With the advent of the new National Health Act, health care in South Africa is at a critical point as this will be the first time in history that a National Health Insurance is being implemented in this country. Globally National Health Insurance has been around for more than a hundred years, however some countries with long established national health schemes are currently grappling with funding issues surrounding their health systems. South Africa should take note of these issues as it embarks on this journey. The objective of this study was to perform a literature review on how South Africa’s National Health Insurance can be funded taking cognisance of the history of the country and experiences of other countries. It is imperative for each country to achieve optimal health care funding to ensure the success and long-term sustainability of National Health Insurance. The analysis of the problems experienced by other countries revealed that balancing the three main funding options namely, allocated from the national revenue fund, user charges and or donations or grants from international organisations, is critical as the funds needed in a system to achieve coverage at an affordable cost is dependent on the current state of health care in a country. Considering South Africa’s history and current inequality in society and health care it is clear that the majority of funding for the National Health Insurance should be supplied by the national revenue fund. The required funds can either be raised by increasing existing taxes or introducing a new tax specifically aimed at financing the National Health Insurance. The use of user charges is important however, although not purely for a revenue collection point, but from a cost control point of view as well. Some studies have revealed that the lack of user charges results in a misuse of the system. / Financial Accounting / M. Phil. (Accounting Science)

Changes and challenges that have occurred in the past two decades have forced a radical shift in the basic foundations of how business is conducted. Internal, as well as external forces have forced organisations to constantly monitor their surrounding environment in order to create an awareness of opportunities and threats to allow them to survive in their competitive environment. Organisations need to gather all the information at their disposal, and turn the raw data into intelligence through a process of analysis and an exercise of human judgement. By utilising the potential offered by information systems in the process of generating intelligence and creating a corporate knowledge base to be used in strategic decision-making will lead to competitive advantage and constant innovation. Strategic Intelligence has information as its foundation. This research proposes that through its ability to absorb sources of information, the synergy of Business Intelligence, Competitive Intelligence, and Knowledge Management combined to form Strategic Intelligence, will allow organisations to incorporate all of their information and intellectual capital into a single database or system which will meet the intelligence requirements of management. The purpose of this study is to identify the current use of Strategic Intelligence in the Long-term Insurance Industry in the South African environment, and through the use of a survey questioned the benefits or problems experienced by executive management who have not yet implemented and used Strategic Intelligence as an input to the Strategic Management process, and identified the perceived value Strategic Intelligence could add in the decision-making process. The research study shows that organisations have not yet fully embraced a model for a cooperative global internal corporate Strategic Intelligence System or Portal that will incorporate all aspects of Strategic Intelligence into a single, easily manageable resource for management’s strategic planning and decision-making process, even though it could enhance their ability to withstand the onslaught of global competitors and expand their business into new markets, protect their local market or identify potential merger or acquisition targets, and increase innovation within the organisations. / Business Management / M. Com. (Business Management

The aim of this study was to capture nurses’ experiences and reality of practice in order to understand their views on National Health Insurance (NHI) policy. A hermeneutic phenomenological research design was used to collect data from professional nurses working at Embuleni Hospital in the Gert Sibande District of Mpumalanga province. A sample of 10 professional nurses was included in the study and semi-structured interviews were used to collect data which was analysed following van Manen’s (1990) approach. The results revealed that professional nurses are of the view that the policy on management of hospitals is the source of health system problems which have caused inequalities and insufficient management of rural hospitals, thus affecting their efficiency in service delivery. However, the study revealed that professional nurses viewed the same policy in the light of national core-standards which they use as an objective tool for the purpose of monitoring their practice. The findings present an opportunity for policy makers to use evidence-based knowledge in realigning policy for relevance, bringing nurses on board in the policy process and understanding the key constituents of policy content. / Health Studies / M.A. (Public Health)

Thesis (MPhil)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: South Africa is facing an energy crisis on two levels; the existing capacity to supply electricity is unable to support future growth in demand, and the electricity being produced comes mostly from coal-fired power stations with associated emission problems. The South African government has a target for renewable energy to service 23% of the country’s energy consumption by 2013. This could potentially be realised through achievement of another government target, the installation of one million Solar Water Heaters (SWHs). On a technical level, Solar Water Heaters (SWHs) represent a completely viable renewable energy alternative for South Africa. It is an established and proven technology which has the potential to have a big impact on the country’s electricity capacity problems. SWHs can be used in a variety of applications from industry to households. Most of the hot water in South African homes is heated by electric resistance heating in standard electric water heaters and there are no technical obstacles to replacing most of these with SWHs, thereby delivering a saving of up to 70% of the water heating energy bill. Water heating currently accounts for 40% of domestic electricity consumption within a residential sector that uses 20-30% of the national supply. At the macroscale, the roll out of SWH programmes is completely scalable. The benefits of SWH installation accrue to the consumer in the form of a financial saving in the long-term and to society in the form of reduced emissions. Awareness of the benefits is growing amongst the general public, commercial institutions and in government. Sales are starting to pick up due to, amongst other reasons, electricity price hikes and government subsidies for SWH installations offered through the national electricity supply company, Eskom. A national building regulation enforcing energy-efficient water heating in new buildings has been drafted and is expected to be in place by mid 2011. The rate of change from electric to solar water heaters remains disappointingly slow, however. The SWH industry in South Africa accounts for less than 10% of total hot water solutions sold. This study sought to establish the opportunities as well as possible barriers for the creation of SWH programmes within the insurance sector. Close to 50% of all standard electric water heaters installed in South Africa are procured and installed via the insurance industry due to the failure of units that have endured beyond the manufacturer’s guarantee period. This presents an opportunity for interventions that encourage policyholders to change to SWHs. Such interventions, if successful, would dramatically speed up the roll out of SWHs in South Africa. In addition the study sought to determine the barriers to the uptake of SWHs by policyholders in the case of the two insurance companies that currently have SWH programmes in operation. Data was collected through interviews with representatives in the insurance industry and a range of SWH industry stakeholders and consumers. The literature review focused on SWH policies and regulations and corporate and marketing theories. The material on transition in socio-technological systems proved especially useful in understanding the complex dynamics of the study topic. The conclusion drawn from the research is that the South African insurance industry has the capacity and opportunity to drive the penetration of SWH technology. The opportunity is, however not being exploited to anywhere near its potential. The entire system is geared towards providing a particular ‘business-as-usual’ solution. Analysis conducted in this study confirms that the system is in a “locked-in” state and extremely resistant to change. If the opportunity is to be acted on, to supplant the dominant technology for water heating installed by the insurance industry with what is currently a niche technology (SWHs), an external landscape shock is almost certainly needed. This shock to the system could be aided by interventions that target a change in the current system’s logic. The study provides some suggestions in this regard. / AFRIKAANSE OPSOMMING: Suid-Afrika staar ‘n energie krisis in die gesig. Aan die een kant is die bestaande elektrisiteitsvoorsiening nie genoeg om plek te maak vir die toekomstige vraag na elektrisiteit nie en aan die ander kant word meeste van Suid-Afrika se elektrisiteit opgewek deur steenkoolaangedrewe kragstasies met gevolglike probleme as gevolg van vrylating van kweekhuis-gasse. Die Suid-Afrikaanse regering het ‘n teiken vir hernubare energie om 23% op te maak van die land se totale energie verbruik teen 2013. Hierdie teiken sou potensieel bereik kon word deur die bereiking van ‘n ander van die land se teikens, naamlik die instalering van een miljoen sonverhitters. Op ‘n tegniese vlak verteenwoordig sonverhitters ‘n lewensvatbare hernubare energie alternatief vir Suid-Afrika. Dit is ‘n beproefde tegnologie wat die potensiaal het om ‘n groot impak te hê op die elektrisiteit kapasiteitsprobleme van die land. Sonverhitters kan ‘n verskeidenheid van warm water behoeftes bevredig, van groot industrieë tot tuisverbruik. Meeste warm water in Suid-Afrikaanse huise word verhit deur standaard elektriese geisers. Daar bestaan geen tegniese hindernisse om hierdie geisers deur sonverhitters te vervang en tot 70% van die water verhittings energie rekening te bespaar nie. Water verhitting maak tans 40% van die totale huishoudelike elektrisiteits verbruik op. Die huishoudelike verbruik is 20-30% van die nasionale verbruik en selfs hoer gedurende piek. Op die makro skaal is die uitrol van sonverhitters heeltemal skaleerbaar. Die voordele van die installering van sonverhitters val die verbruiker toe in die vorm van finansiele besparing oor die lang termyn en vir die samelewing as geheel in die vorm van emissie besparings. Bewustheid van die voordele is aan die groei by die algemene publiek, kommersiele instansies en by die regering. Verkope het begin optel as gevolg van onder andere die elektrisiteits prysverhoging en die staatssubsidies vir sonverhitters aangebied via die nasionale elektrisiteits toevoer maatskappy, Eskom. A nasionale bouregulasie wat enegie doeltreffende waterverhitting sal afdwing op nuwe geboue is reeds opgestel en dit word verwag dat hierdie regulasie in plek sal wees teen middel 2011. Die koers van verandering van elektriese water verhitters na sonkrag bly egter teleurstellend laag. Die sonverhittings industrie in Suid-Afrika maak minder as 10% van die totale water verhittings mark uit. Hierdie studie het beoog om die geleenthede sowel as die moontlike versperrings tot die skepping van sonverhittings programme in die versekerings bedryf uit te wys. Die versekerings bedryf koop en installeer ongeveeer 50% van alle standaard elektriese geisers in Suid-Afrika as gevolg van elektriese geisers wat breek na die vervaardiger se waarborg verval het . As gevolg hiervan bestaan daar ‘n geleentheid vir intervensies wat polishouers aanmoedig om te verander na sonverhitters. Sulke intervensies, indien suksesvol, het die potensiaal om die uitrol van sonverhitters in die land dramaties te versnel. Verder het hierdie studie beoog om die versperrings tot die opname van sonverhitters uit te wys by twee versekerings maatskappye in Suid-Afrika wat wel sonverhittings programme het. Data is versamel deur onderhoude met verteenwoordigers van die versekeringsbedryf en ‘n reeks sonverhitting industrie belanghebbendes en verbruikers. Die literatuurstudie het gefokus op sonverhittings beleid en regulasies en korporatiese en bemarkings teorie. ‘n Literatuurstudie in oorgang in sosio-tegnologiese sisteme was veral nuttig om die komplekse dinamika van die sisteem te verstaan. Die gevolgtrekking van hierdie studie is dat die Suid-Afrikaanse versekeringsbedryf wel die kapasiteit en geleentleid het om die penetrasie van sonverhittings tegnologie te dryf. Hierdie geleentheid word egter nie gebruik tot sy volle potensiaal nie. Die ganse sisteem is gerat om ‘n spesifieke tegnologie op ‘n sekere manier te verskaf. Analise in hierdie studie bevestig dat die sisteem in ‘n geslote staat is en daar is uiterste teenkanting tot verandering. Indien hierdie geleentheid om die dominate tegnologie vir waterverhitting geinstaleer deur die versekerings bedryf te verplaas met wat op die oomblik nog ‘n niche tegnologie is (sonverhitters), is ‘n eksterne landskap skok nodig. Hierdie skok tot die sisteem kan aangehelp word deur intervensies wat ‘n verandering in die huidige sisteem logika teiken. Hierdie studie bied ‘n paar voorstelle in hierdie verband.

Thesis (MBA (Business Management))--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: The democratic government of South Africa inherited a healthcare system that was fragmented and inequitable. The Department of Health was mandated by the Constitution and the Bill of Rights to implement a system whereby quality, affordable healthcare could become available to all citizens of the country within the constraints of the available resources. The objective of government, through reform legislation, is to establish a social health insurance (SHI) system for the country which will ultimately lead to the implementation of a national health insurance (NHI) system in order to achieve universal coverage. Medical schemes have been identified as an important component of this transformation process. The private healthcare industry, represented largely by medical schemes, acknowledges that SHI is the ideal pathway chosen by government to achieve universal coverage, but is concerned with the process being used to achieve this aim, the pace at which transformation is occurring, and the effect of this on medical schemes. The movement towards an equitable healthcare system required the introduction of reform legislation necessary for the establishment of an enabling environment. The implementation of community rating, open enrolment and prescribed minimum benefits (PMBs) reforms, succeeded in ending the risk-rating of those medical schemes that were excluding members who were considered vulnerable. However, these legislations were not followed by a risk equalisation mechanism in the form of a proposed risk equalisation fund (REF) for the South African environment. The main purpose of this fund is to ensure that equity within the medical schemes industry is maintained through the equalisation of the risks that had resulted from the implementation of the first components of reform legislation. The research into the experiences of other countries shows that South Africa is the only country in the world that has implemented the above legislation without a system of risk equalisation. All indications are that the proposed implementation of the REF has been delayed to beyond 2009. In addition, the reform legislation regarding the statutory solvency ratio requires medical schemes to maintain this ratio at 25 percent. This, together with the delay in REF is placing financial pressure on medical schemes. Low income medical schemes (LIMS) legislation is pending implementation. Its purpose is to provide basic medical cover to the lower income market until such time that the components of SHI have been fully negotiated; it is thus an interim measure, but no indication to implement LIMS has yet been given. The average number of years for a country to implement SHI is 70. The South African situation is only 13 years old and though some success has been achieved during this relatively short period, much more still needs to be accomplished. The research shows that, the approximate timelines and intended sequence of implementing the reform legislation were perhaps too ambitious. This has caused the industry stakeholders to be disillusioned about the current state of affairs. Given the time that has elapsed, and considering the progress that has been made thus far, it is recommended that the existing plan be revised or even replaced with a more realistically timed one. This will restore some of the confidence into the “future healthcare vision of universal coverage” for South Africa intended by the government, through a system of social health insurance. / AFRIKAANSE OPSOMMING: Die demokratiese regering van Suid-Afrika het ‘n gesondheidsorgstelsel geërf wat gefragmenteerd en onregverdig was. Die Departement van Gesondheid het in die Grondwet en die Handves van Menseregte die mandaat gekry om ‘n stelsel te implementeer waarvolgens bekostigbare gesondheidsorg van goeie gehalte vir alle landsburgers beskikbaar kon word binne die beperkinge van die beskikbare hulpbronne. Die regering se doelwit met hervormingswetgewing is om ‘n maatskaplike gesondheidsversekeringstelsel (SHI) vir die land daar te stel wat uiteindelik sal lei tot die implementering van ‘n nasionale gesondheidstelsel (NHI) met die oog op universele dekking. Mediese skemas is geïdentifiseer as ‘n sleutelkomponent van hierdie transformasieproses. Die privategesondheidsorgindustrie, wat grotendeels deur mediese skemas verteenwoordig word, erken dat SHI die ideale weg is wat deur die regering gekies is om universele dekking te bereik, maar is besorg oor die proses wat gebruik word om hierdie doelwit te bereik, die pas waarteen transformasie geskied, en die uitwerking hiervan op mediese skemas. Die beweging na ‘n regverdige gesondheidsorgstelstel het vereis dat hervormingsgswetgewing ingestel word soos nodig vir die daarstelling van ‘n omgewing wat dit moontlik maak. Die implementering van gemeenskapsevaluering, oop lidmaatskap en hervorming van voorgeskrewe minimum voordele (PMB’s) was suksesvol vir die beëindiging van die risikoevaluering van daardie skemas wat lede uitgesluit het wat as kwesbaar beskou is. Maar hierdie wetgewing is nie opgevolg deur ‘n risikogelykstellingsmeganisme in die vorm van ‘n voorgestelde risikogelykstellingsfonds (REF) vir die Suid-Afrikaanse omgewing nie. Die hoofdoelwit van hierdie fonds is om te verseker dat gelykheid binne die mediesefondsindustrie gehandhaaf word deur die gelykstelling van risiko’s wat die gevolg was van die implementering van die aanvanklike hervormingswetgewing. Navorsing oor die ondervinding in ander lande toon dat Suid-Afrika die enigste land in die wêreld is wat sodanige wetgewing geïmplementeer het sonder ‘n stelsel van risikogelykstelling. Alle tekens dui daarop dat die voorgestelde implementering van die REF uitgestel is tot na 2009. Daarbenewens vereis die hervormingswetgewing ten opsigte van die statutêre solvensieverhouding dat mediese skemas hierdie verhouding op 25% handhaaf. Tesame met die vertraging in REF plaas dit finansiële druk op mediese skemas. Lae-inkomstemedieseskemas (LIMS) is verdere hervormingswetgewing wat wag op implementering. Die doel daarvan is om basiese mediese dekking te voorsien aan die laer-inkomstemark totdat die komponente van SHI ten volle onderhandel is. Dit is dus ‘n oorgangsmaatreël, maar daar is nog geen aanduiding gegee van die implementering van LIMS nie. Die gemiddelde tyd wat dit neem vir ‘n land om SHI te implementeer, is 70 jaar. Die Suid-Afrikaanse situasie is net 13 jaar oud, en hoewel daar heelwat sukses behaal is in hierdie relatief kort tydperk, moet daar nog baie meer bereik word. Navorsing toon dat die geskatte tydperk en voorgenome opeenvolging van die implementering van die hervormingswetgewing dalk te ambisieus was. Dit het veroorsaak dat die belanghebbers in die industrie ontnugter is oor die huidige stand van sake. Met inagneming van die tyd wat verloop het en die vordering wat tot dusver gemaak is, word daar aanbeveel dat die bestaande plan hersien word of selfs vervang word deur een met ‘n meer realistiese tydsbeperking. Dit sal ‘n mate van vertroue herstel in die Suid-Afrikaanse Regering se “toekomsvisie van universele gesondheidsdekking” deur ‘n stelsel van maatskaplike gesondheidsversekering.

The aim of this study was to capture nurses’ experiences and reality of practice in order to understand their views on National Health Insurance (NHI) policy. A hermeneutic phenomenological research design was used to collect data from professional nurses working at Embuleni Hospital in the Gert Sibande District of Mpumalanga province. A sample of 10 professional nurses was included in the study and semi-structured interviews were used to collect data which was analysed following van Manen’s (1990) approach. The results revealed that professional nurses are of the view that the policy on management of hospitals is the source of health system problems which have caused inequalities and insufficient management of rural hospitals, thus affecting their efficiency in service delivery. However, the study revealed that professional nurses viewed the same policy in the light of national core-standards which they use as an objective tool for the purpose of monitoring their practice. The findings present an opportunity for policy makers to use evidence-based knowledge in realigning policy for relevance, bringing nurses on board in the policy process and understanding the key constituents of policy content. / Health Studies / M. A. (Public Health)

Changes and challenges that have occurred in the past two decades have forced a radical shift in the basic foundations of how business is conducted. Internal, as well as external forces have forced organisations to constantly monitor their surrounding environment in order to create an awareness of opportunities and threats to allow them to survive in their competitive environment. Organisations need to gather all the information at their disposal, and turn the raw data into intelligence through a process of analysis and an exercise of human judgement. By utilising the potential offered by information systems in the process of generating intelligence and creating a corporate knowledge base to be used in strategic decision-making will lead to competitive advantage and constant innovation. Strategic Intelligence has information as its foundation. This research proposes that through its ability to absorb sources of information, the synergy of Business Intelligence, Competitive Intelligence, and Knowledge Management combined to form Strategic Intelligence, will allow organisations to incorporate all of their information and intellectual capital into a single database or system which will meet the intelligence requirements of management. The purpose of this study is to identify the current use of Strategic Intelligence in the Long-term Insurance Industry in the South African environment, and through the use of a survey questioned the benefits or problems experienced by executive management who have not yet implemented and used Strategic Intelligence as an input to the Strategic Management process, and identified the perceived value Strategic Intelligence could add in the decision-making process. The research study shows that organisations have not yet fully embraced a model for a cooperative global internal corporate Strategic Intelligence System or Portal that will incorporate all aspects of Strategic Intelligence into a single, easily manageable resource for management’s strategic planning and decision-making process, even though it could enhance their ability to withstand the onslaught of global competitors and expand their business into new markets, protect their local market or identify potential merger or acquisition targets, and increase innovation within the organisations. / Business Management / M. Com. (Business Management

Thesis (LLM. (Labour Law)) -- University of Limpopo, 2022 / This study discusses the legal analysis of social security rights of domestic workers in the South African social security law. The notion social security is concerned with the protection of individuals during the happening of certain event such as unemployment, maternity, disability, old age, sickness, and death. For the purpose of this study, social insurance schemes which arise from the employment relationship will be explored. It is submitted that domestic workers like any other employees should also be afforded social security protection as envisaged in the Constitution of the Republic of South Africa, 1996 (the Constitution). Therefore, domestic workers must also be provided social security rights arising out of their employment. Thus, the research process will involve thorough analysis of statutes, case law, textbooks and scholarly articles dealing with the social security law protection afforded to domestic workers, in particular the social insurance component of social security. For an exceptionally long time, domestic workers have been excluded from the formal employment sector, which followed that they were automatically excluded from social security protection. Despite section 9 of the Constitution, this espouses non-discrimination and equal treatment of all the workers in South Africa. To this end, there is no comprehensive social security system in South Africa that is capable of providing adequate social protection to domestic workers. For example, most domestic workers have no pension fund, and some are not registered with Unemployment Insurance fund and Compensation for Injuries and Diseases schemes.

The financial stability of the insurers is important to fulfil its role as a risk transfer mechanism and to protect the purchasers of their products. The European Union is introducing the Solvency II to modernise the current Solvency I regime and to harmonise the different insurance legislation of the members of the European Union. Solvency II introduces an architecture consisting of three pillars, with Pillar I setting the solvency capital requirements, Pillar II the governance and risk management requirements and Pillar III the reporting requirements. The South African Regulator initiated Solvency Assessment and Management for implementation in 2016 to align the South African prudential regulatory framework to meet the Solvency II requirements for third country equivalence. The problem that this study addressed is the possible effect that the introduction of Solvency Assessment and Management may have on the sustainability of short-term insurers in South Africa. The results of a empirical component of the study indicated that small and medium short-term insurers may be negatively impacted due to the costs incurred to implement and comply with the requirements of the new regulatory framework. The effect on the South African short-term industry can be that cover is concentrated among a few large short-term insurers. / Business Management / M. Com. (Business Management)

With the advent of the new National Health Act, health care in South Africa is at a critical point as this will be the first time in history that a National Health Insurance is being implemented in this country. Globally National Health Insurance has been around for more than a hundred years, however some countries with long established national health schemes are currently grappling with funding issues surrounding their health systems. South Africa should take note of these issues as it embarks on this journey. The objective of this study was to perform a literature review on how South Africa’s National Health Insurance can be funded taking cognisance of the history of the country and experiences of other countries. It is imperative for each country to achieve optimal health care funding to ensure the success and long-term sustainability of National Health Insurance. The analysis of the problems experienced by other countries revealed that balancing the three main funding options namely, allocated from the national revenue fund, user charges and or donations or grants from international organisations, is critical as the funds needed in a system to achieve coverage at an affordable cost is dependent on the current state of health care in a country. Considering South Africa’s history and current inequality in society and health care it is clear that the majority of funding for the National Health Insurance should be supplied by the national revenue fund. The required funds can either be raised by increasing existing taxes or introducing a new tax specifically aimed at financing the National Health Insurance. The use of user charges is important however, although not purely for a revenue collection point, but from a cost control point of view as well. Some studies have revealed that the lack of user charges results in a misuse of the system. / Financial Accounting / M. Phil. (Accounting Science)