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NHI First 18 Months – 2013

DoH Nantional Health Insurance First 18 Months – 2013


South Africa is poised at the brink of effecting significant and much needed change to its health system; a change based on the principles of social solidarity, equity and fairness. A National Health Insurance (NHI) is the vehicle which is intended to bring about this change and is expected to have a lasting and recurring impact on the health of all South Africans. The policy objective of NHI is to ensure that everyone has access to appropriate, efficient and quality health services. Intended to be phased in over a period of 14 years, such a system will require significant overhaul of existing service delivery structures, administrative and management systems.

This chapter summarises the progress and future plans for introducing the NHI in South Africa. Since the NHI Green Paper was launched in August 2011 there has been considerable progress in preparing the final NHI policy and in preparing South Africa’s health system for the introduction of NHI. This chapter summarises progress against the key features of the NHI’s development as outlined in the Green Paper and includes input on key areas and initiatives that have been identified for the successful implementation of NHI. This includes, amongst others, management reforms, hospital reimbursement reforms, establishment of the Office for Health Standards Compliance, undertaking of the national health facility audit, quality improvement and certification, and strengthening of district health authorities.

Many challenges and risks exist but plans to mitigate these are being put in place; in particular, to continue the process of consultation, improving on communications (including the timetable for changes to happen), strengthening oversight of the reform process in existing and future pilot districts and keeping a focus on equity to ensure that introducing the NHI will lead to a fairer healthcare system.

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