The Role of Primary Healthcare in Health Reform

The Role of Primary Healthcare in Health Reform


In the previous NHI research note series we discussed various aspects of the proposed NHI plan and provided cost estimates for implementation of such a scheme. We illustrated that extending comprehensive coverage to all South Africans would be massively expensive. The current note is the first in a new series of research notes in which we turn our attention to issues of general health reform in South Africa. The aim is to contribute to the debate about what steps should be taken on the road to reforming our health system. Health Minister Aaron Motsoaledi recently commented that the proposed NHI would be unaffordable if based on the current public health system, and assured the public that the NHI would not be an event, “it’s going to be a process and a process that will take a long time.”

In line with what has been stated by the Minister concerning the importance of primary healthcare (PHC), this note looks at some of the available data on PHC in South Africa. The importance of PHC was emphasised by Minister Motsoaledi and in this regard he mentioned that he will untertake a study tour to Brazil later this year where the implementation of a NHI primarily focused on the delivery of PHC has been very successful. In accordance with Minister Motsoaledi’s turnaround strategy with a renewed focus on PHC, this note argues that PHC remains the foundational pillar of any health system and should be prioritised within a review of health reform.

In further research notes in this series, the focus will be on engaging with some of the detailed questions that arise from the current national health insurance debate. These will include issues of accreditation, human resource requirements, optimisation of the public and private sectors, reimbursement models, etc. In the current note we point out that although (physical) access to and affordability of healthcare have improved during the past decade, quality of care remains a concern.


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