Resumen
The South African healthcare sector stands at the threshold of major restructuring in an attempt to address inadequacies as a result of fragmentation of health services in apartheid South Africa. The level of health services, particularly in rural areas, has decreased and has led to reduced quality and productivity of health services. For individuals residing in rural communities, access to health services can be arduous. Delivery of essential services has to meet the needs of marginalised people who live in remote areas. The health sector is reputed to be good at formulating policies, discussing ideas, making recommendations, and spending resources, but poor on implementing policies. The government insists that the policy framework is transparent and well-defined and that what is needed is effective implementation. Regrettably, the transition of policy into practice is more complex than the perceived judgement of government. Critical concerns regarding issues about how policy can be effectively implemented and who should be responsible for implementation is one of major concern.