ABSTRACT
BACKGROUND: Universal health coverage (UHC) improves national health outcomes while addressing social inequalities in access to quality healthcare services. The district health system (DHS) is critical to the success of UHC in South Africa through the National Health Insurance (NHI) scheme. Family physicians (FPs), as champions of primary care, are central to the DHS operation and implementation of NHI. METHODS: This was a qualitative exploratory study that used semi-structured interviews to explore FPs views and engagement on NHI policy and implementation in their districts. Ten FPs were included through purposive sampling. RESULTS: Most of the FPs interviewed were not engaged in either policy formulation or strategic planning. The NHI bill was seen as a theoretical ideology that lacked any clear plan. Family physicians expressed several concerns around corruption in governmental structures that could play out in NHI implementation. Family physicians felt unsupported within their district structures and disempowered to engage in rollout strategies. The FPs were able to provide useful solutions to health system challenges because of the design of their training programmes, as well as their experience at the primary care level. CONCLUSION: Healthcare governance in South Africa remains located in national and provincial structures. Devolution of governance to the DHS is required if NHI implementation is to succeed. The FPs need to be engaged in NHI strategies, to translate plans into actionable objectives at the primary care level.Contribution: This study highlights the need to involve FPs as key actors in implementing NHI strategies at a decentralised DHS governance level.
Subject(s)
National Health Programs , Physicians, Family , Humans , South Africa , Health Policy , Delivery of Health CareABSTRACT
There is an escalating interest in research capacity building across the globe. Research is an integral part of the continuous improvement process, clinical decision making and health system strengthening and should be embedded into the health system. The South African Family Practice Journal editorial team held a workshop on 19 August 2022 at the 24th National Family Practitioners Congress in Cape Town, with the aim of supporting primary care clinicians in their development from early-career researchers to established clinician-scientists. Small group and plenary discussions yielded valuable insights into the lived experiences of early career researchers and highlighted critical action areas to build the landscape of clinician-led research in the South African context.Contribution: This article contributes to current literature by providing insight into the lived experiences of early-career researchers and explores opportunities for research capacity-building.