Readiness assessment for the implementation of the National Health Insurance Scheme at a hospital in Johannesburg

Abstract

The National Health Insurance Scheme is currently being implemented in South Africa. Some gaps were observed concerning the rollout, and the purpose of the study was to assess the readiness of a hospital in Johannesburg for the implementation of the said scheme. The study utilised a qualitative approach with an explorative, descriptive, qualitative study design. The target population consisted of 15 departmental managers at the hospital that were directly involved in the implementation of the NHI amounting. The sample size was determined by category saturation in the sense that when no new data could be found from the interviews, data collection ceased. Purposive sampling was used to select the participants for the study, with the researcher aiming for participants who were knowledgeable about the NHI scheme at the institution, and this amounted to n=8. Data was collected using semi-structured interviews(n=8) and two focus group discussions were held, with 8 participants that took part in the semi structured interviews being split into two groups. Thematic analysis was used to analyse the data of the focus group discussion and semi-structured interviews (one on one interviews). This study sought to determine if there are potential barriers to the implementation of the NHI scheme and provide recommendations to improve the readiness for its implementation at a hospital in Johannesburg. The results of the study revealed that the hospital was preparing to ready itself for the NHI implementation but was a long way from being fully prepared due to poor infrastructure, staff shortages, lack of technology resources, inadequate training on the NHI, and management issues. Recommendations were made on increasing the human resources, upgrading infrastructure, increasing medicines and equipment, as well as providing adequate training on the NHI implementation.