ABSTRACT
In 1994, following the first democratic elections, the new South African state sought to create a unitary public healthcare system. It was to be a particularly daunting task, given the uneven, discriminatory and inequitable structures that had been inherited from the apartheid state. Out of a number of parallel and racialized health services, the new state planned to bring together and yet to decentralize health delivery across national, provincial, district and community levels of organization. Resources and services were to be distributed between the different organizational levels in order to provide a ‘continuum of care’ for patients through various forms of referral that, in addition to hospital and clinic care, encompassed community and home-based care (Marais 2005: 64).
