3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item How much community engangement of patient stakeholders has there been on the National Health Insurace ? A bioethic enquiry(2018-11-02) Tandwa, LizekaCommunity engagement in health refers to the collaborative effort of citizens in a community to organize and participate in health promotion, research and policy development. Community engagement encompasses the participation of patients at micro, meso and macro levels. The National Health Insurance (NHI) is a South African health legislation that is under development which aims to ensure universal health coverage. Community involvement is a constitutional requirement and the policy makers of the NHI have a duty to involve the community and specifically; patients in the decision-making and implementation of the policyItem Ethical issues identified by General Practitioners in private practice in the Johannesburg area as challenges to the successful implementation of the proposed National Health Insurance(2017) Jacovides, AndrewIntroduction National Health Insurance (NHI) has been proposed in South Africa to ensure that everyone has access to appropriate, efficient and quality health services. Involving the private healthcare sector is essential for this to occur because of its resources. Significant changes to the private healthcare structure are anticipated for its incorporation into the NHI plan. This study examines the perceptions of General Practitioners (GPs) from the private sector in the Johannesburg area on the NHI. It examines the challenges they foresee that will impact on their willingness to participate in the NHI and how these might manifest as ethical concerns. These findings will yield effective ways these concerns are addressed with regard to their acceptance of the NHI and any ethical issues they may have regarding the effective delivery thereof. Study design The study took the form of an exploratory-descriptive empirical method using semi-structured interviews. Method The qualitative data was analysed using thematic content analyses. Results The general perception of the NHI by the General Practitioners was negative. The NHI was perceived by the doctors in this study to be an extension of the current public health sector. The current perception of the public health sector is one of inferior care; an over worked and understaffed facility; a poorly maintained system with inadequate supervision; and one that is rampant with corruption. The key ethical concerns arising from this study is the quality of care for the patients, basic working conditions in government facilities; corruption in, and a general mistrust of the government. Concerns were raised about quality of patient care in the public sector and the possibility of “downgrading” private health care. These factors impose on the patients’ right to dignity, equality and freedom as poor quality of health care infringes these rights. Conclusion and recommendations To gain “buy-in” from GPs, the establishment of trust, improved communication and an end to mismanagement and corruption are essential for the NHI to be successfully implemented.Item The views of primary health care nurses towards the National Health Insurance(2015) Khuzwayo, Phindaphiwe BrianThis study examines the views of Primary Health Care (PHC) nurses towards the National Health Insurance (NHI) in Johannesburg District D2. The main aim of this study is to respond on the views of PHC nurses towards NHI that is going to be implemented in 2015 and how to avoid, and manage, any challenges that might emerge with the implementation of the project. Primary data was collected by means of interviews guide with PHC nurses from the Johannesburg district D 2. The study is qualitative. Purposive sampling was used to identify participants who are knowledgeable about the NHI. Nine participants were selected and interviewed. The sample selected was non-probability sampling. For this study, purposive or judgmental sampling is used. Data was collected by means of interviews questionnaires with PHC nurses from the Johannesburg district D2. The research questions addressed the concepts which are critical on the views of PHC nurses towards NHI in Johannesburg Metro district D2. The findings indicate that the general views of the nurses are positive towards the NHI. Nurses are positive and ready to support the implementation of the project but proper buy-ins, stakeholder engagement and proper planning needs to be in place in order for the successful implementation of the project. The study recommends that the training of nurses should take place before the implementation the project. Sufficient availability of resources to ensure that quality health care service is rendered. There should a sufficient workforce to ensure that a quality service is not compromised.