Exploring the perceptions of general practitioners on National Health Insurance in Chris Hani District, Eastern Cape, South Africa
Thesis (MFamMed)--Stellenbosch University, 2018.
ENGLISH SUMMARY : Introduction: The South African health system is at crossroads. Public health care is struggling to provide quality healthcare to 86% of the population while private health care costs have been spiralling out of control for the 16% of the population that it serves. The National Health Insurance (NHI) intends to provide universal health coverage to all South Africans, with equity and quality as its tenets. The participation of private general practitioners in NHI is essential to ensure access to quality primary care. Aim: To explore perceptions of general practitioners (GPs) on NHI in Chris Hani district, Eastern Cape, South Africa. Methods: Phenomenological qualitative study using semi-structured individual interviews of twelve GPs from six municipalities. Data analysis used the framework method assisted by Atlas.ti software. Results: GPs in Chris Hani district felt that NHI would improve health and benefit society. They felt that NHI will be of particular benefit to poor and rural people as it will improve access to healthcare. Lack of governmental administrative capacity and a human resource plan were seen as barriers to implementation of NHI. GPs felt that NHI would benefit them through a single purchaser system and support more comprehensive care. GPs were concerned about a lack of information on primary care packages, accreditation, remuneration and patient allocation. GPs felt that NHI might disadvantage solo GPs. GPs felt that NHI implementation could be improved by actively engaging with GP organisations. Improvement of existing government health facilities and continued medical education were seen as possible ways to better implement NHI. Conclusion: GPs in this study were generally positive about NHI as they thought it would benefit both patients and providers. However, they had concerns regarding the capacity of government to implement NHI, the implications for solo GPs and needed more information. Government needs to actively engage GPs on NHI implementation.
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