Policy coherence and health system reform: the case of health benefit package design for national health insurance in South Africa
1
School of Public Health, University of Cape Town, Cape Town, South Africa
2
School of Public Health, University of the Western Cape, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3611
ABSTRACT
INTRODUCTION:
Health reforms require coordination across all facets of the health system as defined by the World Health Organization building blocks, e.g. health financing, service delivery, etc. These reforms are, in turn, supported by and/or inform governance-related interventions such as health legislation and policy, and mechanisms for their enforcement and accountability. What is less commonly discussed is the underlying assumption that the content of these documents is aligned and coherent and thereby supports an integrative approach to system reform. This research investigates the degree of policy coherence in existing legislation, regulation and national service delivery-related policy in South Africa as it relates to the implementation of the first national primary health care benefits package (HBP). This includes documents developed to guide the public and private sector, which have historically operated in parallel, and which the Government seeks to align under National Health Insurance (NHI) reform towards universal health coverage.
METHODS:
The research will be based on thematic analysis of approximately 30 South African health-related acts, regulations and national policy documents that refer to a HBPs in either the public or private sector, and have been published since the beginning of democracy, i.e. 1994. The documents will be selected based on defined inclusion and exclusion criteria and interpreted within the context of a wider set of reference policy documents as well as the current social, political, and economic context.
RESULTS:
The results will be used to discuss the nature and role of health policy design for system reform to support implementation of the first national HBP in South Africa; the implications for implementation of NHI as the overarching policy reform in South Africa; and broader lessons learned.
CONCLUSIONS:
The results will be used to provide guidance on areas of research that could serve to expand and/or strengthen the existing evidence base.
Health reforms require coordination across all facets of the health system as defined by the World Health Organization building blocks, e.g. health financing, service delivery, etc. These reforms are, in turn, supported by and/or inform governance-related interventions such as health legislation and policy, and mechanisms for their enforcement and accountability. What is less commonly discussed is the underlying assumption that the content of these documents is aligned and coherent and thereby supports an integrative approach to system reform. This research investigates the degree of policy coherence in existing legislation, regulation and national service delivery-related policy in South Africa as it relates to the implementation of the first national primary health care benefits package (HBP). This includes documents developed to guide the public and private sector, which have historically operated in parallel, and which the Government seeks to align under National Health Insurance (NHI) reform towards universal health coverage.
METHODS:
The research will be based on thematic analysis of approximately 30 South African health-related acts, regulations and national policy documents that refer to a HBPs in either the public or private sector, and have been published since the beginning of democracy, i.e. 1994. The documents will be selected based on defined inclusion and exclusion criteria and interpreted within the context of a wider set of reference policy documents as well as the current social, political, and economic context.
RESULTS:
The results will be used to discuss the nature and role of health policy design for system reform to support implementation of the first national HBP in South Africa; the implications for implementation of NHI as the overarching policy reform in South Africa; and broader lessons learned.
CONCLUSIONS:
The results will be used to provide guidance on areas of research that could serve to expand and/or strengthen the existing evidence base.
| eISSN: | 2654-1459 |
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