In South Africa, demand for home-based care is rising as more people face ageing, disability, chronic illness, and HIV/AIDS. Home-based care services provide medical and personal support at home, offering dignity and easing pressure on hospitals.
In 2025, the National Health Insurance (NHI) has expanded access to some free services, but most fully free care is limited to low-income households through government and NGO programmes. Private providers remain costly, charging R300-R500 per hour.
This guide explains where to find free or subsidised home-based care in South Africa, who qualifies, and how to apply.
Understanding Home-Based Care Services
Home-based care refers to healthcare and support delivered in a person’s residence rather than in hospitals, clinics, or long-term institutions. These services are designed to maintain health, independence, and dignity while reducing hospital admissions and healthcare costs.
Types of Home-Based Care Services
Nursing and medical support:
Wound dressing, injections, and monitoring of chronic conditions such as diabetes or hypertension.
Medication management and adherence support.
Personal and daily living assistance:
Help with bathing, grooming, toileting, mobility, and feeding.
Assistance with household tasks, meal preparation, and shopping.
Palliative and end-of-life care:
Symptom management for terminal illnesses such as cancer, HIV/AIDS, or organ failure.
Emotional and spiritual support for both patients and families.
Disability and rehabilitation support:
Assistance with mobility aids, exercise, and therapy to maintain function.
Support for adults and children with long-term disabilities.
Psychosocial and community care:
Counselling, mental health support, and referrals to social services.
Transport to clinics or hospitals for check-ups.
Why Home-Based Care Matters
For patients, HBC means comfort and familiarity. For families, it reduces costs and the burden of transporting loved ones to distant hospitals. For the healthcare system, it reduces congestion at clinics and hospitals. The combination of medical, personal, and emotional support makes HBC a cornerstone of community health in South Africa.
Who Qualifies for Free Home-Based Care?
Not all South Africans qualify for free HBC. In 2025, eligibility criteria include:
Residency status: South African citizens, permanent residents, and recognised refugees may qualify.
Income threshold: Families earning less than approximately R86,000 per year (single applicants) or R172,000 per year (married couples) are usually eligible for free or subsidised services.
Medical need: A frailty or disability assessment, usually conducted by a clinic or community health worker, is required to confirm eligibility.
Special categories:
Adults with disabilities may qualify for the Disability Grant plus CHW support.
Older persons over 60 years who are frail or unable to perform daily tasks.
HIV/AIDS and TB patients requiring palliative or adherence support.
Children with severe disabilities may qualify for the Care Dependency Grant (R2,180 per month in 2025).
Documentation Required
Applicants typically need:
South African ID or refugee permit.
Proof of residence (e.g., utility bill or affidavit).
Proof of income or unemployment.
Medical reports or clinic letters confirming diagnosis or frailty.
Government Programmes Offering Free Home-Based Care
The Department of Health (DoH) and Department of Social Development (DSD) manage most free or subsidised HBC programmes in partnership with clinics and NGOs.
Key Programmes
| Programme/Service | Description | Eligibility & Access | Contacts/Regions |
|---|---|---|---|
| Ward-Based Primary Healthcare Outreach Teams (WBOTs) | Free home visits by community health workers. Services include disease monitoring, nutrition advice, family planning, and palliative HIV/TB care. | Open to low-income households. No ID required for initial visits. Register at local clinic. | Nationwide. DoH hotline: 0800 029 999. Western Cape directory: d7.westerncape.gov.za. |
| Older Persons Programme (DSD) | Daily living support for frail elderly. Services delivered by NGOs with government subsidies. | Means-tested. Apply through local DSD office. | All provinces. WC: 021 483 0000. KZN: 033 846 8600. |
| Disability Grant & Home Support | R2,180 monthly grant plus free home visits by CHWs. | Adults with disability confirmed by medical assessment. Apply via SASSA. | Nationwide. sassa.gov.za, 0800 60 10 11. |
| NHI-Integrated Home Care | New in 2025. Offers post-discharge home nursing and biometric ID-based access. | Valid SA ID or refugee card. No co-pay. | Piloted in Johannesburg, Pretoria, Cape Town. SMS “CLINIC” + suburb to 43323. |
| Community Health Centres (CHCs) | Entry points for HBC referrals. Includes mobile clinics for rural communities. | Open to all, priority for vulnerable groups. | Gauteng: 011 355 3000. Eastern Cape: 043 711 2323. |
Provincial Differences
Gauteng: More developed network of WBOTs, especially in Johannesburg and Pretoria.
Western Cape: Strong integration of NGOs with public health, including palliative care.
KwaZulu-Natal: DSD-funded older persons’ programmes and HIV/TB-focused HBC.
Eastern Cape: Reliant on CHCs and mobile clinics due to rural spread.
Limpopo & Mpumalanga: Fewer NGOs, longer wait times, but mobile outreach expanding.
NGOs and Non-Profit Organisations
NGOs play a crucial role in filling the gaps left by government shortages. Many offer free or sliding-scale services, particularly for elderly, disabled, or chronically ill individuals.
| Organisation | Services | Eligibility | Contact |
|---|---|---|---|
| South African Red Cross Society | Free nursing, wound care, disaster relief. | Low-income households, assessment required. | Nationwide. redcross.org.za, 021 461 0000. |
| Tafta (Durban) | Carers for hygiene, shopping, household tasks. Free for destitute elderly. | 60+, means-tested. | KZN. tafta.org.za, 031 332 3721. |
| Amcare Welfare | Transport, food relief, home care. | Elderly and disabled. | Gauteng. amcare.org.za, 011 907 2900. |
| CANSA (Cancer Association) | Training for families in cancer home care, referrals. | Cancer patients and families. | Nationwide. cansa.org.za, 021 380 4226. |
| Age-in-Action | Counselling, HIV care, home visits for elderly. | 50+, partnered NGOs. | Nationwide. age-in-action.co.za, 011 482 2029. |
| HelpAge International | Meals, counselling, HIV caregiver training. | Elderly in poverty. | Southern Africa. helpage.org. |
| Procare Hospice | Palliative home care for terminally ill patients. | End-of-life care referrals. | Gauteng. procare.org.za, 012 361 8628. |
Finding NGOs Near You
Families can also use platforms like ngobase.org to search for local health-related NGOs or globalgiving.org for funded community projects. Many rural households rely on smaller, community-driven NGOs supported by larger networks.
How to Apply for Home-Based Care
The process varies depending on whether you apply through government channels or NGOs, but the general steps are similar.
Step-by-Step Application Process
Assessment: Visit your nearest clinic for a frailty or disability evaluation.
Documentation: Collect SA ID, proof of residence, income documents, and medical records.
Application: Submit at your local DSD office, SASSA branch, or clinic. For NGOs, call directly to request an assessment.
Processing: Government grants take 1–3 months; NGO referrals are often quicker.
Follow-up: Use the NHI SMS service (43323) or DoH hotline (0800 029 999) for updates.
Appeals: If declined, contact provincial DSD or request assistance from Legal Aid SA.
Ensuring Service Quality and Safety
Quality varies significantly. Families should:
Confirm caregiver accreditation through the DoH or DSD.
Ensure NGOs are registered and officially funded.
Regularly monitor patient condition and keep clinic appointments.
Report neglect or abuse immediately. Lifeline SA offers a national helpline at 0861 322 322.
Tips for Caregivers and Families
Work closely with assigned community health workers to coordinate care.
Make use of free caregiver training provided by DSD.
Combine grants (Old Age, Disability, or Care Dependency) with NGO support for comprehensive care.
Build support networks in your community to reduce isolation and stress.
Challenges and Opportunities in 2025
Urban vs. rural divide: Cities have more programmes, while rural areas still face long wait times.
Funding increases: The DSD budget for elder care reached R2.5 billion in 2025, with more focus on home care than institutional facilities.
Digital integration: The NHI system now uses biometric IDs and SMS-based referrals, making access simpler in urban provinces.
Workforce shortages: Despite improvements, South Africa faces a shortage of trained home-based care workers, particularly in rural areas.
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Free home-based care services in South Africa are vital for elderly individuals, people with disabilities, and those with long-term illnesses. While private care remains unaffordable for most households, government and NGO programmes provide critical support to vulnerable communities.
The key steps are knowing where to apply, preparing the correct documents, and making use of provincial and NGO networks. With early registration and consistent follow-up, families can secure dignified and reliable care at home.
Home-based care is not only a medical service but also a pathway to independence, dignity, and quality of life for South Africa’s most vulnerable citizens.
