The short answer: it depends on what you measure.
- Perceived quality of care (Numbeo Health Care Index, 2026 mid-year): South Africa leads Africa with 63.9, followed by Kenya (62.2) and Ghana (57.9).
- Coverage of essential health services (WHO, 2023): Tunisia leads (76), followed by Mauritius (75) and South Africa (74).
- Life expectancy (World Bank, 2024): Tunisia (76.7), Algeria (76.5) and Morocco (75.5) lead. South Africa is at 66.3.
South Africa’s top place rests on its private sector, so access to private care is what matters most for anyone living or working here.
Numbeo Health Care Index 2026 (mid-year): African countries
| Africa rank | Country | Health Care Index | Global position (of 101) |
| 1 | South Africa | 63.9 | 50 |
| 2 | Kenya | 62.2 | 57 |
| 3 | Ghana | 57.9 | 73 |
| 4 | Tunisia | 56.6 | 75 |
| 5 | Algeria | 54.7 | 82 |
| 6 | Nigeria | 48.0 | 94 |
| 7 | Egypt | 47.9 | 95 |
| 8 | Morocco | 46.8 | 98 |
Numbeo’s index is based on surveys of residents’ perceptions of their health system, including the quality of staff and equipment, waiting times and cost. Only these eight African countries are included.
A second view: coverage and outcomes
| Country | WHO UHC service coverage index (2023) | Life expectancy at birth, years (2024) |
| Tunisia | 76 | 76.7 |
| Mauritius | 75 | 73.8 |
| South Africa | 74 | 66.3 |
| Egypt | 71 | 71.8 |
| Algeria | 70 | 76.5 |
| Morocco | 65 | 75.5 |
| Botswana | 60 | 69.3 |
| Rwanda | 59 | 68.0 |
| Kenya | 57 | 63.8 |
| Ghana | 56 | 65.7 |
| Nigeria | 47 | 54.6 |
South Africa: two systems in one country
- Population: about 63.5 million (Stats SA mid-year estimate, 2026).
- Medical scheme cover: about 9.17 million people were medical scheme beneficiaries in 2024, according to the Council for Medical Schemes. That is roughly one in seven South Africans. Most people rely on the public sector.
- National Health Insurance: the NHI Act was signed in May 2024. In February 2026 the President undertook not to bring any part of it into force until the Constitutional Court rules on challenges to it. The court heard the case in May 2026 and reserved judgment.
Kenya, Ghana and Tunisia
Kenya and Ghana rank second and third on Numbeo, reflecting private hospitals in Nairobi and Accra. Their WHO coverage scores (57 and 56) show how uneven access to that care still is.
Tunisia ranks fourth on perception but first on both service coverage and life expectancy, which makes it the strongest all-round system on these measures.
What this means for expats and employers
- In South Africa: budget for private medical aid. The private sector is what puts South Africa at the top of the perception rankings.
- Elsewhere in Africa: international health insurance with medical evacuation is the norm, because complex cases are often transferred to South Africa, Europe or the UAE.
Moving staff across Africa? See group international health insurance for employers or international health insurance for individuals, and compare destinations in our guides to the top African countries for expats and healthcare systems for expats.
Frequently asked questions
Which country has the best healthcare in Africa?
On Numbeo’s 2026 Health Care Index, South Africa ranks first in Africa with 63.9. On WHO service coverage and life expectancy, Tunisia leads.
Is healthcare in South Africa good?
South Africa’s private sector is among the highest rated in Africa, but about 9.17 million people had medical scheme cover in 2024, out of a population of about 63.5 million.
What is the NHI and has it started?
The National Health Insurance Act was signed in May 2024. No part of it is in force while the Constitutional Court challenge is pending.
Sources: Numbeo Health Care Index by Country 2026 Mid-Year, the WHO UHC service coverage index, World Bank life expectancy data, Stats SA mid-year population estimates 2026, the Council for Medical Schemes 2024 industry report and reporting on the NHI case by IOL and EWN.
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