Sash welcomes 10+ NHI pilot district announced by Minister of Health

Advocacy Programme Manager Elroy Paulus attended the media briefing in Pretoria on 22 March 2012 to hear about the long-awaited announcement of the 10+ National Health Insurance (NHI) pilot districts in South Africa.

Seated in front of a banner entitled “A long and health life for all South Africans”, Minister of Health Aaron Motsoaledi announced the 10+ NHI pilot districts selected for the phased piloting of the NHI due to start on 1 April 2012.

 

27 Indicators in 3 categories were used from different sources to summarise overall performance across districts.  Districts were ranked from best to worst performance for each indicator and a score from 1-52 was given where 1 is the best performing district and 52 the worst. 

10 indicators were used from the first category, viz. socio-economic indicators, and included indicators such as unemployment rate, deprivation index and access to sanitation and water;

Twelve (12) indicators were used for the health service performance management indicators were used, including TB cure rates, weighing rates, measles coverage. Finally, a 3^rd category used was the financial and resource management , that used 5 indicators that included PHC expenditure per capita. These indicators made up the 27 indicators in the 3 categories.

Districts are ranked from best to worst performance for each indicator and a score from 1-52 is given where 1 is the best performing district and 52 the worst. This led the department of Health to select the following 10 districts, based on the above criteria:

The work in these provinces is set to commence 1 April 2012. To date, there have been 4500 Primary Health Care Agents trained by November 2011, and 143 PHC Teams trained for districts in January 2012, with a further 61 teams in March 2012.

The media briefing also heard from the European Union (a primary funder of the NHI), who endorsed this work.

Paulus said that this launch marks the beginning of a crucial policy implementation initiative, and that a lot is at stake to ensure its success. In work done by the Black Sash, in partnership with the Health Economics Unit of UCT, and Health-e, funded by Atlantic Philantropies – more than 400 community leaders in each of the 9 provinces in 2010-2011, a final synthesis report outlining the preferences for health system reform, highlighted the endorsement and support of this primary health care initiative, but that community leaders that were consulted asserted that the rich must cross-subsidise the poor, that the sources of tax funding should not disproportionately affect the poor, and that the inequity of the current health system is unsustainable and urgently requires  such an intervention.

The diagram below shows the selected 10 districts (red arrows). KZN chose to fund an additional district using provincial funds.

 

Source: amended from the District Health Barometer, Health Systems Trust 2010-11

View the Mininster of Health's presentation on NHI Pilot District Selection