Assessing healthcare professionals' perspectives: a knowledge and perceptions survey on South Africa's National Health Insurance
1
Health Systems Strengthening Programme, Clinton Health Access Initiative, Pretoria, South Africa
2
National Health Insurance Branch, National Department of Health, Pretoria, South Africa
3
Novartis, Midrand, South Africa
4
School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
5
Project Last Mile, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3765
ABSTRACT
BACKGROUND:
The National Health Insurance (NHI) Act (2023) in South Africa is a major health policy reform aimed at achieving Universal Health Coverage (UHC)[1]. Health care professionals (HCPs) are critical stakeholders in NHI implementation, as both providers and users of the health system[2]. This study aimed to assess HCP’s knowledge and perceptions of the NHI, to identify gaps that may affect workforce participation and policy uptake during implementation.
METHODS:
A national descriptive cross-sectional survey was conducted among HCPs working in public and private sectors across all nine provinces in South Africa. Data were collected using a structured online questionnaire. The survey assessed socio-demographic characteristics, knowledge of NHI, and perceptions related to workforce distribution under the NHI. Descriptive statistics were used to describe participant characteristics and overall knowledge scores. Logistic regression analyses were used to identify factors associated with good knowledge of the NHI.
RESULTS:
A total of 2394 HCPs participated. Overall, 69.2% demonstrated good knowledge of the NHI (score =/> 8.5/14); however, substantial gaps were identified regarding governance structures, contracting arrangements, and professional autonomy. More than a quarter (26.3%) of respondents incorrectly believed that private healthcare services would cease under NHI, and over half (51.2%) believed contracting with the NHI Fund would be compulsory. Older age (aOR = 2.61, 95% CI: 1.15–5.19, p = 0.02), being a pharmacist (aOR = 1.94, 95% CI: 1.00–3.74, p = 0.04), and working in the Free State province (aOR = 1.58, 95% CI: 1.00–2.51, p = 0.04) were significantly associated with higher knowledge scores. Willingness of HCPs to relocate to underserved areas was positive, with 41.1% expressing willingness.
CONCLUSIONS:
While awareness of NHI among HCPs is high, critical misconceptions persist, particularly regarding governance and operational aspects. Addressing these gaps through targeted communication, education, and change management strategies will be essential to support NHI implementation[3].
The National Health Insurance (NHI) Act (2023) in South Africa is a major health policy reform aimed at achieving Universal Health Coverage (UHC)[1]. Health care professionals (HCPs) are critical stakeholders in NHI implementation, as both providers and users of the health system[2]. This study aimed to assess HCP’s knowledge and perceptions of the NHI, to identify gaps that may affect workforce participation and policy uptake during implementation.
METHODS:
A national descriptive cross-sectional survey was conducted among HCPs working in public and private sectors across all nine provinces in South Africa. Data were collected using a structured online questionnaire. The survey assessed socio-demographic characteristics, knowledge of NHI, and perceptions related to workforce distribution under the NHI. Descriptive statistics were used to describe participant characteristics and overall knowledge scores. Logistic regression analyses were used to identify factors associated with good knowledge of the NHI.
RESULTS:
A total of 2394 HCPs participated. Overall, 69.2% demonstrated good knowledge of the NHI (score =/> 8.5/14); however, substantial gaps were identified regarding governance structures, contracting arrangements, and professional autonomy. More than a quarter (26.3%) of respondents incorrectly believed that private healthcare services would cease under NHI, and over half (51.2%) believed contracting with the NHI Fund would be compulsory. Older age (aOR = 2.61, 95% CI: 1.15–5.19, p = 0.02), being a pharmacist (aOR = 1.94, 95% CI: 1.00–3.74, p = 0.04), and working in the Free State province (aOR = 1.58, 95% CI: 1.00–2.51, p = 0.04) were significantly associated with higher knowledge scores. Willingness of HCPs to relocate to underserved areas was positive, with 41.1% expressing willingness.
CONCLUSIONS:
While awareness of NHI among HCPs is high, critical misconceptions persist, particularly regarding governance and operational aspects. Addressing these gaps through targeted communication, education, and change management strategies will be essential to support NHI implementation[3].
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
