scholarly journals Achieving universal health coverage for people with stroke in South Africa: protocol for a scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e041221
Author(s):  
Sjan-Mari van Niekerk ◽  
Gakeemah Inglis-Jassiem ◽  
Sureshkumar Kamalakannan ◽  
Silke Fernandes ◽  
Jayne Webster ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
Universal Health Coverage ◽  
Scoping Review ◽  
Research Question ◽  
Health Coverage ◽  
African Health ◽  
Ethical Approval ◽  
Analyse Data ◽  
Universal Health

IntroductionStroke is the second most common cause of death after HIV/AIDS and a significant health burden in South Africa. The extent to which universal health coverage (UHC) is achieved for people with stroke in South Africa is unknown. Therefore, a scoping review to explore the opportunities and challenges within the South African health system to facilitate the achievement of UHC for people with stroke is warranted.Methods and analysisThe scoping review will follow the approach recommended by Levac, Colquhoun and O’Brien, which includes five steps: (1) identifying the research question, (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, and (5) collating, summarising and reporting the results. Health Systems Dynamics Framework and WHO Framework on integrated people-centred health services will be used to map, synthesise and analyse data thematically.Ethics and disseminationEthical approval is not required for this scoping review, as it will only include published and publicly available data. The findings of this review will be published in an open-access, peer-reviewed journal and we will develop an accessible summary of the results for website posting and stakeholder meetings.

scholarly journals Are we advancing universal health coverage through cataract services? Protocol for a scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e039458
Author(s):  
Chan Ning Lee ◽  
Jacqueline Ramke ◽  
Ian McCormick ◽  
Justine H Zhang ◽  
Ada Aghaji ◽  
...  
Keyword(s):  
Global Health ◽  
Universal Health Coverage ◽  
Scoping Review ◽  
Population Based ◽  
Financial Protection ◽  
Health Coverage ◽  
Surgical Services ◽  
Ethical Approval ◽  
Service Data ◽  
Universal Health

IntroductionUniversal health coverage (UHC) includes the dimensions of equity in access, quality services that improve health and protection against financial hardship. Cataract continues to be the leading cause of blindness globally, despite cataract surgery being an efficacious intervention. The aim of this scoping review is to map the nature, extent and global distribution of data on cataract services for UHC in terms of equity, access, quality and financial protection.Methods and analysisThe search will be constructed by an Information Specialist and undertaken in MEDLINE, Embase and Global Health databases. We will include all published non-interventional primary research studies and systematic reviews that report a quantitative assessment of access, equity, quality or financial protection of cataract surgical services for adults at the subnational, national, regional or global level from population-based surveys or routinely collected health service data since 1 January 2000 and published through to February 2020.Screening and data charting will be undertaken using Covidence systematic review software. Titles and abstracts of identified studies will be screened by two authors independently. Full-text articles of potentially relevant studies will be obtained and reviewed independently by two authors against the inclusion criteria. Any discrepancies between the authors will be resolved by discussion, and with a third author as necessary. A data charting form will be developed and piloted on three studies by three authors and amendments made as necessary. Data will be extracted by two reviewers independently and summarised narratively and using maps.Ethics and disseminationEthical approval was not sought as the scoping review will only use published and publicly accessible data. The review will be published in an open access peer-reviewed journal. A summary of the results will be developed for website posting, stakeholder meetings and inclusion in the ongoing Lancet Global Health Commission on Global Eye Health.

scholarly journals Towards universal health coverage for people with stroke in South Africa: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049988
Author(s):  
Sjan-Mari van Niekerk ◽  
Sureshkumar Kamalakannan ◽  
Gakeemah Inglis-Jassiem ◽  
Maria Yvonne Charumbira ◽  
Silke Fernandes ◽  
...  
Keyword(s):  
South Africa ◽  
Service Delivery ◽  
Health System ◽  
Universal Health Coverage ◽  
Scoping Review ◽  
Stroke Care ◽  
Government Support ◽  
Health Coverage ◽  
Diverse Range ◽  
Universal Health

ObjectivesTo explore the opportunities and challenges within the health system to facilitate the achievement of universal health coverage (UHC) for people with stroke (PWS) in South Africa (SA).SettingSA.DesignScoping review.Search methodsWe conducted a scoping review of opportunities and challenges to achieve UHC for PWS in SA. Global and Africa-specific databases and grey literature were searched in July 2020. We included studies of all designs that described the healthcare system for PWS. Two frameworks, the Health Systems Dynamics Framework and WHO Framework, were used to map data on governance and regulation, resources, service delivery, context, reorientation of care and community engagement. A narrative approach was used to synthesise results.ResultsFifty-nine articles were included in the review. Over half (n=31, 52.5%) were conducted in Western Cape province and most (n=41, 69.4%) were conducted in urban areas. Studies evaluated a diverse range of health system categories and various outcomes. The most common reported component was service delivery (n=46, 77.9%), and only four studies (6.7%) evaluated governance and regulation. Service delivery factors for stroke care were frequently reported as poor and compounded by context-related limiting factors. Governance and regulations for stroke care in terms of government support, investment in policy, treatment guidelines, resource distribution and commitment to evidence-based solutions were limited. Promising supporting factors included adequately equipped and staffed urban tertiary facilities, the emergence of Stroke units, prompt assessment by health professionals, positive staff attitudes and care, two clinical care guidelines and educational and information resources being available.ConclusionThis review fills a gap in the literature by providing the range of opportunities and challenges to achieve health for all PWS in SA. It highlights some health system areas that show encouraging trends to improve service delivery including comprehensiveness, quality and perceptions of care.

scholarly journals Policy exclusion or confusion? Perspectives on universal health coverage for migrants and refugees in South Africa

2021 ◽  
Author(s):  
Janine A White ◽  
Laetitia C Rispel
Keyword(s):  
South Africa ◽  
South African ◽  
National Health ◽  
Universal Health Coverage ◽  
Resource Constraints ◽  
Civil Society Organizations ◽  
Public Healthcare ◽  
Health Coverage ◽  
The Public ◽  
Universal Health

Abstract Notwithstanding the promise of the inclusivity of universal health coverage (UHC), the integration of migrants and refugees into host countries’ health systems remains elusive and contested. In South Africa, there is insufficient scholarly attention on UHC, migrants and refugees, given the country’s strategic importance in Africa and the envisaged implementation of the National Health Insurance (NHI) system. In this paper, a social exclusion conceptual framework is used to explore whether South African legislation, health policies and perspectives or actions of health policy actors facilitate UHC for migrants and refugees or exacerbate their exclusion. We combined a review of legislation and policies since 1994, with semi-structured interviews with 18 key informants from government, academia, civil society organizations and a United Nations organization. We used thematic analysis to identify themes and sub-themes from the qualitative data. The South African Constitution and the National Health Act facilitate UHC, while the Immigration Act and the 2019 NHI Bill make the legal status of migrants the most significant determinant of healthcare access. This legislative disjuncture is exacerbated by variations in content, interpretation and/or implementation of policies at the provincial level. Resource constraints in the public health sector contribute to the perceived dysfunctionality of the public healthcare system, which affects the financial classification, quality of care and access for all public sector patients. However, migrants and refugees bear the brunt of the reported dysfunctionality, in addition to experiences of medical xenophobia. These issues need to be addressed to ensure that South Africa’s quest for UHC expressed through the NHI system is realized.

scholarly journals Essential Medicines in Universal Health Coverage: A Scoping Review of Public Health Law Interventions and How They Are Measured in Five Middle-Income Countries

2020 ◽  
Vol 17 (24) ◽  
pp. 9524
Author(s):  
Katrina Perehudoff ◽  
Ivan Demchenko ◽  
Nikita V. Alexandrov ◽  
David Brutsaert ◽  
Angela Ackon ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Universal Health Coverage ◽  
Scoping Review ◽  
Health Law ◽  
Health Coverage ◽  
Public Health Law ◽  
Middle Income ◽  
Middle Income Countries ◽  
Universal Health

Very few studies exist of legal interventions (national laws) for essential medicines as part of universal health coverage in middle-income countries, or how the effect of these laws is measured. This study aims to critically assess whether laws related to universal health coverage use five objectives of public health law to promote medicines affordability and financing, and to understand how access to medicines achieved through these laws is measured. This comparative case study of five middle-income countries (Ecuador, Ghana, Philippines, South Africa, Ukraine) uses a public health law framework to guide the content analysis of national laws and the scoping review of empirical evidence for measuring access to medicines. Sixty laws were included. All countries write into national law: (a) health equity objectives, (b) remedies for users/patients and sanctions for some stakeholders, (c) economic policies and regulatory objectives for financing (except South Africa), pricing, and benefits selection (except South Africa), (d) information dissemination objectives (ex. for medicines prices (except Ghana)), and (e) public health infrastructure. The 17 studies included in the scoping review evaluate laws with economic policy and regulatory objectives (n = 14 articles), health equity (n = 10), information dissemination (n = 3), infrastructure (n = 2), and sanctions (n = 1) (not mutually exclusive). Cross-sectional descriptive designs (n = 8 articles) and time series analyses (n = 5) were the most frequent designs. Change in patients’ spending on medicines was the most frequent outcome measure (n = 5). Although legal interventions for pharmaceuticals in middle-income countries commonly use all objectives of public health law, the intended and unintended effects of economic policies and regulation are most frequently investigated.

scholarly journals Embedding quality at the core of universal health coverage in South Africa

2018 ◽  
Vol 6 (11) ◽  
pp. e1153-e1154 ◽  
Author(s):  
Malebona Precious Matsoso ◽  
Jeanette Rebecca Hunter ◽  
Vishal Brijlal
Keyword(s):  
South Africa ◽  
Universal Health Coverage ◽  
Health Coverage ◽  
The Core ◽  
Universal Health

Introduction to Part 5: Health for the whole population—leaving no-one behind

2015 ◽  
Author(s):  
Francis Omaswa ◽  
Nigel Crisp
Keyword(s):  
South Africa ◽  
Global Health ◽  
Universal Health Coverage ◽  
Health Coverage ◽  
Health It ◽  
Universal Health ◽  
The Way

Chapter 16 addresses the way in which universal health coverage has become one of the most important concepts in global health. It sets the scene for the following chapters in which leaders discuss the implementation of universal health coverage in Rwanda, South Africa, and Ghana.

scholarly journals Testing the Contextual Interaction Theory in a UHC Pilot District in South Africa

2020 ◽  
Author(s):  
Janet Michel ◽  
Nthabiseng Mohlakoana ◽  
Till Bärnighausen ◽  
Fabrizio Tediosi ◽  
David Evans ◽  
...  
Keyword(s):  
South Africa ◽  
Policy Implementation ◽  
South African ◽  
Research Question ◽  
Health Coverage ◽  
Interaction Theory ◽  
Policy Practice ◽  
Power Resources ◽  
Information Power ◽  
Leadership Interactions

Abstract Background: World-wide, there is growing universal health coverage (UHC) enthusiasm. The South African government began piloting policies aimed at achieving UHC in 2012. These UHC policies have been and are being rolled out in the ten selected pilot districts. Our study explored policy implementation experiences of 71 actors involved in UHC policy implementation, in one South African pilot district using the Contextual Interaction Theory (CIT) lens.Method: Our study applied a two-actor deductive theory of implementation, Contextual Interaction Theory (CIT) to analyse 71 key informant interviews from one National Health Insurance (NHI) pilot district in South Africa. The theory uses motivation, information, power, resources and the interaction of these to explain implementation experiences and outcomes. The research question centred on the utility of CIT tenets in explaining the observed implementation experiences of actors and outcomes particularly policy- practice gaps.Results: All CIT central tenets (information, motivation, power, resources and interactions) were alluded to by actors in their policy implementation experiences, a lack or presence of these tenets were explained as either a facilitator or barrier to policy implementation. This theory was found as very useful in explaining policy implementation experiences of both policy makers and facilitators. Conclusion: A central tenet that was present in this context but not fully captured by CIT was leadership. Leadership interactions were revealed as critical for policy implementation, hence we propose the inclusion of leadership interactions to the current CIT central tenets, to become motivation, information, power, resources, leadership and interactions of all these.

Structuring Sustainable Universal Health Care in South Africa

2020 ◽  
Vol 50 (2) ◽  
pp. 234-245
Author(s):  
Salimah Valiani
Keyword(s):  
South Africa ◽  
Health Care ◽  
South African ◽  
Health Care Financing ◽  
Historical Sociology ◽  
Public Health Care ◽  
Universal Health Care ◽  
African Health ◽  
Analytical Tools ◽  
Universal Health

Intervening in debates around universal health care in South Africa, this article draws on class-based analytical tools from social medicine, political economy, and historical sociology. It is argued there are 3 keys to achieving sustainable universal health care in South Africa: addressing the socioeconomic roots of ill health; establishing a fully public, nonprofit health care system; and adequate investment in undervalued female workers who are the backbone of public health care. Each key is discussed with accompanying recommendations, using evidence from South Africa and other countries. Principal constraints are also identified through an analysis demonstrating the links between inequality, health care financing, and the monopoly structure of the South African health care industry.

Conclusion

2017 ◽  
Author(s):  
Joseph Harris
Keyword(s):  
United States ◽  
South Africa ◽  
Universal Health Coverage ◽  
Essential Medicine ◽  
The United States ◽  
The Other ◽  
Health Coverage ◽  
Political Dynamics ◽  
A Minor ◽  
Universal Health

This chapter summarizes the overall argument and points to the influential role that elites from esteemed professions played in the institutionalization of policy in the three cases. While in all cases democratization provided new opportunities for professional movements in medicine to use the organizational vehicle of the state to advance universal health coverage and the power of the law to deepen commitments to essential medicine, The chapters relate how the differences in outcomes between Thailand and Brazil, on one hand, and South Africa, on the other, hinged on dramatically different political dynamics. I consider the contemporary state of professional movements and health reforms in the three countries; why health has remained a minor concern to mass movements; the durability of professional movements; the influence of professional movements in other policy domains and cases; and their relevance to the United States and other countries in the industrializing world.

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