Limits...
Consumers' perspectives on national health insurance in South Africa: using a mobile health approach.

Weimann E, Stuttaford MC - JMIR Mhealth Uhealth (2014)

Bottom Line: Public participation in any such reform process facilitates successful implementation.It is noteworthy that measures for dealing with corruption or implementing ethical values are neither described in the WHO building blocks nor in the NHI.Furthermore, the study reveals discrepancies between the everyday lived reality of public health care consumers and the intended health policy reform.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Public Health and Family Medicine, Health Sciences Faculty, University of Cape Town, Observatory, Cape Town, South Africa. prof.dr.weimann@gmail.com.

ABSTRACT

Background: Building an equitable health system is a cornerstone of the World Health Organization (WHO) health system building block framework. Public participation in any such reform process facilitates successful implementation. South Africa has embarked on a major reform in health policy that aims at redressing inequity and enabling all citizens to have equal access to efficient and quality health services.

Objective: This research is based on a survey using Mxit as a mobile phone-based social media network. It was intended to encourage comments on the proposed National Health Insurance (NHI) and to raise awareness among South Africans about their rights to free and quality health care.

Methods: Data were gathered by means of a public e-consultation, and following a qualitative approach, were then examined and grouped in a theme analysis. The WHO building blocks were used as the conceptual framework in analysis and discussion of the identified themes.

Results: Major themes are the improvement of service delivery and patient-centered health care, enhanced accessibility of health care providers, and better health service surveillance. Furthermore, health care users demand stronger outcome-based rather than rule-based indicators of the health system's governance. Intersectoral solidarity and collaboration between private and public health care providers are suggested. Respondents also propose a code of ethical values for health care professionals to address corruption in the health care system. It is noteworthy that measures for dealing with corruption or implementing ethical values are neither described in the WHO building blocks nor in the NHI.

Conclusions: The policy makers of the new health system for South Africa should address the lack of trust in the health care system that this study has exposed. Furthermore, the study reveals discrepancies between the everyday lived reality of public health care consumers and the intended health policy reform.

No MeSH data available.


WHO building blocks of a health system [46].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4259968&req=5

figure1: WHO building blocks of a health system [46].

Mentions: A qualitative analysis [59-61] was performed on the responses. Messages were “cleaned” by deleting space holders and re-allocating the answers to the appropriate questions where necessary. Replies were coded until a saturation of themes was reached, and no new topics emerged. The qualitative data took the form of phrases but were mainly embedded in free-flowing text. Analysis of free-flowing text requires methods that reduce the text to codes [61]. Codes were analyzed by using NVivo as a qualitative data analysis tool, and these were mapped to both NHI themes and the framework of the WHO building blocks (Figure 1). Overall, the dataset should provide a picture of how reform of national health policy is perceived by the public.


Consumers' perspectives on national health insurance in South Africa: using a mobile health approach.

Weimann E, Stuttaford MC - JMIR Mhealth Uhealth (2014)

WHO building blocks of a health system [46].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4259968&req=5

figure1: WHO building blocks of a health system [46].
Mentions: A qualitative analysis [59-61] was performed on the responses. Messages were “cleaned” by deleting space holders and re-allocating the answers to the appropriate questions where necessary. Replies were coded until a saturation of themes was reached, and no new topics emerged. The qualitative data took the form of phrases but were mainly embedded in free-flowing text. Analysis of free-flowing text requires methods that reduce the text to codes [61]. Codes were analyzed by using NVivo as a qualitative data analysis tool, and these were mapped to both NHI themes and the framework of the WHO building blocks (Figure 1). Overall, the dataset should provide a picture of how reform of national health policy is perceived by the public.

Bottom Line: Public participation in any such reform process facilitates successful implementation.It is noteworthy that measures for dealing with corruption or implementing ethical values are neither described in the WHO building blocks nor in the NHI.Furthermore, the study reveals discrepancies between the everyday lived reality of public health care consumers and the intended health policy reform.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Public Health and Family Medicine, Health Sciences Faculty, University of Cape Town, Observatory, Cape Town, South Africa. prof.dr.weimann@gmail.com.

ABSTRACT

Background: Building an equitable health system is a cornerstone of the World Health Organization (WHO) health system building block framework. Public participation in any such reform process facilitates successful implementation. South Africa has embarked on a major reform in health policy that aims at redressing inequity and enabling all citizens to have equal access to efficient and quality health services.

Objective: This research is based on a survey using Mxit as a mobile phone-based social media network. It was intended to encourage comments on the proposed National Health Insurance (NHI) and to raise awareness among South Africans about their rights to free and quality health care.

Methods: Data were gathered by means of a public e-consultation, and following a qualitative approach, were then examined and grouped in a theme analysis. The WHO building blocks were used as the conceptual framework in analysis and discussion of the identified themes.

Results: Major themes are the improvement of service delivery and patient-centered health care, enhanced accessibility of health care providers, and better health service surveillance. Furthermore, health care users demand stronger outcome-based rather than rule-based indicators of the health system's governance. Intersectoral solidarity and collaboration between private and public health care providers are suggested. Respondents also propose a code of ethical values for health care professionals to address corruption in the health care system. It is noteworthy that measures for dealing with corruption or implementing ethical values are neither described in the WHO building blocks nor in the NHI.

Conclusions: The policy makers of the new health system for South Africa should address the lack of trust in the health care system that this study has exposed. Furthermore, the study reveals discrepancies between the everyday lived reality of public health care consumers and the intended health policy reform.

No MeSH data available.