Hospital management and health policy—a South African perspective

Stewart, Jacqui; Wolvaardt, Gustaaf

doi:10.21037/jhmhp.2019.06.01

Cited by 6 publications

(3 citation statements)

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“…Human resources training is critical for the NHI's implementation to be a success as suggested by a study which focused on South Africa's alignment of strategic human resources towards the NHI, whose findings revealed that more resources for subject-matter training were required [ 28 ]. Participants lamented about the scarcity of skilled personnel across the board.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing the preparedness for the implementation of the national health insurance scheme at a selected hospital in Gauteng Province, South Africa

Mukwena

Manyisa

2022

BMC Health Serv Res

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Research studies as well as anecdotal evidence suggest that there are challenges regarding the NHI plan implementation. These include problems such as an increase in illnesses and a shortage of personnel to drive the project in South African public hospitals. This is exacerbated by the existing situation of most government-funded healthcare institutions, which are characterized by bad administration, insufficient budget, inadequate infrastructure, and insufficient drug supply, as highlighted in several studies. The hospital under investigation is one such facility, with a history of patients sleeping on the floor and people being turned away owing to a shortage of experts and an overburdened staff. This situation is concerning, given that the government claims to be providing appropriate funds to the institution. The hospital under research is highly regarded by the surrounding community. However, a visit by the Health MEC in 2014 revealed that the facility had insufficient sanitary standards and a high complaint rate. Based on the foregoing, as well as the difficulties that both employees and patients are confronted with at the selected hospital, the question that emerges is whether the hospital is fit for the implementation of the NHI.Aim: The aim of this study was to assess the preparation for the launch of the national health insurance scheme at a Johannesburg hospital.Setting: The study was conducted at a hospital situated in eastern suburbs of Johannesburg, Gauteng, South Africa.Method: The study employed a qualitative method with an explorative, descriptive, qualitative study design. The population consisted of selected hospital employees, such as doctors, dispensary officers, hospital managers, human resources workers, facility managers, and administration record officials who were employed at the selected hospital. Purposive sampling was used to select participants.Sample size: Category saturation was used to determine the sample size. The participants for the study were chosen using purposeful sampling, with the researcher aiming for those who were familiar with the NHI scheme at the institution. Semi structured interviews and a focus group discussion were used to gather data. The data from the focus group discussion and semi-structured interviews were analysed using thematic analysis.Results: The investigation found that the hospital was preparing to for the NHI implementation, but that was riddled with lack of resources, poor infrastructure, lack of training, delays in development and poor technological advances.Recommendations: The paper suggests that human resources be increased, infrastructure be upgraded, medicines and equipment be increased, and enough training on NHI implementation be provided.Contribution: The paper adds to the body of knowledge regarding the NHI in South Africa.

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Section: Discussionmentioning

confidence: 99%

Factors influencing the preparedness for the implementation of the national health insurance scheme at a selected hospital in Gauteng Province, South Africa

Mukwena

Manyisa

2022

BMC Health Serv Res

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“…For example, despite the PPP policy and cost support of the government in China and Viet Nam, the absence of regulation guides has led to an increase of PPPs[ 48 ] and a dominant share of the public hospitals, by the same token, the lax regulation allowed private corporate entities to dominate the PHSs in South Africa. [ 34 52 ] Furthermore, in spite of the mixed health system strategy in Mongolia, the lack of the implementation guide resulted in a rapidly unrestricted growth of the small PH that include the low proportion of total hospital beds (20%) and play an increasing role in providing inpatient care. [ 32 44 ] Governments need to pay attention to the forms of privatization.…”

Section: Discussionmentioning

confidence: 99%

Nature of the private hospital services toward universal health coverage

Fallah

Maleki

2021

Journal of Education and Health Promotion

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Private hospital services (PHS) with the undeniable effects on the Universal Health Coverage (UHC) goals have a considerable contribution to the health system of developing countries. The purpose of this systematic scoping review (ScR) was to identify and map the available evidence regarding the developing countries to scrutinize the nature of the PHS toward UHC through providing graphical/tabular information of the records trends and types, sources of the records, frequent settings, drivers of the PHS growth, range of the PHS, behaviors of the PHS, and opportunities for policy actions. This study was performed following the 2017 published methodological guidance of the Joanna Briggs Institute for the conduct of ScR. Furthermore, a narrative-thematic synthesis integrated with the systematic analysis applying approach to health system strengthening (HSS) through systems thinking was employed. Thirty-two included records in English that met the inclusion criteria were found between 2011 and July 2020. There has been a sharp increase in the generation of the records with a 90.6% growth rate between 2015 and 2020. The most frequent records types were review article, and the lancet was the most specialized journal. India was the most frequent country. Near half of the growth drivers of PHS have been originated from the governance. Besides, the range of PHS was identified only about Mongolia, and the significant frequency of codes of the PHS behaviors (32.6%) was related to integrated people-centered health service delivery. 47.8% of the identified HSS interventions were recommended about governance. Governance plays a decisive role in the nature of the PHS in UHC. Concerning the dynamic architectures of interactions between health system functions, probably the countries themselves have realized the importance of the governance role in the HSS than other functions. Given the all of the recommended interventions were a combination of foundational and institutional, sustainable participation of PHS in the health system seems far and requires a solid will of the governments. Future research is needed about the range of PHS and its behaviors in terms of consumables, revenue-raising, and pooling of funds.

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“…We are grateful to Joseph Kutzin, coordinator in the Health Financing Policy Department of the WHO, for helping us to find some inaccessible references in the backward-searching step, and also thanks to Sajad Delavari, the Assistant Professor of Health Policy, Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, for the constructive comment he provided to the final draft of this review. 63 …”

Section: Acknowledgmentmentioning

confidence: 99%

Participation of delivering private hospital services in universal health coverage

Fallah

Bazrafshan

2021

Journal of Education and Health Promotion

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There is a lack of conceptual clarity about the role of delivering private hospital services (DPHS) accompanied by major gaps in evidence. The purpose of this systematic scoping review was to identify and map the available evidence regarding the developing countries to scrutinize the participation of DPHS exclusively in the universal health coverage (UHC) through providing graphical/tabular classifications of the bibliometric information, sources of the records, frequent location, contribution of the private hospital services in the health system, and roles of DPHS in UHC. This study was performed following the published methodological guidance of the Joanna Briggs Institute for the conduct of scoping review, applying some major databases and search engines. In addition, a narrative-thematic synthesis integrated with the systematic analysis using the policy framework of the World Health Organization was employed. The 28 included records in English which met the inclusion criteria were found between 2014 and January 2020. The chronological trend of records was progressive until 2019. India was the most frequent location (12%). China and Sri Lanka on the one end of the spectrum and Somalia along with South Korea from the other end were, respectively, the least and the most contributed countries in terms of DPHS. Overall, 90% of the roles were concerned with UHC goals. Although evidence has revealed inconsistency in the identified roles, a continuous chain of positive or negative effects in the UHC objectives and goals was observed. Some knowledge gaps about the roles, causes of the increasing and decreasing DPHS contribution, and its behaviors around the privatization types and circumstances of the delivery were recommended as prioritized research agendas for evidence-based policymaking in future.

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Hospital management and health policy—a South African perspective

Cited by 6 publications

References 0 publications

Factors influencing the preparedness for the implementation of the national health insurance scheme at a selected hospital in Gauteng Province, South Africa

Factors influencing the preparedness for the implementation of the national health insurance scheme at a selected hospital in Gauteng Province, South Africa

Nature of the private hospital services toward universal health coverage

Participation of delivering private hospital services in universal health coverage

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