An overview of the National Health Insurance and its possible impact on eye healthcare services in South Africa

Abstract

The National Health Insurance (NHI) is an important development that underpins democracy in South Africa. It aims to redress the inequities of public healthcare delivery by implementing transformational policies towards establishing inclusive public healthcare coverage for the entire population of South Africa, with more emphasis on health promotion. The implementation of this initiative has created some hope amongst primary eye healthcare professionals, such as optometrists, that their profession may finally be given the recognition it deserves. Although the government is contemplating introducing a new directorate for eye healthcare and forming an advisory committee on eye healthcare reporting to the Minister of Health, the extent to which eye healthcare will be incorporated into the NHI is currently not clear. It is believed that the white paper on the NHI will shed some light on these issues. Unfortunately, current indications are that the initiative has serious challenges to overcome such as poor infrastructure, budgetary constraints and lack of interest from other healthcare professionals. Furthermore, corruption issues may also need to be addressed if the NHI is to be implemented successfully. Nevertheless, the NHI remains a positive proposition for universal health coverage for the people of South Africa, and there is hope that primary eye care providers, such as optometrists and other eye care professionals, will also play a greater role in the NHI than they currently do in the public healthcare system.

Eye care services and benefits paid by medical schemes in South Africa

“…Optometrists are primary healthcare providers responsible for eye examination to detect visual abnormalities and promote clear vision. 9,10 Studies by Ehrlich et al 11 and Elliott et al 12 corroborate this, showing that low optometrist-topatient ratios in low-income nations were highly associated with more blindness and VI. Similar disparities are notable when looking at the private sector versus public sector and urban relative to rural areas.…”

Experiences and perceptions of undergraduate optometry students towards public eye care services in South Africa

“…Prior to South African democracy, health care services allocation was racially based, with more resources allocated for the white minority and fewer resources allocated for the African majority. 21 As a result, the democratic government in 1994 inherited a deeply fragmented and dysfunctional health care system. The right to health care is now enshrined in the Bill of Rights, which is the cornerstone of the Constitution of South Africa.…”

“…However, Sithole cautioned that 'there seems to be no adequate advocacy for eye health to be fully implemented as part of the NHI'. 21 As with most facets of life, technological advances are expected to bring changes and new demands in the ophthalmic industry. Computer vision syndrome is a topic that has become important in recent years.…”

Decolonising research methodologies: lessons from a qualitative research project, Cape Town, South Africa

“…Though on paper there are several policies to redress these health inequities, there has been very little progress regarding the transformation of the healthcare system via the envisaged National Health Insurance system (NHI). The NHI system aims to prioritise healthcare services and to provide inclusive comprehensive public healthcare coverage and access to the healthcare services to all population groups in the country [11]. However, Rispel [12] and van Rensburg [13] warn that factors such as poor leadership, management and governance, lack of a fully functional district health system and political commitment to address the health workforce crisis may inhibit the successful implementation of the NHI system.…”