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Abstract:
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Background: Countries around the world are working towards achieving universal health coverage by means of Health Reforms, South Africa is also in the process of achieving this goal through the National Health Insurance (NHI) scheme. There are countries in the world including those in Africa that proved that employing this measure is possible to attain universal health coverage, though there may be challenges around Human, Material and Financial resources that needs to be addressed successfully. Challenges around poor access to health services are reported almost around the world including South Africa and health care workers are also implicated as a means to an end or an end themselves. Health care workers including Nurses, Doctors, Allied health personnel and emergency medical services personnel (EMS) are responsible for the implementation of the NHI therefore their views and perceptions regarding the NHI are very important in the study.
Purpose: The purpose of the study was to describe the views and perceptions of health care workers with regard to the roll-out of the NHI at Pietersburg-Mankweng tertiary hospital, Limpopo Province.
Materials and Methods: This was a cross sectional study conducted at Pietersburg and Mankweng tertiary Hospitals. Self-administered questionnaires were issued out to 255 health care workers in order to describe their views and perceptions with regard to the roll-out of the NHI at Pietersburg-Mankweng tertiary hospital, Limpopo Province. All statistical tests were conducted and based on a p-value < 0.05, and considered statistically significant.
Results: A total of 255 healthcare workers participated in this study. A greater proportion (64%) of the respondents had knowledge of what the NHI is about: “Of these, only 37% have detailed information on how their facility is involved in its implementation’’. Thirty nine percent of the respondents said that healthcare workers are prepared for the implementation of the NHI in their facility. The health care workers (43%) further said their facility is ready to provide some of the tertiary services when NHI is rolled-out, the findings were not statistically significant. Participants’ response regarding the perceived challenges during the implementation of the NHI in their institution illustrated that the most common challenges were administrative issues (30%), funding (21%) and personnel (11%). In relation to the key characteristics of health services delivery building blocks (comprehensiveness, continuity, service access and patient waiting times) linked to the NHI, more than half of the participants (56%) said that the healthcare services are accessible to all people in need of them and sixty percent of the respondents reported that the institution adhere to the required waiting time.
The participants indicated that bad staff attitude, personnel factors such as shortage of staff, shortage of qualified staff, shortage of equipment and supplies, lack of insurance, lack of regular source of care, lack of finance, infrastructure and administrative factors as barriers towards adhering to the health services delivery building blocks characteristics. The measures to improve on barriers as identified by participants includes, hiring/training staff, positive staff attitude, good relationship between the community and health care providers, incorporate cultural differences, resolving infrastructural challenges, improving on availability of equipment and supplies, appropriate health system financing, improve health system coverage, increase health information sharing, reducing waiting times, improving on staff factor, improving on patient factors and improving on financial resources.
Conclusion: The findings in this study provides important information on health care workers views and perceptions on the NHI. Therefore as South Africa continues with the roll-out of the NHI through various phases it is important that health care workers are educated and engaged to ensure that the ideal of achieving universal health coverage through the NHI is realised. |