jooste k. & jasper m. (2012) Journal of Nursing Management20, 56–64 A South African perspective: current position and challenges in health care service management and education in nursing Aim The present study discusses the current context of South African nurse managers’ working environment, exploring the challenges of disease demographics, service change and development, and educating a nursing workforce to meet healthcare delivery demands. Background Post-apartheid South Africa has a legacy of inequalities in access to healthcare; increasingly poor morbidity and mortality demographics; and inadequate numbers of qualified nurses to provide a service to meet the Millennium Development Goals outlined by the Government in 2010. Evaluation The present study discusses the current position and developments pertaining to nursing management relating to both healthcare challenges and educating a nursing workforce. Key issues Collaborative action by various stakeholders in the development of nursing management will ensure a nursing workforce and service environment fit-for-purpose in delivering the healthcare outcomes envisaged in the transformed South Africa in the future. Conclusion Different role players are involved in critical issues regarding the management and education of nursing in South Africa. Nurse managers are central to the success of service redesign, delivery and education. Implications for nursing management Nurse managers need to influence policy decisions regarding nursing service design and delivery, and the education required to prepare the next generation of practitioners for these new services.