Health minister Zweli Mkhize. Picture: SUNDAY TIMES/RAYMOND PRESTON
Health minister Zweli Mkhize. Picture: SUNDAY TIMES/RAYMOND PRESTON

The controversial National Health Insurance (NHI) fund will need political will to thrive, health minister Zweli Mkhize says. 

NHI is the government’s fiercely contested plan for achieving universal health coverage. It envisages the establishment of a central fund that will purchase health services on behalf of all patients from public- and private-sector providers.

Mkhize addressed a media briefing on Friday where the findings and recommendations in the NHI pilot site evaluation report, commissioned by the department of health from Genesis Analytics, were released. 

“Everywhere you go, NHI starts with political will. Without it, it doesn’t happen,” he said, stressing that this one was the key issue that came out of the report. 

Mkhize, whose biggest challenge will be the implementation of the NHI, addressed the recommendations made by the report. The  report is unambiguous on what worked in the pilot programme and what did not. 

He said the second issue is collaboration among different role-players and different government departments. 

The controversial bill was recently accepted by the cabinet, and will be submitted to parliament in the coming days, Mkhize said.

Dr Saul Johnson, who presented some the outcomes from the analysis of the pilot project, said the implementation of the interventions had mixed success across the districts picked.

He said none of the interventions could be considered “failures”, as all were implemented at scale, but stressed that there were, however, important lessons to be learnt that could strengthen the programmes in the future.  

“Where successful, we identified a few common factors: strong political will; adequate human and financial resources for implementation; good co-ordination and communication; and good monitoring systems put in place at the time of implementation,” Johnson said. 

He said the challenges faced by the interventions, included inadequate planning; lack or resources; inconsistent communication; a lack of co-ordination; and insufficient mechanisms to monitor progress to ensure course correction. 

Specific recommendations were made to the 10 different interventions used in the pilot programme. 

The report found that it was “difficult to assess the impact of the pilots on the access to and quality of services”. The report found, however, that almost all the interventions were appropriately designed to either improve access to services or improve quality. 

In terms of the infrastructure intervention, the report found that there is an urgent need to address aging and inadequate infrastructure, and to develop a streamlined process that complies with state procurement standards and the Public Finance Management Act.