scholarly journals Awareness of Health Care Practitioners About the National Health Insurance in Tshwane District, South Africa

2018 ◽  
Vol 11 (1) ◽  
pp. 93-103 ◽  
Author(s):  
L.H. Mabuza ◽  
G.A. Ogunbanjo ◽  
K.E. Hlabyago ◽  
M. Mogotsi
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
School Health ◽  
Health Coverage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Care Practitioners

Background: In 2012, the National Department of Health of South Africa launched the National Health Insurance (NHI) pilot program in 11 districts, towards universal health coverage for all South Africans. Health Care Practitioners (HCPs) are important role-players in its implementation. We decided to evaluate to what extent the HCPs were aware of the NHI program after three years of the pilot phase. Objective: To evaluate the awareness of HCPs about the NHI in the pilot Tshwane district of South Africa. Method: A cross-sectional survey was conducted among 1753 HCPs in Tshwane district. At 95% confidence level and 5% error margin, the sample size was 315 HCPs, but we over-sampled to 480. The study was conducted in 25 health facilities within the district. A pre-tested self-administered questionnaire was used. Results: A high proportion of HCPs were unaware of the objectives of the NHI program (p < 0.001); number of NHI pilot sites [(281; 59.4%) versus (145; 30.7%), p < 0.001]; rationale used to select pilot sites [(223; 46.9%) versus (193; 40.5%), p = 0.047]; role of the Integrated School Health Services (ISHP) [(250; 52.7%) versus (70; 14.8%), p < 0.001]; and specialists constituting the District Clinical Specialist Team (DCST) (p < 0.001). However, awareness regarding the Ward-Based Outreach Team (WBOT) leader was high [(236; 49.9%) versus (135; 28.5%), p < 0.001]. Conclusion: HCPs in Tshwane district demonstrated poor awareness of the NHI. This reveals that any awareness effort towards the NHI has not taken effect among the HCPs in this district.

scholarly journals Ghana’s Journey towards Universal Health Coverage: The Role of the National Health Insurance Scheme

2019 ◽  
Vol 10 (1) ◽  
pp. 94-109 ◽  
Author(s):  
Kipo-Sunyehzi ◽  
Amogre Ayanore ◽  
Dzidzonu ◽  
Ayalsuma Yakubu
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Universal Health Coverage ◽  
National Health Insurance Scheme ◽  
Health Insurance Scheme ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Universal Health

: Background: the main aim of the study is to find if the National Health Insurance Scheme (NHIS) in Ghana is achieving universal health coverage (UHC) or not. The study gives the trajectories of health policies in Ghana and their implications on long term health financing. NHIS in Ghana was implemented in 2004, with the aim of increasing subscribers’ access to health care services and reduce financial barriers to health care. On equity access to healthcare, it addresses two core concerns: (1) enrolling particular groups (persons exempted from annual premium payments) and (2) achieving UHC for all citizens and persons with legal residence. It utilizes a multifactor approach to the conceptualization of UHC. The research question: is Ghana’s NHIS on course to deliver or achieve universal health coverage? Methods: we used qualitative methods. In doing so, the study engaged participants in in-depth interviews, focus group discussions and direct observations of participants in their natural settings, like hospitals, clinics, offices and homes, with purposive and snowball techniques. This data triangulation approach aims to increase the reliability and validity of findings. Results: the empirical evidence shows NHIS performed relatively well in enrolling more exempt groups (particular groups) than enrolling all persons in Ghana (UHC). The biggest challenge for the implementation of NHIS from the perspectives of health insurance officials is inadequate funding. The health insurance beneficiaries complained of delays during registrations and renewals. They also complained of poor attitude of some health insurance officials and health workers at facilities. Conclusions: both health insurance officials and beneficiaries emphasized the need for increased public education and for implementers to adopt a friendly attitude towards clients. To move towards achieving UHC, there is a need to redesign the policy, to move it from current voluntary contributions, to adopt a broad tax-based approach to cover all citizens and persons with legal residence in Ghana. Also, to adopt a flexible premium payment system (specifically ‘payments by installation’ or ‘part payments’) and widen the scope of exempt groups as a way of enrolling more into the NHIS.

scholarly journals Relationship between Health Insurance Status and the Pattern of Traditional Medicine Utilisation in Ghana

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Razak Mohammed Gyasi
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Traditional Medicine ◽  
National Health Insurance ◽  
National Health ◽  
Health Care Professionals ◽  
Work Experience ◽  
Insurance Status ◽  
Cross Sectional Survey ◽  
Health Insurance Status

This paper examines the relationship between national health insurance status and the pattern of traditional medicine (TRM) use among the general population in Ghana. A retrospective cross-sectional survey of randomly sampled adults, aged ≥18 years (N=324), was conducted. The results indicate that TRM use was high with prevalence of over 86%. The study found no statistically significant association between national health insurance status and TRM utilisation (P>0.05). Paradoxically, major sources of TRM, frequency of TRM use, comedical administration, and disclosure of TRM use to health care professionals differed significantly between the insured and uninsured subgroups (P<0.001). Whereas effectiveness of TRM predicted its use for both insured [odds ratio (OR) = 4.374 (confidence interval (CI): 1.753–10.913;P=0.002)] and uninsured [OR = 3.383 CI: 0.869–13.170;P=0.039)], work experience predicted TRM use for the insured [OR = 1.528 (95% CI: 1.309–1.900;P=0.019)]. Cultural specific variables and health philosophies rather than health insurance status may influence health care-seeking behaviour and TRM use. The enrollment of herbal-based therapies on the national health insurance medicine plan is exigent to ensure monitoring and rational use of TRM towards intercultural health care system in Ghana.

scholarly journals The bypassing of healthcare facilities among National Health Insurance Scheme enrollees in Ibadan, Nigeria

2020 ◽  
Author(s):  
Adetola O Oladimeji ◽  
David A Adewole ◽  
Folashayo Adeniji
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Health Facilities ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional Survey ◽  
Additional Time ◽  
Cross Sectional

Abstract Background Bypassing occurs when patients knowingly visit a health facility other than the one they live nearest to. In Ibadan, southwest Nigeria, the majority of enrollees in the National Health Insurance Scheme (NHIS) receive medical care in just 12% of the available NHIS-accredited facilities. Given that enrollees access healthcare services at highly subsidized rates under the scheme, this study aimed to determine the factors responsible for the observed distribution of enrollees across these health facilities. Methods The study was a descriptive cross-sectional survey conducted among NHIS enrollees receiving care at outpatient departments of five randomly selected accredited health facilities in Ibadan. A total of 311 NHIS enrollees were consecutively recruited and a semistructured, pretested, interviewer-administered questionnaire was used to elicit information from respondents. Descriptive and inferential statistics were used to present results at 5% level of significance. Distance traveled by patients from their residence to the facilities was measured using Google maps. Results The mean age of respondents was 37.1±16.1 y. There were 167 (53.7%) males and 224 (72.3%) were married. The bypassing rate was 174 (55.3%). More than a third of enrollees, 127 (41.0%), reported that their hospital choice was made based on physician referral, 130 (41.8%) based on personal choice, 26 (8.4%) based upon the recommendation of the Health Management Organization (HMO), while 27 (8.7%) were influenced by friends/family/colleagues. Bypassing was positively associated with educational status (X2 = 13.147, p=0.004). Respondents who bypassed expended additional time and money traveling to the farther away hospitals, 35.1 (±34.66) min and 389.51 (±545.21) naira per visit, respectively. Conclusion The level of bypassing among enrollees was fairly high. Enrollees should be properly guided regarding the need to access healthcare in facilities closer to them by their HMOs and physicians in the case of referrals. This will reduce bypassing and the cost of travel leading to better outcomes among enrollees.

scholarly journals Universal Health Coverage (UHC)

2018 ◽  
Vol 32 (4) ◽  
pp. 322-324
Author(s):  
Samlee Plianbangchang
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Universal Health Coverage ◽  
Health Care Systems ◽  
Good Health ◽  
Health Coverage ◽  
Content Type ◽  
Universal Health

Purpose The WHO Health for All goal of the year 2000 was unreachable due to a number of irreconcilable factors. However, governments agree that a resolution must be found to effectively cope with increasing health care costs. Furthermore, national health insurance schemes must be properly refined to suit local situations. Workable health policies and strategies for caring and treating sick people through reduced or cost effective methods must be developed as part of a Universal Health Coverage scheme. A review of progress made toward achieving the WHO goal of health for all. The purpose of this paper is to explore the government’s role and responsibilities to educate and support society to achieve optimum health. Design/methodology/approach This is a commentary piece. Findings Participation and involvement of all people of all walks of life in the development and management of their nation’s health care programs is an important requisite of good health for all. This should include financial participation and co-payment into the national health insurance scheme. Furthermore, national health care systems should involve or include the traditional/local and alternative systems of medicine in the most appropriate manner. Health care has to encompass the total range of comprehensive health interventions, inclusive of at least preventive, curative and rehabilitative care. Originality/value This paper provides a review of the current health system constraints and assesses the effectiveness of available options by way of ensuring that a country-specific UHC system may be successfully implemented.

scholarly journals Factors Of National Health Insurance, Factors Of Health Service And Factors Of Social Security Administrator Influence On The Satisfaction Of Independent BPJS Class One At Kertha Usada General Hospital

2020 ◽  
Vol 3 (2) ◽  
pp. 508-515
Author(s):  
Aditha Angga Pratama
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
National Health Insurance ◽  
National Health ◽  
Universal Coverage ◽  
Simple Random Sampling ◽  
Dominant Factor ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional

Since 2004 Indonesia has campaigned for universal coverage as one of the improvements in health status. But until now there are still many Health insurance organizer (BPJS) participants who feel unsatisfied with the services they get, especially when Health insurance organizer participants are self-employed in class I inpatient services. The goal of this study is to identify the most dominant factor that can affect the satisfaction of Health insurance organizer participants' services in Kertha Usadha. The cross sectional survey research was conducted on 104 class 1 independent Health insurance organizer participants by simple random sampling. The selected Health insurance organizer participants were interviewed while in a state of hospitalization that was adjusted to the inclusion criteria of this study. The instrument used a structured questionnaire, with several related variables: characteristics, National Health Insurance factors, Health insurance organizer and health services. Variables were analyzed using Chi Square and then Logistic Regression with software. The results of this study found that 54.8% of B Health insurance organizer participants were satisfied with the services provided. While the results of multivariate analysis found that the factors influencing the satisfaction of Health insurance organizer participants were the National Health Insurance Factors that were good to moderate services (AOR: 1.2, 95% CI 0.8-1.43), good to less services (AOR: 3.4, 95% CI 1.5-7.53) and health service factors (AOR: 9.6, 95% CI 2.37-39.3). Health insurance organizer participant satisfaction is still low so it needs improvement in everything. So that later with increased satisfaction can improve the degree of public health

scholarly journals DETERMINANT OF INDEPENDENT NATIONAL HEALTH INSURANCE OWNERSHIP IN INDONESIA

2019 ◽  
Vol 19 (2) ◽  
pp. 109-115
Author(s):  
Bela Sari ◽  
Haerawati Idris
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Junior High School ◽  
P Value ◽  
Health Coverage ◽  
Chi Square ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Chi Square Analysis

The increasing of Independent National Health Insurance (NHI) membership is one of the indicators to achieve Universal Health Coverage. One of the challenges in extending such coverage is reaching it out to the informal sector. This study was aimed to analyze the determinants of Independent NHI ownership in Indonesia. This study used cross-sectional design, and the data were derived from Indonesian Family Live Survey (IFLS) 2014. 6,888 individuals aged ≥40 years were the sample of this study. To analyze the data, chi-square analysis and logistic regression were used. Based on the analysis, the proportion of respondent with Independent NHI is 16.6%. The ownership of independent NHI is influenced by the following factors: age 40-55 (PR=1.72 95%CI 1.41-2.09, p-value <0.001), Sumatra Island (PR=7.67 95%CI 5.55-10.59 p-value<0.001), very rich (PR = 2.26 95%CI 1.85-2.75 p-value <0.001), history of chronic disease (PR=1.33 95%CI 1.15-1.53 p-value<0.001), junior high school (PR = 2.21 95%CI 1.92-2.55 p-value<0.001), and urban (PR=1.79 95%CI 1.57-2.04 p-value <0.001). Region is the most dominant variable related to NHI ownership (p-value <0.001; Exp B= 7.03; 95% CI: 5.06-9.77). Independent NHI membership has not been maximal, yet. To increase this participation, the Social Security Administrator should approach each region with low NHI membership through promotion, socialization, and education about registration and the benefits of independent NHI.

scholarly journals An overview of the National Health Insurance and its possible impact on eye healthcare services in South Africa

2015 ◽  
Vol 74 (1) ◽  
Author(s):  
H. Lawrence Sithole
Keyword(s):  
South Africa ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
Public Healthcare ◽  
Health Coverage ◽  
Care Providers ◽  
Eye Care

The National Health Insurance (NHI) is an important development that underpins democracy in South Africa. It aims to redress the inequities of public healthcare delivery by implementing transformational policies towards establishing inclusive public healthcare coverage for the entire population of South Africa, with more emphasis on health promotion. The implementation of this initiative has created some hope amongst primary eye healthcare professionals, such as optometrists, that their profession may finally be given the recognition it deserves. Although the government is contemplating introducing a new directorate for eye healthcare and forming an advisory committee on eye healthcare reporting to the Minister of Health, the extent to which eye healthcare will be incorporated into the NHI is currently not clear. It is believed that the white paper on the NHI will shed some light on these issues. Unfortunately, current indications are that the initiative has serious challenges to overcome such as poor infrastructure, budgetary constraints and lack of interest from other healthcare professionals. Furthermore, corruption issues may also need to be addressed if the NHI is to be implemented successfully. Nevertheless, the NHI remains a positive proposition for universal health coverage for the people of South Africa, and there is hope that primary eye care providers, such as optometrists and other eye care professionals, will also play a greater role in the NHI than they currently do in the public healthcare system.

scholarly journals Public engagement in the development of the National Health Insurance: a study involving patients from a central hospital in South Africa.

2019 ◽  
Author(s):  
Lizeka Amanda Tandwa ◽  
Ames Dhai
Keyword(s):  
South Africa ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Policy Making ◽  
Public Involvement ◽  
Structured Interview ◽  
P Value ◽  
Cross Sectional ◽  
Policy Making Process

Abstract Background: Public involvement of citizens in the legislative development process is a constitutional requirement in South Africa. Patient engagement refers to the active involvement of patients in the decision-making processes at multiple levels in the health system. In order for patients to be engaged, they need to be provided with relevant information and an opportunity to be involved in the policy-making process. Methods: This was cross sectional and quantitative study with descriptive and comparative analyses. Two hundred and forty-four patients from the follow-up clinics at the Internal Medicine Department of Charlotte Maxeke Johannesburg Academic Hospital in the Gauteng Province, South Africa. The patients were interviewed through a structured interview process, using a questionnaire. Descriptive statistics and logistic regression univariate and multivariate analyses were run. Results: The majority (79.51%) of the participants were not aware of the proposed National Health Insurance (NHI) in South Africa even though process commenced in 2011. Most of the participants (86%) who were aware of the NHI had not received an opportunity to be involved in the policy making process of the NHI. About ninety-one percent of the participants (91.39%) knew that they had a right to be involved in the policy making process of the NHI. The odds of awareness were higher for male (OR: 2.08, 95% CI: 1.11 – 3.9, p value: 0.02) than female participants. The odds of awareness were higher for White (OR: 2.36, 95% CI: 1.06 – 5.26, p value: 0.04) and Indian (OR: 2.76, 95% CI: 0.10 – 7.60, p value: 0.05) participants when compared to Black participants. The odds of awareness were higher for retired (OR: 3.13, 95% CI: 1.35 – 7.25, p value: 0.008) than unemployed participants. Conclusions: Without the awareness and information about the NHI, patients are not equipped to be involved in the NHI policy process in a meaningful way.

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