Senior Specialist Scientist, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; Honorary Research Associate, Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Principal Consultant, NMG Consultants and Actuaries, Cape Town, South Africa.
S Afr Med J. 2020 Jul 29;110(8):747-750. doi: 10.7196/SAMJ.2020.v110i8.14699.
Broader policy research and debate on the issues related to the planning of National Health Insurance (NHI) in South Africa (SA) need to be complemented by case studies to examine and understand the issues that will have to be dealt with at micro and macro levels. The objective of this article is to use caesarean section (CS) as a case study to examine the health systems challenges that NHI would need to address in order to ensure sustainability. The specific objectives are to: (i) provide an overview of the key clinical considerations related to CS; (ii) assess the CS rates in the SA public and private sectors; and (iii) use a health systems framework to examine the drivers of the differences between the public and private sectors and to identify the challenges that the proposed NHI would need to address on the road to implementation.
需要对南非国家健康保险（NHI）规划相关问题进行更广泛的政策研究和辩论，并辅之以案例研究，以检查和了解必须在微观和宏观层面上处理的问题。本文的目的是使用剖宫产（CS）作为案例研究，以检查 NHI 需要解决的卫生系统挑战，以确保可持续性。具体目标是：（i）提供与 CS 相关的主要临床注意事项概述；（ii）评估南非公共和私营部门的 CS 率；（iii）使用卫生系统框架检查公私部门之间差异的驱动因素，并确定拟议的 NHI 在实施过程中需要解决的挑战。
