scholarly journals The Views of Public Service Managers on the Implementation of National Health Insurance in Primary Care

2021 ◽  
Author(s):  
Shane Darren Murphy ◽  
Shabir Ahmed Moosa
Keyword(s):  
Health Insurance ◽  
South African ◽  
National Health Insurance ◽  
National Health ◽  
South African Government ◽  
The South ◽  
Top Down ◽  
African Government ◽  
Strategic Purchasing ◽  
Universal Healthcare

Abstract Background The South African government is implementing National Health Insurance as a monopsony health care financing mechanism to drive the country towards Universal Health Coverage. Strategic purchasing, with separation of funder, purchaser and provider, underpins this initiative. The NHI plans contracting units for primary healthcare services to function as independent sub-district purchasers and District Health Management Offices to support and monitor these contracting units. This decentralised governance model to the operational unit of primary healthcare, the heartbeat of any universal healthcare system, is critical to programme success. The views of district-level managers, who are at the centre of the planned phased rollout will shed light on current policy implementation.ObjectivesThis is a qualitative study to explore district and sub-district managerial views on National Health Insurance and its implementation. Methods Purposive sampling was used to identify key respondents from a major urban district in Gauteng, South Africa, for participation in exploratory in-depth interviews. This study employed framework analysis within MaxQDA software for robust thematic analysis. Results Managers viewed National Health Insurance as a social and moral imperative but lacked clarity and insight into the National Health Insurance Bill and relevant implementation strategies. The majority of respondents had not received any engagement or had the opportunity to engage in policy formulation. District managers highlighted several pitfalls in current organisational operations. National and provincial government continue to function in a detached and rigid top-down hierarchy. The voices of coalface managers and workers, who live the reality of South African healthcare service provision, go unheard and unengaged. The findings of this study dishearteningly echo lessons already learned around established pillars of universal healthcare implementation such as human resources, multi-lateral stakeholder engagement and collaboration, devolution of governance with empowerment and capacitation of district managers. These findings imply that the South African Government has failed to anticipate and address these challenges and raises questions around reflective and experiential practices of the South African government. Conclusion It appears that strategic purchasing is not being operationalised in PHC. NHI policy implementation appears trapped in a rigid top-down hierarchy. District managers need to be engaged and capacitated to operationalise the planned decentralised purchasing-provision function of NHI.

scholarly journals The views of public service managers on the implementation of National Health Insurance in primary care: a case of Johannesburg Health District, Gauteng Province, Republic of South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
S D Murphy ◽  
S Moosa
Keyword(s):  
South Africa ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Policy Development ◽  
Implementation Strategies ◽  
Policy Formulation ◽  
Top Down ◽  
Urban District ◽  
Strategic Purchasing

Abstract Background The South African government is implementing National Health Insurance (NHI) as a monopsony health care financing mechanism to drive the country towards Universal Health Coverage (UHC). Strategic purchasing, with separation of funder, purchaser and provider, underpins this initiative. The NHI plans Contracting Units for Primary healthcare (PHC) Services (CUPS) to function as either independent sub-district purchasers or public providers and District Health Management Offices (DHMOs) to support and monitor these CUPS. This decentralised operational unit of PHC, the heartbeat of NHI, is critical to the success of NHI. The views of district-level managers, who are responsible for these units, are fundamental to this NHI implementation. This qualitative study aimed to explore district and sub-district managerial views on NHI and their role in its implementation. Methods Purposive sampling was used to identify key respondents from a major urban district in Gauteng, South Africa, for participation in in-depth interviews. This study used framework analysis methodology within MaxQDA software. Results Three main themes were identified: managerial engagement in NHI policy development (with two sub-themes), managerial views on NHI (with three sub-themes) and perceptions of current NHI implementation (with six sub-themes). The managers viewed NHI as a social and moral imperative but lacked clarity and insight into the NHI Bill as well as the associated implementation strategies. The majority of respondents had not had the opportunity to engage in NHI policy formulation. Managers cited several pitfalls in current organisational operations. The respondents felt that national and provincial governments continue to function in a detached and rigid top-down hierarchy. Managers highlighted the need for their inclusion in NHI policy formulation and training and development for them to oversee the implementation strategies. Conclusions It appears that strategic purchasing is not being operationalised in PHC. NHI policy implementation appears to function in a rigid top-down hierarchy that excludes key stakeholders in the NHI implementation strategy. The findings of this study suggest an inadequate decentralisation of healthcare governance within the public sector necessary to attain UHC. District managers need to be engaged and capacitated to operationalise the planned decentralised purchasing-provision function of the DHS within the NHI Bill.

Exploring the South African Government Communication on Land Expropriation without Compensation

2020 ◽  
Vol 72 (1-3) ◽  
Author(s):  
Lungisani Moyo
Keyword(s):  
South Africa ◽  
Food Security ◽  
South African ◽  
Small Scale ◽  
South African Government ◽  
Eastern Cape ◽  
The South ◽  
Land Expropriation ◽  
African Government ◽  
Government Communication

ABSTRACT This paper used qualitative methodology to explore the South African government communication and land expropriation without compensation and its effects on food security using Alice town located in the Eastern Cape Province South Africa as its case study. This was done to allow the participants to give their perceptions on the role of government communication on land expropriation without compensation and its effects on South African food security. In this paper, a total population of 30 comprising of 26 small scale farmers in rural Alice and 4 employees from the Department of Agriculture (Alice), Eastern Cape, South Africa were interviewed to get their perception and views on government communications and land expropriation without compensation and its effects on South African food security. The findings of this paper revealed that the agricultural sector plays a vital role in the South African economy hence there is a great need to speed up transformation in the sector.

Sustainable housing financing model to reduce South Africa housing deficit

2017 ◽  
Vol 10 (3) ◽  
pp. 410-430 ◽  
Author(s):  
Bashir Olanrewaju Ganiyu ◽  
Julius Ayodeji Fapohunda ◽  
Rainer Haldenwang
Keyword(s):  
South Africa ◽  
South African ◽  
Affordable Housing ◽  
Low Income ◽  
Low Cost ◽  
South African Government ◽  
The South ◽  
African Government ◽  
Content Type ◽  
Mortgage Payment

Purpose This study aims to identify and establish effective housing financing concepts to be adopted by government in achieving its mandate of providing sustainable affordable housing for the poor to decrease the building of shacks, as well as proposing solutions to the housing deficit in South Africa. A rise in demand and shortage in supply of housing calls for the need to address issues of affordable housing in South Africa, and developing countries in general, to ensure a stable and promising future for poor families. Design/methodology/approach Literature has revealed that the South African government, at all levels, accorded high priority to the provision of low-cost housing. Thus, government has adopted subsidy payment as a method of financing affordable housing to ensure that houses are allocated free to the beneficiaries. This also addresses the historically race-based inequalities of the past, but unfortunately, this has not been fully realised. This study uses a sequential mixed method approach, where private housing developers and general building contractors were the research participants. The qualitative data were analysed using a case-by-case analysis, and quantitative data were analysed using a descriptive statistical technique on SPSS. Findings The results of the qualitative analysis reveal a gross abuse of the housing subsidies system by the beneficiaries of government-funded housing in South Africa. This is evident from illegal sale of the houses below market value. This has led to a continual building of shacks and an increased number of people on the housing waiting list instead of a decrease in the housing deficit. The results from quantitative analysis affirm the use of “Mortgage Payment Subsidies, Mortgage Payment Deductions, Down-Payment Grant and Mortgage Interest Deductions” as viable alternatives to subsidy payment currently in use to finance affordable housing projects by the South African Government. Practical implications At the moment, the focus of the South African National Government is continual provision of free housing to the historically disadvantage citizens, but the housing financing method being used encourages unapproved transfer of ownership in the affordable housing sector. This study thus recommends the use of an all-inclusive housing financing method that requires a monetary contribution from the beneficiaries to enable them take control of the process. Originality/value The relational interface model proposed in this study will reduce pressure on government budgetary provision for housing and guarantee quick return of private developers’ investment in housing. Government must, as a matter of urgency, launch a continuous awareness programme to educate the low-income population on the value and the long-term benefits of the housing.

scholarly journals Profligate spending exploits wildlife in Taiwan

Oryx ◽  
1991 ◽  
Vol 25 (1) ◽  
pp. 18-20 ◽  
Author(s):  
Chryssee Bradley Martin ◽  
Esmond Bradley Martin
Keyword(s):  
South Africa ◽  
South African ◽  
South African Government ◽  
The South ◽  
African Government ◽  
Return Visit

When the authors visited Taiwan in 1988 they discovered that much of the rhino horn on sale there had come from South Africa. Since then action by the South African Government and Taiwanese Customs has stopped these illegal imports. A return visit in 1990 revealed that the same is not true of horn from Asian rhinos; demand for this is increasing and wealthy Taiwanese, aware that prices will rise even higher as rhinoceros numbers decline, are buying it as an investment. Although imports of rhino horn have been prohibited in Taiwan since 1985, the smuggling goes on, encouraged by the fact that domestic sales of horn still continue despite a total ban initiated in 1989.

scholarly journals TRANSFORMATION OF GOVERNANCE IN STATE-OWNED COMPANIES: THE CASE OF SOUTH AFRICA AS A DEVELOPING COUNTRY

2021 ◽  
Vol 9 (7) ◽  
pp. 162-176
Author(s):  
Maphelo Malgas ◽  
Bonginkosi Wellington Zondi
Keyword(s):  
South Africa ◽  
South African ◽  
General Public ◽  
African State ◽  
South African Government ◽  
The South ◽  
African Government ◽  
Financial Reports ◽  
The People ◽  
The Will

The basis of this article is an article published by Thomas (2012) whose objective was to track over a two-year period the performance of five strategic South African state-owned enterprises with regards to issues of governance. These enterprises were ESKOM, South African Airways (SAA), South African Broadcasting Corporation (SABC), Telkom, and Transnet. The paper revealed that there were serious transgressions in these entities and recommendations were made to address these. The aim of this article therefore was to establish whether or not the transgressions reported by Thomas are still happening within these entities. The data was collected from the 2014/2015, 2015/2016, 2016/2017, and 2017/2018 financial reports of these entities. The study revealed that the transgressions are still taking place. With regards to issues of sustainability SAA and SABC continue to make loses, with SAA continuing to be bailed out by the South African government against the will of the South African general public. Fruitless and wasteful expenditure increased in all the five entities mentioned above and no serious action has been taken by the South African government to hold the people responsible accountable. While Telkom, Transnet and Eskom were making profits these profits are not at the envisaged level.

Ethnicity, Tribalism, and Xenophobia in a South African Rural-Based University

2021 ◽  
pp. 152-172
Author(s):  
Mavhungu Abel Mafukata
Keyword(s):  
Social Behavior ◽  
Cultural Diversity ◽  
South African ◽  
Higher Learning ◽  
South African Government ◽  
The South ◽  
African Government ◽  
Ethnic Tensions ◽  
Institutions Of Higher Learning ◽  
The University

The South African government has lobbied institutions of higher learning to recruit academics from across Africa to address the challenge of shortage of skills. Some universities have indeed exploited this opportunity. However, it has emerged that these nationals get to face unbearable anti-social behavior from the locals. Among others, these expatriates contend incidences of tribal-ethnic tensions and xenophobia. Multiple theories were adopted to assist the analysis. The results revealed that there was evidence of tribalism, ethnicity, and incited xenophobia at this university. Furthermore, the study found that the acts of tribalism and ethnicity cut across the university community. The study revealed that deaneries and departments reflected ethnic-tribal orientations depending on the tribes of the respective incumbents in those sections. The university should recognise that it has become a space of cultural diversity where people should be recognized outside the ethnic and tribal framework of locality.

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