Making sense of the “national” in National Health Insurance
1
National Health Insurance branch, South African National Department of Health, Pretoria, South Africa
2
Department of Community Health, University of the Witwatersrand, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1539
ABSTRACT
BACKGROUND:
National Health Insurance (NHI) is widely advanced as a pathway to Universal Health Coverage (UHC) and achieving Sustainable Development Goal 3. While UHC rests on shared principles of equity, financial protection, and access; its realisation is deeply shaped by context. Decisions regarding governance, financing, purchasing, benefits, and provider participation reflect political economy, constitutional arrangements, health systems, and social values. This session will reflect on how universal UHC ambitions are translated into system designs that respond to local realities.
OBJECTIVES:
This workshop aims to explore the principles and processes through which NHI reforms are designed and implemented in different settings. Drawing comparative insights from South Africa, Canada, Brazil, Zambia, and the United Kingdom; the session will focus on how countries interpret shared UHC goals while navigating local contexts. A core objective is to foster cross-country learning that deepens understanding of how responsibility for health is organised within systems, and what can be meaningfully transferred across contexts.
METHODS:
The workshop will use a facilitated, interactive format combining brief country reflections with structured dialogue. Participants will examine: •How shared UHC principles are operationalised through financing, pooling, purchasing, and benefits design •How responsibility is distributed across national and sub-national levels •How public and private providers are integrated within nationally coordinated arrangements •The political and institutional trade-offs shaping reform trajectories Expected Outcomes The session will support a deeper, comparative understanding of NHI as a set of context-sensitive design choices, contributing to more equitable and sustainable progress toward UHC and SDG 3. Participants will gain practical insights into how learning across borders can strengthen local system design, moving beyond policy imitation toward informed adaptation.
CONCLUSIONS:
By centering learning and understanding across borders, this workshop highlights how shared ambitions for health can be advanced through systems that are locally grounded, yet globally informed.
National Health Insurance (NHI) is widely advanced as a pathway to Universal Health Coverage (UHC) and achieving Sustainable Development Goal 3. While UHC rests on shared principles of equity, financial protection, and access; its realisation is deeply shaped by context. Decisions regarding governance, financing, purchasing, benefits, and provider participation reflect political economy, constitutional arrangements, health systems, and social values. This session will reflect on how universal UHC ambitions are translated into system designs that respond to local realities.
OBJECTIVES:
This workshop aims to explore the principles and processes through which NHI reforms are designed and implemented in different settings. Drawing comparative insights from South Africa, Canada, Brazil, Zambia, and the United Kingdom; the session will focus on how countries interpret shared UHC goals while navigating local contexts. A core objective is to foster cross-country learning that deepens understanding of how responsibility for health is organised within systems, and what can be meaningfully transferred across contexts.
METHODS:
The workshop will use a facilitated, interactive format combining brief country reflections with structured dialogue. Participants will examine: •How shared UHC principles are operationalised through financing, pooling, purchasing, and benefits design •How responsibility is distributed across national and sub-national levels •How public and private providers are integrated within nationally coordinated arrangements •The political and institutional trade-offs shaping reform trajectories Expected Outcomes The session will support a deeper, comparative understanding of NHI as a set of context-sensitive design choices, contributing to more equitable and sustainable progress toward UHC and SDG 3. Participants will gain practical insights into how learning across borders can strengthen local system design, moving beyond policy imitation toward informed adaptation.
CONCLUSIONS:
By centering learning and understanding across borders, this workshop highlights how shared ambitions for health can be advanced through systems that are locally grounded, yet globally informed.
| eISSN: | 2654-1459 |
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