Mokoena Samuel Vuyo, Naidoo Panjasaram
Discipline of Pharmaceutical Science, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Health Res Policy Syst. 2024 Dec 20;22(1):173. doi: 10.1186/s12961-024-01251-2.
Governance and leadership are regarded as the most crucial aspects in delivering quality health care, and yet they are arguably the most complex functions of any health system. The objective of the study was to investigate the structural problems affecting the implementation of the National Health Insurance (NHI) and address the challenges affecting the NHI building blocks. Further objective of the study was to evaluate if there were appropriate controls and accountability measures in leadership and governance to inform the development of a workable model for the implementation of the NHI in South Africa.
A quantitative study was undertaken to interrogate the structural problems affecting the implementation of the NHI by seeking to address the challenges affecting the NHI building blocks.
The study was undertaken with participants who are decision-makers and/or contribute to the health sector reforms in South Africa in the realization of the NHI.
The main outcome of the study was to determine the requisite interventions to deal with challenges that affect governance and/or leadership functions in the implementation of the NHI.
The questionnaire was distributed via SurveyMonkey over a period of 2 months, and the data were analysed using R Statistical computing software of the R Core Team, 2020, version 3.6.3. The results were presented in the form of descriptive and inferential statistics.
The study found that the success to implement NHI needs to be supported by clarity and commitment to specific policy fundamentals aimed at improving efficiency, stakeholder participation, and accountability. This imperative remains very much in doubt since the different occupations hold different views about the progress made in the implementation of the NHI across the governance and leadership functions.
The study confirmed the interrelatedness of the subthemes identified for the governance and leadership construct and pointed to the importance of sharpening policy development and implementation approaches in collaboration with all relevant stakeholders.
The Ethics approval reference number is HSSREC 00002565/2021.
治理与领导力被视为提供高质量医疗保健的最关键方面，但它们无疑也是任何卫生系统中最复杂的功能。本研究的目的是调查影响国家医疗保险（NHI）实施的结构问题，并应对影响NHI各个组成部分的挑战。该研究的进一步目的是评估在领导力和治理方面是否存在适当的控制和问责措施，以为南非NHI实施的可行模式的制定提供参考。
进行了一项定量研究，通过设法应对影响NHI各个组成部分的挑战来探究影响NHI实施的结构问题。
该研究的参与者为南非在实现NHI过程中参与卫生部门改革的决策者和/或相关人员。
该研究的主要结果是确定应对影响NHI实施中治理和/或领导功能挑战的必要干预措施。
通过SurveyMonkey在两个月的时间内分发问卷，并使用R核心团队2020年版本3.6.3的R统计计算软件对数据进行分析。结果以描述性和推断性统计的形式呈现。
该研究发现，NHI的成功实施需要明确并致力于旨在提高效率、利益相关者参与度和问责制的特定政策基础。由于不同职业对NHI在治理和领导功能方面的实施进展持有不同观点，这一必要性仍备受质疑。
该研究证实了为治理和领导结构确定的子主题之间的相互关联性，并指出了与所有相关利益者合作加强政策制定和实施方法的重要性。
伦理批准参考编号为HSSREC 00002565/2021。
