National Health Insurance implications for rehabilitation professionals and service delivery

Myezwa, Hellen; Niekerk, Matty van

doi:10.4102/sajp.v69i4.372

Cited by 8 publications

(10 citation statements)

References 6 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The perceived barriers to the integration of occupational therapy services into the NHI PHC reengineering streams, including lack of policy implementation were similar to those reported with previous findings 16,56,60 . Poor resources and the lack of adequate staffing is supported by other studies on the public health care services in South Africa 3,12 .…”

Section: Discussionsupporting

confidence: 84%

“…Findings from the two phases of the study showed that the integration of occupational therapy services in the PHC reengineering streams of the NHI should be considered essential to improve the health outcomes of the population and reduce the overall healthcare cost and growing burden of non-communicable diseases in South Africa. The participants concern about policy implementation and the present state of the underestimation of occupational therapy services reinforces the previous findings on the importance of occupational therapy being an integral part of PHC 13,16,17,45 through the holistic approach. Issues that affect clients' occupational performance should be addressed though activities and strategies to support their value system, habits, and routines within their family and community context to promote health and wellbeing 59 .…”

Section: Discussionsupporting

confidence: 81%

“…The lack of clarity is evidenced by the absence of detailed steps in implementing the policy. The lack of clarity is compounded by inadequate local evidence of the occupational therapy service provision in PHC even though there is a growing evidence for this role internationally [12][13][14][15] Thus, at this point in South Africa, when policies and frameworks in relation to disability and rehabilitation in PHC are in the initial phases of implementation, it is important to fill the knowledge gap by providing an evidence base for the integration of and provision of occupational therapy services in PHC 16 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Occupational therapy services and perception of integration of these at primary healthcare level in South Africa

Jejelaye¹,

Maseko²,

Franzsen³

2019

S. Afr. j. occup. ther.

View full text Add to dashboard Cite

Background: Literature indicates that access to rehabilitation services in South Africa is limited. Recent policy documents by the National Department of Health related to disability and rehabilitation propose the integration of occupational therapy services in primary healthcare (PHC). However, the implementation strategies concerning integration are not clear as there is inadequate evidence locally on the occupational therapy service provision in PHC even though there is growing evidence internationally.Purpose: This study sought to determine the services provided by occupational therapists in PHC and to explore the perceptions of the occupational therapists on the integration of occupational therapy services within the PHC reengineering streams of the National Health Insurance (NHI).Method: A two-phase explanatory sequential mixed method strategy was utilised in this study. A quantitative survey was sent to members of the occupational therapy professional association and an organisation of professionals providing rehabilitation services in rural communities. Qualitative data were then collected using semi-structured interviews with five therapists who completed the survey.Findings: Findings from this study showed there is increasing alignment of occupational therapy services in PHC with the communitybased rehabilitation (CBR), the Social Model, the International Classification of Functioning, Disability and Health (ICF), and the Medical Model using client self-management and case-management intervention approaches. The majority of occupational therapists are currently based in district hospitals (42%), community health centres (16%), community organisations (8%), and clinics (8%). Those working in the community indicated they work in a multidisciplinary team (MDT). They also use PHC service delivery models to manage people with disabilities (PWDs). Occupational therapists in PHC have a strong perception of their relevance in the PHC reengineering streams, despite the numerous barriers and few facilitators to the integration of occupational therapy services in the PHC reengineering streams of the NHI.Conclusion: The perception of the study participants is that occupational therapy service integration in the PHC reengineering streams will lead to improved healthcare. However, they are also of the opinion that integration will not happen without advocacy from occupational therapists or occupational therapy being adequately supported in PHC.✥ Anthony Jejelaye -Postgraduate student -conceptualisation and completion of project and article manuscript. ✥ Lebogang Maseko -supervisor of MSc project -helped with the conceptualisation and guidance for completion of project. ✥ Denise Franzsen -supervisor of MSc project -helped with the conceptualisation and guidance for completion of project.

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Occupational therapy services and perception of integration of these at primary healthcare level in South Africa

Jejelaye¹,

Maseko²,

Franzsen³

2019

S. Afr. j. occup. ther.

View full text Add to dashboard Cite

show abstract

“…These include that WBPHCOTs need regular and appropriate supervision; that the scope of practice of CHWs should be reviewed and possibly expanded in the areas of health promotion and referrals and that electronic systems would enable teams to report on household data (Genesis Analytics 2019 :17). Myezwa and Van Niekerk ( 2013 :4) refer to the inclusion, in the NHI, of rehabilitation services at the district hospital level and also list underfunding and pooled resources as considerations when negotiating the inclusion of rehabilitation at different levels of care. With the recommendations from Phase 2 of the NHI referring to an expansion in the scope of practice of CHWs, to focus on health promotion and referrals (Genesis Analytics 2019 :17), clear evidence of the role physiotherapists could play in the realm of health promotion exists (Narain & Mathye 2019 ), and there might be an opportunity to utilise PTTs/CRWs in this area.…”

Section: Background and Literature Reviewmentioning

confidence: 99%

Impactful educational transitions: Crossroads for physiotherapy education in South Africa?

Vuuren

2022

South African Journal of Physiotherapy

View full text Add to dashboard Cite

Background: Global changes in physiotherapy entry-level educational programmes to exit with a Doctorate or Master’s degree have consequences if physiotherapy education, worldwide, is to remain professionally competitive. However, within the South African context, such global competitiveness should be carefully considered against the national healthcare needs and implementation of the National Health Insurance (NHI) programme, with a bigger emphasis on a skilled mid-level workforce, including physiotherapy technicians or community rehabilitation workers.Objectives: These competing interests are carefully considered, against the theoretical background of international DPT training; human resource and financial constraints in the South African healthcare sector; reforms of the South African health and educational sectors intended to address the inequalities of the past; the need for quality healthcare delivery and the professional reputation of physiotherapy in South Africa.Methods: A framework for physiotherapy education in South Africa, to move on from the current educational crossroads, is proposed through an integration of multiple theoretical perspectives.Results: The framework is based on the current challenges being experienced in physiotherapy education and healthcare service delivery, which could be addressed by changes in the education sphere.Conclusion: The baseline suggestions for (re)considering the current education environment for physiotherapy, as proposed in my article, are to ensure that the profession remains relevant and able to confront the current changes presented by the South African healthcare system, including the implementation of the NHI plan, whilst remaining globally aligned and competitive.Clinical implications: The suggested, reconsidered, educational framework for physiotherapy in South Africa could become pivotal in advancing the profession on both a national and international level, through further critical conversations.

show abstract

“…Prior to the actual implementation of such programmes, it is important to gather the necessary information to determine the preparedness and readiness of this level of healthcare for provision of NIHS services. According to Myezwa and Van Niekerk (2013) each medical profession, including rehabilitation professionals need to assess their service delivery in terms of quality, financial allocation of resources and personnel, and their response to the burden of disease. Gathering information related to the availability of services and resources at the defined NHI PHC pilot clinics will assist in the planning and clinical implementation phases of NIHS programmes at PHC level within the proposed NHI framework.…”

Section: Introductionmentioning

confidence: 99%

Newborn and infant hearing screening at primary healthcare clinics in South Africa designated as National Health Insurance pilot sites: An exploratory study

Kanji

2022

South African Journal of Communication Disorders

View full text Add to dashboard Cite

Primary healthcare is the first level of care and entry for individuals into the healthcare system, which is accessible at PHC clinics and community health centres (CHCs). The services at these healthcare facilities include maternal and child care, immunisations, family planning and care for chronic illnesses, usually managed by nurses with advisory support and regular visits by medical practitioners and other relevant healthcare specialists (Bresick, Von Pressentin, & Mash, 2019;Cullinan, 2006). Such services can more broadly be categorised as preventative, promotional, curative and rehabilitative in nature (Cullinan, 2006;Schellack, Meyer, Gous, & Winters, 2011).An earlier review of the quality of services was conducted at 16 clinics in Johannesburg. Poor quality child health services for children who are ill was observed in relation to waiting periods, staff skills, triage and promotional, prevention and curative care. This was further accompanied by insufficient developmental assessment (Thandrayen & Saloojee, 2010). Of the 16 clinics, inconsistency was noticed in terms of immunisation and rehabilitation in 14 and 5 clinics, respectively. The Integrated Management of Childhood Illnesses (IMCI) approach was only utilised in 3 clinics, despite 12 having had an IMCI-trained professional. These findings by Thandrayen and Saloojee (2010), Background: Primary healthcare (PHC) is the first point of entry, providing basic services to individuals. South Africa is in the process of re-engineering its PHC as part of National Health Insurance (NHI) plans to ensure universal healthcare coverage.Aim: This study aimed to establish whether newborn and infant hearing screening (NIHS) could be integrated into the re-engineering process of the PHC as part of the NHI framework. Setting:The NHI pilot clinics in five provinces in South Africa.Methods: A non-experimental, descriptive, cross-sectional survey research design was adopted. Questionnaires were sent to nursing managers, unit managers or acting managers at PHC facilities. Nineteen of these self-administered questionnaires were completed. Data were analysed using descriptive statistics.Results: Immunisation services were the most common type of service offered at the clinics. Over a quarter of the respondents indicated that NIHS services were offered at their facility in the form of universal NIHS. Equipment was limited with a lack of valid and reliable screening measures. Only 2 (11%) respondents indicated budgetary resources. Follow-up and referral pathways were reported by 10 (53%) respondents, which did not include an audiologist. Conclusions:There is a need for careful and systematic planning in terms of early hearing detection programmes at PHC level. Planning needs to commence with considerations of who will perform NIHS, training of these personnel by audiologists and the role of the audiologist within the teams outlined in the NHI Bill.

show abstract

National Health Insurance implications for rehabilitation professionals and service delivery

Abstract: This paper reviews the National Health Insurance (NHI)

Cited by 8 publications

References 6 publications

Occupational therapy services and perception of integration of these at primary healthcare level in South Africa

Occupational therapy services and perception of integration of these at primary healthcare level in South Africa

Impactful educational transitions: Crossroads for physiotherapy education in South Africa?

Newborn and infant hearing screening at primary healthcare clinics in South Africa designated as National Health Insurance pilot sites: An exploratory study

Contact Info

Product

Resources

About