What is the status quo of South Africa's National Health Insurance pilot project?

Abstract Molecular diagnosis is now an official part of the diagnosis of brain tumors. Since WHO2016 incorporated the status of IDH mutation and 1p/19q codeletion as a part of the definition for oligodendrogliomas, astrocytomas and glioblastomas, molecular tests have become an essential part of the clinical management of adult gliomas. However, these tests are not covered by the National Health Insurance in Japan, and the cost and the limited availability of tests are prohibitive to perform molecular tests in most hospitals where brain tumor patients are treated. In 2015, the Committee for Molecular Diagnosis of Brain Tumor was established within the Japan Society for Neuro-Oncology in order to develop a standardized molecular tests for adult gliomas under the National Health Insurance. For the detection of 1p/19q codeletion, FISH is the most commonly used method. However, the widely available commercial FISH probe is located within 1p36, the regions where partial deletion often occurs in glioblastoma. This could lead to miss-judgement of 1p/19q codeletion which may result in miss-diagnosis. We have designed a novel FISH probes located in the region of 1p and 19q where partial deletions are rarely found, and are developing them as an in vitro diagnostic tests. Our ultimate aim is to establish a standardized molecular tests for adult gliomas under the National Health Insurance.

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Inclusion of family planning within the National Health Insurance benefits package in Ghana: A health facility assessment

10.31899/sbsr2021.1034 ◽

2021 ◽

Keyword(s):

Health Insurance ◽

Family Planning ◽

National Health Insurance ◽

National Health ◽

Scale Up ◽

Pilot Project ◽

Health Facilities ◽

Insurance Benefits ◽

Facility Assessment ◽

Benefits Package

In Ghana, National Health Insurance Act 852 of 2012 ensures that health-care benefits include family planning (FP) services, however people continue to pay for FP services because the policy is yet to be implemented in practice. Under the leadership of the Ministry of Health, the National Health Insurance Authority in collaboration with the Ghana Health Service, Marie Stopes International-Ghana and the Population Council implemented a pilot project to remove FP service out-of-pocket costs. All modern clinical FP methods were added to national health insurance and expensed by health facilities through the national health insurance claims process. The intervention significantly increased the number of new acceptors of FP services and increased uptake of specific methods. According to this report, the pilot also demonstrated that FP can be included in the national health insurance benefits package without setbacks as health facilities were able to process their claims. As stakeholders consider scaling up the intervention of including FP into the national health insurance benefits package, it is important to assess the availability of FP services and readiness of health facilities for the scale-up.

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South Africa: Embracing National Health Insurance—In Name Only

Achieving Access ◽

10.7591/cornell/9781501709968.003.0005 ◽

2017 ◽

Author(s):

Joseph Harris

Keyword(s):

South Africa ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Political Competition ◽

African National Congress ◽

Radical Reform ◽

The Status ◽

National Congress ◽

Measured Response

Although a constellation of factors would seem to have predisposed South Africa to make major new commitments to expand access to healthcare after the fall of apartheid, embrace of National Health Insurance has taken place in name only more than 20 years later. The chapter suggests that this sad tragedy owes its fate paradoxically to dynamics of political competition that left the African National Congress unrivalled and unchallenged, with a strong mandate to rule. Torn between a desire for radical reform – that would destroy the medical schemes that serve a privileged few – and a more incremental and measured response that would leave them in place, amid a lack of political competition, the ruling party has opted for the status quo. And the entreaties of a professional movement have gone unanswered.

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