The White Paper on National Health Insurance was published on 11 December.
This draft policy has its origins in debates that emerged in the late 1980s.
For those of you interested in the history of these debates, read the publication below that was published by Wits University’s Centre for Health Policy in 2000.
The document talks about the important design features of different policy proposals during the 1990s, as well as the lessons learned during this time with respect to managing the process of policy development.
The document is out of print, but I’ve managed to resurrect it using an old copy.
Doherty J, McIntyre D, Gilson L, Thomas S, Brijlal V, Bowa C, Mbatsha S. 2000. Social health insurance in South Africa: past, present and future. Johannesburg: Centre for Health Policy, for the Centre for Health Policy (University of the Witwatersrand) and the Health Economics Unit (University of Cape Town).
To mark the second international Universal Health Coverage Day on 12 December, my colleague, Di McIntyre, and I have just published an editorial in the South African Medical Journal.
The article argues that both the education and health sectors have been underfunded since the demise of apartheid. This is for several reasons, including fiscal policy choices.
Strengthened public funding is required for both sectors, not only from a human rights perspective, but also because economic growth depends on investment in these sectors.
You can read the article here.
Tax-based financing is increasingly recognised as one of the better ways to finance universal health coverage.
But how feasible is it for low- and middle-income countries to increase tax revenue, and how likely is it that the public health sector will benefit from additional revenue? In other words, how easy is it to increase the fiscal space for health?
I have contributed to a study by the research consortium RESYST which explores some of these issues, using Kenya, Lagos State (in Nigeria) and South Africa as case studies.
See here for documents from this study.
Here are the powerpoint slides for a recent presentation I gave about National Health Insurance to a Symposium by Economic Research Southern Africa (ERSA) on 6 February 2014: ERSA NHI presentation_Jane Doherty
The theme of the Symposium was “Critical choices regarding universal health coverage” and it was held at the Stellenbosch Institute for Advanced Study.
My presentation was titled “Getting South Africa ready for NHI: critical next steps.”
If you look on ERSA’s website you will find more details on the Symposium.
Here is some information on my latest policy brief, as well as the report on which it is based:
EQUINET Policy Brief 35: Legislation on the for-profit private health sector in East and Southern Africa
Doherty J (2013) with UCT HEU, TARSC. Wemos Foundation, Policy brief 35, EQUINET, Harare
While the private sector contributes new resources to the health system, international evidence shows that if left unregulated it may distort the quantity, distribution and quality of health services, and lead to anti-competitive behaviour. As the for-profit private sector is expanding in east and southern African (ESA) countries, governments need to strengthen their regulation of the sector to align it to national health system objectives. This policy brief examines how existing laws in the region address the quantity, quality, distribution and price of private health care services, based on evidence made available from desk review and in-country experts. It proposes areas for strengthening the regulation of individual health care practitioners, private facilities and health insurers. A more detailed discussion paper (#87) on the laws and information in the brief is available at www.equinetafrica.org/bibl/docs/EQ%20Diss%2087%20Private%20HS.pdf.
EQUINET (the Network on Equity in Health in Southern Africa) have just published an editorial and report on legislation governing the for-profit private health sector in east and southern Africa. To access these publications, click on the links below:
Doherty J. 2013. We cannot afford to leave the for-profit private health sector unregulated in Africa (editorial). EQUINET Newsletter 150: 01 August 2013. Available at: http://www.equinetafrica.org/newsletter/
Doherty J. 2013. Legislation on the for-profit private health sector in east and southern Africa. EQUINET Discussion Paper 99. Harare: HEU, EQUINET. Available at: http://www.equinetafrica.org/bibl/docs/Diss%2099%20privsector%20laws%20Aug2013.pdf
I have just published the following open source article on mid-level medical health workers (Clinical Associates) in South Africa:
Doherty J, Conco D, Couper I, Fonn S. (2013) Developing a new mid-level health worker: lessons from South Africa’s experience with Clinical Associates. Global Health Action; 6: 19282. Available at: http://dx.doi.org/10.3402/gha.v6i0.19282
I would like to get into contact with researchers, policy-makers and legal experts working on appropriate policies and legislation governing the for-profit private health sector in Africa.
Or perhas you do work on other low- or middle-income countries that might be relevant to the African situation?
On the ‘About Jane Doherty’ tab above you will find my e-mail address if you want to let me know about the work you are doing or have research or reports to share.
On the ‘Private health sector’ tab you will find my own work on the private sector (with links to the electronic versions where available). Of particular interest might be:
- FORTHCOMING: A situation analysis of private sector legislation in East and Southern Africa which is still in an early draft form
- FORTHCOMING: Doherty J, McIntyre D. (2013) Addressing the failings of public health systems: should the private sector be an instrument of choice? In: Surender R, Walker R. (2013) Social policy in a developing world. Cheltenham, UK: Edward Elgar
- Doherty J. 2011. Expansion of the private for-profit health sector in East and Southern Africa. EQUINET with HEU, UCT and TARSC Policy Brief 26. Harare: EQUINET.
- Doherty J. 2011. Expansion of the private health sector in East and Southern Africa. EQUINET Discussion Paper 87. EQUINET: Harare.
- A report summarising research on the for-profit private health sector in South Africa from the 1980s to 2003: Doherty J, Steinberg M. 2003. Priority health care information needs for reform: what role for BHF? Johannesburg: Board of Healthcare Funders.
It’s come to my attention that the final report of the Health Systems Knowledge Network of WHO’s Commission on the Social Determinants Health is not readily available online.
Here is the full final report: HSKN Full report
Here is the condensed version of the final report (an extended executive summary): HSKN Condensed Report Cover A3; HSKN Condensed report
Here is the policy brief: HSKN A5 Leaflet