Naidoo Vivian, Suleman Fatima, Bangalee Varsha
Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Westville Campus, F-Block, Room F2-519, Durban, South Africa.
School of Health Sciences, University of KwaZulu-Natal, Westville Campus, F-Block, Room F2-519, Durban, South Africa.
J Pharm Policy Pract. 2023 May 5;16(1):61. doi: 10.1186/s40545-023-00564-x.
Universal health coverage has gained significant momentum internationally as the policy solution to address healthcare system deficiencies and promote equitable distribution of quality healthcare. The South African government has adopted this option and developed policy papers for discussion on a National Health Insurance (NHI) system for South Africa. A large part of the policy has been focused on promoting functionality of the primary healthcare system (PHC); to promote an efficient referral pathway. This study sought to explore potential barriers perceived by policy developers that could hinder achieving the NHI goal. Furthermore, given that a large focus is centred on PHC re-engineering, it was imperative to understand participant's opinions and perspectives on the role of a pharmacist at this level.
A qualitative research design was adopted in this study. Semi-structured interviews were conducted with ten policy developers that were selected via a referral technique. These were audio recorded using a digital voice recorder on an online platform, transcribed verbatim and saved on Microsoft Word documents. NVivo, was utilized to facilitate the analysis of data. A thematic analytical approach was used to categorize codes into themes.
The findings revealed that participants were in agreement that healthcare system reform is crucial in promoting equitable distribution of healthcare services in South Africa. However, the reality of this is dependent on addressing key concerns perceived by participants that have been reported as three major themes: (1) the benefit of NHI implementation; (2) concerns about NHI implementation; (3) implications for pharmacy.
South Africa is in the second phase of NHI implementation. This phase is focused on the development of sound NHI legislation and structures. This study identified a number of concerns regarding legislative anomalies and role-player involvement that could compromise the efficient implementation of NHI.
全民健康覆盖作为解决医疗体系缺陷和促进优质医疗服务公平分配的政策方案，在国际上已获得显著发展势头。南非政府已采纳这一方案，并制定了政策文件，以讨论南非的国家健康保险（NHI）体系。该政策的很大一部分重点在于促进初级医疗保健系统（PHC）的功能，以推动建立高效的转诊途径。本研究旨在探讨政策制定者认为可能阻碍实现NHI目标的潜在障碍。此外，鉴于重点大量集中在PHC的重新设计上，了解参与者对药剂师在这一层面作用的意见和观点至关重要。
本研究采用定性研究设计。通过推荐技术选取了十位政策制定者进行半结构化访谈。在在线平台上使用数字录音机对访谈进行录音，逐字转录并保存在Microsoft Word文档中。利用NVivo软件辅助数据分析。采用主题分析方法将代码归类为主题。
研究结果显示，参与者一致认为医疗体系改革对于促进南非医疗服务的公平分配至关重要。然而，实际情况取决于解决参与者所意识到的关键问题，这些问题被报告为三个主要主题：（1）实施NHI的益处；（2）对NHI实施的担忧；（3）对药学的影响。
南非正处于NHI实施的第二阶段。该阶段侧重于制定完善的NHI立法和架构。本研究确定了一些关于立法异常和利益相关者参与的问题，这些问题可能会损害NHI的有效实施。
