The South African government’s vision for 2030 is to provide quality health care for all. In alignment with this vision, South Africa is on a path towards Universal Health Coverage (UHC) and the National Department of Health (NDoH) released a White Paper in December 2015 on a National Health Insurance (NHI) for South Africa, subsequently updated in June 2017.
In order to provide a platform for South African policymakers to engage with local and international experts around this area, a Policy Dialogue was organised in South Africa by iDSI partners in March 2017. The Policy Dialogue followed a workshop entitled “Designing and Adjusting the Health Services Package for Universal Health Coverage in South Africa”. Representatives from the South African Treasury and the NDoH engaged with experts from South Africa, the United Kingdom and Thailand to discuss topics related to a Health Services Package (HSP).
After a discussion of key challenges, the participants agreed upon some important next steps to address these. Firstly, clarity on the budget envelope and financing of NHI in the context of the relationship between national and provincial-level decision making and resource allocation (fiscal federalism) is required. Due to the large variability of quality, transparency and availability of clinical guidelines, there is a need for a dedicated unit responsible for coordinating clinical guidelines. It is also important to build understanding of and commitment to evidence-based medicine especially amongst clinicians, and to strengthen the local ownership of clinical guidelines. Clear criteria need to be developed for ‘value for money’ such as a cost-effectiveness threshold. Establishing a national health technology assessment (HTA) unit will provide the technical and analytic input required to inform evidence based decision making for the NHI and HSP. Furthermore, priority topics for HTA need to be identified. Lastly, formal public engagement processes and collaboration with a wide range of stakeholders is important for the successful and appropriate implementation of an HSP.
The white paper was revised and gazetted as the National Health Insurance Policy in June of this year. You can access the policy document here.