to strengthen this link. By acquiring hospitals, expanding existing sites, and co-investing in healthcare funds, RHB supports environments where clinicians work effectively, patients receive care closer to home, and communities benefit from expanded access.
Why the Healthcare Gaps Persist
McKinsey estimates that over half of the world’s population lives in ‘worker-scarce’ countries, where there are too few practitioners relative to demand. In South Africa, shortages are amplified by uneven distribution, burnout, emigration, and weak long-term planning.
Other nations highlight valuable lessons. In Poland, high attrition was linked not only to migration and stress but also to excessive paperwork, poor management, and limited career pathways – issues that modern systems and better organisational design can help address.
Short-term measures seldom fix structural problems. In Australia, 81% of workforce policies were temporary grants or recruitment drives, easing immediate pressure but failing to build durable solutions. South Africa risks similar outcomes unless infrastructure, investment, and human-resource planning are linked into one coordinated strategy.
Mobilising private capital is essential to achieving this integrated strategy, as it creates the durable foundation necessary to complement government efforts and build a stable healthcare workforce.
Strengthening the Healthcare Workforce Triangle
McKinsey frames the solution as a ‘Healthcare Workforce Triangle’ – Grow, Thrive, Stay. Expanding training pipelines (Grow) could add 5.6 million healthcare workers globally, yet significant gaps remain. Tackling administrative inefficiencies and leveraging technology (Thrive) could free up 2 million more workers, while addressing retention challenges (Stay) could keep 1.8 million in the system.
Global case studies show this in practice. Brazil expanded medical schools by 160 between 2013–2023, boosting its primary-care physician base by 12% and reducing mortality by 1.4%. In the US, VR-enabled nursing training lifted licensure pass rates by 10%. These examples illustrate that targeted investment across the triangle delivers measurable, lasting results.
Towards Integrated Workforce Planning
South Africa can adapt international lessons while focusing on local realities:
- Improve working conditions and career pathways to reduce burnout.
- Expand roles for nurses, pharmacists, and community health workers.
- Invest in education and mentorship to attract new talent.
- Deploy telemedicine, AI diagnostics, and digital tools to boost reach and efficiency.
Together with consistent investment, these measures would expand access and create conditions where healthcare workers can build sustainable careers.
Financing a Sustainable Future
Addressing Africa’s workforce shortage requires capital not only for facilities but also for incentives and delivery models that strengthen both access and careers. Task-shifting, community health worker empowerment, and technology-enabled care must become central to the system.
Building for Tomorrow
The Australian experience shows the risks of fragmented, reactive policy and the importance of coordinated, long-term planning. Without national alignment, health workforce policy risks becoming inconsistent and vulnerable to political cycles.
South Africa’s path forward lies in adopting an integrated, forward-looking strategy that expands access while creating conditions for health professionals to thrive.
At RH Bophelo, financing health care goes beyond building assets – it is about investing in people. By aligning capital with systemic needs, we can help transform today’s workforce crisis into a foundation for resilience, inclusion, and sustainable growth.
