According to the World Health Organisation (WHO) the goal of universal health coverage is to ensure that all people obtain the necessary health services without being financial limped because of the payable fees. This requires: - A strong, efficient, well-run health system; - A system for financing health services; - Access to essential medicines and technologies; and - A sufficient capacity of well-trained, motivated health workers. In an effort to compliment the abovementioned, the South African government proposed the National Health Insurance System (NHIS) to address the health inequality and to improve access to quality healthcare for its citizens. The National Department of Health (NDOH) has already consulted with several stakeholders since the launch of the NHI Green Paper in August 2011. Already 11 National Health Insurance (NHI) pilot sites have been established in the nine South African provinces to assess the feasibility, acceptability, effectiveness and affordability to engage the private healthcare sector. This study aimed to evaluate the feasibility of the NHI in South Africa as well as the way in which it could be implemented to be more acceptable to all stakeholders involved. A qualitative research approach was followed due to the nature of the study. Furthermore, an exploratory methodology was applied in order to generate hypotheses. The research design for this study included a literature review, participatory data collection, semi-structured interviews and data analysis. The study found that there is a need for NHI in South Africa. However, medical practitioners (also referred to as general practitioners or GPs further in the study) feel uncertain about the implementation progress which is unclear to them. Also evident is the, fear for loss of income should the NHI be implemented and thus the remuneration package remained a main concern for all. / MBA, North-West University, Potchefstroom Campus, 2015

According to the World Health Organisation (WHO) the goal of universal health coverage is to ensure that all people obtain the necessary health services without being financial limped because of the payable fees. This requires: - A strong, efficient, well-run health system; - A system for financing health services; - Access to essential medicines and technologies; and - A sufficient capacity of well-trained, motivated health workers. In an effort to compliment the abovementioned, the South African government proposed the National Health Insurance System (NHIS) to address the health inequality and to improve access to quality healthcare for its citizens. The National Department of Health (NDOH) has already consulted with several stakeholders since the launch of the NHI Green Paper in August 2011. Already 11 National Health Insurance (NHI) pilot sites have been established in the nine South African provinces to assess the feasibility, acceptability, effectiveness and affordability to engage the private healthcare sector. This study aimed to evaluate the feasibility of the NHI in South Africa as well as the way in which it could be implemented to be more acceptable to all stakeholders involved. A qualitative research approach was followed due to the nature of the study. Furthermore, an exploratory methodology was applied in order to generate hypotheses. The research design for this study included a literature review, participatory data collection, semi-structured interviews and data analysis. The study found that there is a need for NHI in South Africa. However, medical practitioners (also referred to as general practitioners or GPs further in the study) feel uncertain about the implementation progress which is unclear to them. Also evident is the, fear for loss of income should the NHI be implemented and thus the remuneration package remained a main concern for all. / MBA, North-West University, Potchefstroom Campus, 2015

Philosophiae Doctor - PhD / This study is a philosophical analysis of the National Health Insurance (NHI) policy and legislation, including the related NHI Fund, with a view to assessing its prospects in realising Universal Health Coverage (UHC). The NHI system is about ensuring universal access to quality healthcare for all. The rationale is to provide free healthcare for all at the point of care/service. This legislation has the potential to transform, on the one hand, the relationship between the public and private healthcare sectors and, on the other, the nature of public funding for healthcare. Part of the challenge with the NHI system is that it seeks to provide healthcare for all, but by seeking to integrate the private sector it runs the risk of commercializing healthcare. The study is philosophical in that it holds that ideas have consequences (and conversely actions have presuppositions with certain meanings). In part, it aims to show that an implementing mechanism of the NHI system as presently envisaged has socio-political and economic implications with fundamental contradictions within it; for it seeks to incorporate the private healthcare sector in offering free public healthcare services. This introduces a tension for private healthcare services operate with a neoliberal outlook and methodology which is at odds with a public approach that is based on a socialist outlook. The analysis may make explicit conceptual and ideological tensions that will have practical consequences for healthcare. Much of the commentary on the NHI system have focused on the practical consequences for healthcare; my intervention is to explore and critically assess the various philosophical assumptions that lie behind these practical concerns. Some of these practical consequences are related to the possibility that healthcare is likely to become commercialized and the public healthcare sector will remain in a crisis. This study argues for the provision of access to high quality healthcare facilities for all members of the South African population. Healthcare must be provided free at the point of care through UHC legislation or by the setting up of the NHI Fund as financing mechanism. The study provides reason for the decommercialization of healthcare services completely – that is for eliminating private healthcare from contracting with the NHI Fund. Essentially, it argues for the claim that healthcare should not be traded in the market system as a commodity and that the NHI system in its current incarnation seeks to do precisely that. I further argue that in theory and in practice the neoliberal and socialist assumptions underlying the NHI system in its present formulation do not fit together. On the contrary, rather than a two-tiered system incorporating the private and public healthcare sectors, the dissertation argues for a different way of conceptualizing the NHI system that privileges the latter.

Magister Legum - LLM / In South Africa, there are two health systems through which health services are delivered,1 namely private and public. These two systems were inherited from the apartheid regime.2 With South Africa’s political change from a system of parliamentary sovereignty to a constitutionally supreme system in 1996, huge changes were bound to come including changes to the health sector.3 This meant the overhauling of health legislation, as the right of access to health care services became guaranteed in the Constitution of the Republic of South Africa, 1996.4 In 1997, the White Paper on the Transformation of the Health System (White Paper on Health)5 was introduced with the aim of developing a national health system.6 There has been a lot of progress made in reforming the health sector, however there are still many cracks that the national government aims to remedy through the realisation of universal health coverage (UHC).

Magister Public Health - MPH / The introduction of National Health Insurance (NHI) and the Ideal Clinic Monitoring System have highlighted gaps and challenges with regard to medicine supply management (MSM) at primary health care (PHC) facilities. PHC facilities are the first point of contact communities have for their health needs, however, frequent stock-outs of medicines at PHC facilities in uMkhanyakude district, a rural district in KwaZulu-Natal, and have raised questions as to how medicine stock is managed at these facilities.