| Summary: | Faith-based health providers (FBHPs) have been identified as important actors and allies in health service delivery, especially in weak and fragile health systems in sub-Saharan Africa (SSA). Although FBHPs are still present in a number of SSA countries in varying degrees and capacities, in South Africa FBHPs were nationalized in the 1970s with some of these missionary facilities later being entirely closed. This historical case study draws on primary and secondary archival data collection as well as in-depth interviews, and discusses the reasoning and some of the results of nationalizing FBHPs in South Africa. We find that FBHPs were nationalized for financial and political reasons in the Apartheid era with the effects of the decision still being felt in the late 1990s. This has resulted in the shifting of efforts of some faith communities from health service delivery to more ‘health-related development programming’ such as orphanages, old age homes, step-down primary clinics and ‘faith inspired organizations’ that promote health through the provision of food, water and shelter. The story of the nationalization of FBHPs into the South African health system is important, especially for other countries still pondering the presence of these types of faith health providers in their national health systems’ architecture.
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