Description

This study evaluated the implementation of the National Health Insurance (NHI) scheme in the Thabo Mofutsanyana District of the Free State Province in South Africa. The NHI is designed to cater to the vulnerable people and disadvantaged in society to enable them to have access to quality health care. The study adopted the qualitative research approach. To collect data, twelve key informants were interviewed and further, six Focus Group discussions were conducted with ten participants per group. The results were analysed through open codes, which were further reduced to axial codes, and finally selective codes which are themes. The themes established in the study were: challenges, impact, support systems, and systems improvement. The study established that there are major medical, information technology support and cleaning staff shortages. These shortages adversely affect the smooth implementation of the NHI scheme. Compounded, they affect the patients waiting time as patients will have to wait for long a long time to get services. This, however, hurts the healthcare delivery system. Lack of proper budgeting was also found to affect the allocation of scarce resources. Due to this, the procurement of medical equipment and medication would be affected and compromise the NHI scheme's efficiency and effectiveness. Institutional support systems such as information technology equipment that could help to access patients’ files at the click of a button affect the efficiency of the medical staff. A shortage of data-capturing clerks and pharmacists in clinics adds too much work to the medical staff who are supposed to concentrate treatment of patients. The study recommended the recruitment of medical and support staff to enable the effective implementation of the NHI scheme. It was recommended that medication be supplied to facilitate adequate treatment of patients. Further, financial resources must be availed to facilitate the procurement of medicines, servicing and calibration of medical equipment and maintenance as well as construction of adequate infrastructure to accommodate the patients. There is a need to put in place effective communication structures to enhance good communication between medical staff, patients, and the communities. Staff training and development for example through seminars must be put in place to update staff with the NHI scheme developments. Institutional support systems need to be in place to enable the smooth flow of information within the clinics. Stakeholder engagement is required to ensure that all the stakeholders have a contribution to make towards the NHI scheme.