ABSTRACT
The article discusses the aspirations and achievements of 10 Bantustan departments of health in trying to develop integrated district healthcare for their African populations from the 1970s to 1990s. These aimed to prioritise preventive and promotive rather than curative medicine, and to decentralise healthcare in an expanding network of clinics. The departments were both helped and hindered in their innovative work by their relationship with South Africa which, whilst aiding them with resources, at the same time caused growing problems because of a migrant labour system in which many people worked in South Africa but were forced to reside in the Bantustans. In addition the article suggests that, within a wider South African context, Bantustan healthcare provided a hidden link between the progressive but abortive proposals for a national health service proposed in the Gluckman Report (1944) and attempts by the democratic government half a century later to provide a district system of primary healthcare.
