Bertha Centre for Social Innovation and Entrepreneurship, The University of Cape Town Graduate School of Business, Cape Town, South Africa.
Infect Dis Poverty. 2021 Mar 1;10(1):19. doi: 10.1186/s40249-021-00804-9.
Despite the end of apartheid in the early 1990s, South Africa remains racially and economically segregated. The country is beset by persistent social inequality, poverty, unemployment, a heavy burden of disease and the inequitable quality of healthcare service provision. The South African health system is currently engaged in the complex project of establishing universal health coverage that ensures the system's ability to deliver comprehensive care that is accessible, affordable and acceptable to patients and families, while acknowledging the significant pressures to which the system is subject. Within this framework, the Bertha Centre for Social Innovation & Entrepreneurship works to pursue social impact towards social justice in Africa with a systems lens on social innovation within innovative finance, health, education and youth development. The aim of this study is to demonstrate the capacity for social innovation in health with respect for South Africa, and to highlight some current innovations that respond to issues of health equity such as accessibility, affordability, and acceptability.
Different data types were collected to gain a rich understanding of the current context of social innovation in health within South Africa, supported by mini-case studies and examples from across the African continent, including: primary interviews, literature reviews, and organisational documentation reviews. Key stakeholders were identified, to provide the authors with an understanding of the context in which the innovations have been developed and implemented as well as the enablers and constraints. Stakeholders includes senior level managers, frontline health workers, Ministry of Health officials, and beneficiaries. A descriptive analysis strategy was adopted.
South Africa's health care system may be viewed, to a large extent, as a reflection of the issues facing other Southern African countries with a similar disease burden, lack of systemic infrastructure and cohesiveness, and societal inequalities. The evolving health landscape in South Africa and the reforms being undertaken to prepare for a National Healthcare Insurance presents the opportunity to understand effective models of care provision as developed in other African contexts, and to translate these models as appropriate to the South African environment.
After examining the cases of heath innovation, it is clear that no one actor, no matter how innovative, can change the system alone. The interaction and collaboration between the government and non-state actors is critical for an integrated and effective delivery system for both health and social care.
尽管南非在 20 世纪 90 年代初结束了种族隔离制度，但该国仍然存在着种族和经济上的隔离。这个国家饱受持续的社会不平等、贫困、失业、沉重的疾病负担和医疗服务提供的不平等质量的困扰。南非的卫生系统目前正在从事建立全民健康覆盖的复杂项目，该项目确保系统有能力为患者和家庭提供可及、负担得起和可接受的综合护理，同时承认系统所面临的重大压力。在这个框架内，Bertha 社会创新与创业中心致力于通过创新金融、卫生、教育和青年发展领域的系统视角，追求对非洲社会正义的社会影响。本研究的目的是展示对南非尊重的卫生领域社会创新能力，并强调一些当前的创新举措，以应对可及性、可负担性和可接受性等卫生公平问题。
收集了不同类型的数据，以深入了解南非卫生领域社会创新的当前背景，同时支持来自非洲大陆的小型案例研究和实例，包括：主要访谈、文献综述和组织文件审查。确定了关键利益攸关方，使作者了解创新开发和实施的背景以及促进因素和制约因素。利益攸关方包括高级管理人员、一线卫生工作者、卫生部官员和受益人。采用描述性分析策略。
南非的医疗保健系统在很大程度上可以被视为其他南部非洲国家面临的问题的反映，这些国家面临着类似的疾病负担、缺乏系统基础设施和凝聚力以及社会不平等问题。南非不断变化的卫生格局以及为准备国家医疗保健保险而进行的改革，为了解在其他非洲背景下开发的有效护理模式提供了机会，并将这些模式适当地转化为南非环境。
在审查了卫生创新案例后，很明显，没有一个行为者，无论多么具有创新性，都可以独自改变系统。政府和非国家行为者之间的互动和协作对于卫生和社会保健的综合有效交付系统至关重要。
