scholarly journals Drawing lessons from the standard treatment guidelines and essential medicines list concept in South Africa as the country moves towards national health insurance

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Velisha A. Perumal-Pillay ◽  
Fatima Suleman
Keyword(s):  
South Africa ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Essential Medicines ◽  
Essential Medicines List ◽  
Standard Treatment Guidelines

scholarly journals Use of evidence and negotiation in the review of national standard treatment guidelines and essential medicines list: experience from Ghana

2019 ◽  
Vol 34 (Supplement_2) ◽  
pp. ii104-ii120 ◽  
Author(s):  
Augustina Koduah ◽  
Brian A Asare ◽  
Edith Gavor ◽  
Martha Gyansa-Lutterodt ◽  
Edith Andrews Annan ◽  
...  
Keyword(s):  
Review Process ◽  
Standard Treatment ◽  
Service Providers ◽  
Treatment Guidelines ◽  
Essential Medicines ◽  
National Standard ◽  
Expert Committee ◽  
Research And Practice ◽  
Essential Medicines List ◽  
Standard Treatment Guidelines

Abstract Understanding how countries review their national standard treatment guidelines (STGs) and essential medicines list (EML) is important in the light of ever-changing trends in public health and evidence supporting the selection and use of medicines in disease management. This study examines the 2017 STGs and EML review process, the actors involved and how the list of medicines and disease conditions evolved between the last two editions. We examined expert committee reports, stakeholder engagement reports and the last two editions (2010, 2017) STGs and EML. The review process occurred in both bureaucratic and public arenas where various actors with varied power and interest engaged in ways to consolidate their influence with the use of evidence from research and practice. In the bureaucratic arena, a national medicines selection committee inaugurated by the Minister of Health assessed the 2010 edition through technical sessions considering the country’s disease burden, hierarchical healthcare structure and evidence on safety and efficacy and expert opinion. To build consensus and ensure credibility service providers, professional bodies and healthcare managers scrutinized the assessed guidelines and medicines list in public arenas. In such public arenas, technical discussions moved towards negotiations with emphasis on practicability of the policies. Updates in the 2017 guidelines involved the addition of 64 new disease conditions in the STG, with the EML including 153 additional medicines and excluding 56 medicines previously found in the 2010 EML. Furthermore, the level of care categorization for Level ‘A’ [i.e. community-based health planning and services (CHPS)] and Level ‘M’ (i.e. midwifery and CHPS with a midwife) evolved to reflect the current primary healthcare and community mobilization activities for healthcare delivery in Ghana. Ghana’s experience in using evidence from research and practice and engaging wide stakeholders can serve as lessons for other low and middle-income countries.

scholarly journals Evaluating the implementation of the standard treatment guidelines (STGs) and essential medicines list (EML) at a public South African tertiary institution and its associated primary health care (PHC) facilities

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Tashni Govender ◽  
Fatima Suleman ◽  
Velisha Ann Perumal-Pillay
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Essential Medicines ◽  
Tertiary Institution ◽  
Essential Medicines List ◽  
Primary Health ◽  
Retrospective Audit ◽  
Standard Treatment Guidelines

Abstract Background The standard treatment guidelines (STGs) and essential medicines list (EML) were a policy option recommended in the National Drug Policy for South Africa in 1996 to address the irrational and bloated medicines procurement list. STGs/EML serve as a tool to promote cost-effective use of medicines; rational prescribing; and improve accessibility to medicines for all citizens. The purpose of this study was to evaluate the use and implementation of the STGs/EML by prescribers at a public tertiary institution and its associated Primary Health Care (PHC) facilities in the uMhlathuze subdistrict of KwaZulu Natal. The study aimed to provide feedback and to make recommendations to policy makers to improve the use and implementation of the STGs/EML and to inform National Health Insurance (NHI) policy development. Method An observational quantitative descriptive research design was used. A retrospective audit of prescriptions was conducted, and questionnaires were utilized to collect data from prescribers and the facilities to evaluate the utilization of the STGs/EML and the rational use of medicines. All descriptive analyses were presented as counts with percentages, and Fisher’s exact test was used to compare results. The data was summarized, reduced, and analysed using SAS statistics software. Results 107 medical doctors (97%) responded to the questionnaire at hospital level and 98 nurses (98%) responded to the questionnaire at the PHC level. Results revealed that the majority of doctors, 94.4%, had access to the latest STGs/EML compared with only 41.8% of nurses. 70.3% and 78.3% of doctor’s and nurse’s prescriptions, respectively, adhered to the guidelines. 94.9% of nurses requested training on the use of STGs/EML as most of them had not received formal training on its use. Conclusion This study showed suboptimal adherence to STGs/EML by all prescribers, in contrast to previous research amongst nurses when hardcopies were available. Training on the use of the STGs/EML is needed at PHC level and improved monitoring of STGs/EML compliance is necessary. This study may be replicated for a wider population to paint a national picture and to periodically assess the extent of the implementation of the STGs/EML.

scholarly journals Public awareness and knowledge of the National Health Insurance in South Africa

2015 ◽  
Vol 22 ◽  
Author(s):  
Geoffrey Setswe ◽  
Samson Muyanga ◽  
Jacqueline Witthun ◽  
Peter Nyasulu
Keyword(s):  
South Africa ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Public Awareness

scholarly journals Prices of medicines for the management of pain, diabetes and cardiovascular diseases in private pharmacies and the national health insurance in Tanzania

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Rashid Bakari Kirua ◽  
Mary Justin Temu ◽  
Amani Thomas Mori
Keyword(s):  
Health Insurance ◽  
Cardiovascular Diseases ◽  
National Health Insurance ◽  
National Health ◽  
Essential Medicines ◽  
High Price ◽  
Sign Test ◽  
Insurance Fund ◽  
Reference Prices ◽  
Significant Difference

Abstract Background High price is a major challenge limiting access to essential medicines especially among the poorest families in developing countries. The study aims to compare the prices of medicines used in the management of pain, diabetes, and cardiovascular diseases in private pharmacies and the National Health Insurance Fund (NHIF) in Tanzania. Pharmacy prices were also compared with the prices of medicines surveyed nationally by WHO/HAI in 2012. Method This cross-sectional study was conducted in Dar es Salaam, Morogoro, Dodoma, and Kilimanjaro regions from February to April 2015. Data were collected from 33 private pharmacies, NHIF and, the HAI database. The study used the WHO/HAI methodology. The analysis was done using non-parametric Kruskal-Wallis and post-hoc pair-wise comparison Dunn test, while a possible change in prices between our survey and 2012 WHO/HAI national survey data was tested using a Sign test in Stata version 16.1. Results Twenty-eight essential medicines, of which 9 are used for management of pain, 7 for diabetes, and 12 for cardiovascular diseases were analyzed. There was a significant difference in the mean pharmacy prices of some medicines between the regions and between the pharmacies and NHIF reference prices. NHIF reference prices were higher than the pharmacy prices for 16 of the 28 medicines. There was a significant increase in the prices of 5 out of the 8 medicines that were also nationally surveyed by the WHO/HAI in 2012. Conclusion The study found that medicine prices in private pharmacies vary a lot between the study regions, which raises equity concerns. Also, there was a significant difference between the pharmacy and the NHIF reimbursement prices, which may expose patients to fraudulent co-payments or hinder timely access to prescribed medicines. Therefore, effective price control policies and regulations for medicines are warranted in Tanzania.

HIV/AIDS and National Health Insurance in South Africa

2015 ◽  
Author(s):  
Nigel Crisp
Keyword(s):  
South Africa ◽  
Health Insurance ◽  
South African ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Insurance Scheme ◽  
African Health ◽  
South African Health ◽  
Hiv Aids

Chapter 18 describes how Dr Motsoaledi, the South African Health Minister, set about leading the fight on HIV/AIDS in South Africa, and introducing a national health insurance scheme in order to offer healthcare to every person in the country, by building on the work that was already underway. It describes his complex story, with many confusing cross-currents and elements of conflict and intrigue, and how a large part of the Minister’s role involved trying to cut through the confusion, offer a clear pathway for the future, and communicate

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