Trade Unions in Social Development Policy Formulation in South Africa: COSATU and the National Health Insurance (NHI)

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This article examines the role of trade unions in shaping social development policy in post-apartheid South Africa, using the Congress of South African Trade Unions (COSATU) and the National Health Insurance (NHI) policy formulation process as an illustrative case. Employing a qualitative single-case design, the study draws on semi-structured interviews with twelve (12) purposively selected key informants, complemented by documentary analysis of submissions and position papers, and thematic analysis informed by the Interest Group Theory (IGT). Findings show that COSATU continues to exercise meaningful influence through institutional access (notably NEDLAC), research partnerships, and grassroots mobilisation. However, influence is conditional: internal capacity constraints, organisational fragmentation, and external power asymmetries within the policymaking environment all limit the union’s impact. The study argues that trade unions remain necessary actors in the formulation of equitable social development policies, but to exert more substantive influence, they must invest in technical capacity, rebuild internal coherence, and strengthen strategic alliances across civil society. Lessons from the COSATU–NHI case contribute to broader debates on participatory governance, interest group politics, and the evolving nature of organised labour in developing democracies.

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