An examination of health care financing models : lessons for South Africa
- Authors: Vambe, Adelaide Kudakwashe
- Date: 2012
- Subjects: National health insurance -- South Africa , Medical care -- South Africa , Public health administration -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9032 , http://hdl.handle.net/10948/d1021110
- Description: South Africa possesses a highly fragmented health system with wide disparities in health spending and inequitable distribution of both health care professionals and resources. The national health system (NHI) of South Africa consists of a large public sector and small private sectors which are overused and under resourced and a smaller private sector which is underused and over resourced. In broad terms, the NHI promises a health care system in which everyone, regardless of income level, can access decent health services at a cost that is affordable to them and to the country as a whole. The relevance of this study is to contribute to the NHI debate while simultaneously providing insights from other countries which have implemented national health care systems. As such, the South African government can then appropriately implement as well as finance the new NHI system specific to South Africa’s current socio-economic status. The objective of this study was to examine health care financing models in different countries in order to draw lessons for South Africa when implementing the NHI. A case study was conducted by examining ten countries with a national health insurance system, in order to evaluate the health financing models in each country. The following specific objectives are pursued: firstly, to review the current health management system and the policy proposed for NHI; secondly, to examine health financing models in a selected number of countries around the world and lastly to draw lessons to inform the South African NHI policy debate. The main findings were firstly, wealthier nations tend to have a much healthier population; this is the result of these developed countries investing significantly in their public health sectors. Secondly, the governments in developing nations allocate a smaller percentage of their GDP and government expenditure on health care. Lastly, South Africa is classified as an upper middle income developing country; however, the health status of South Africans mirrors that of countries which perform worse than South Africa on health matters. In other words the health care in South Africa is not operating at the standard it should be given the resources South Africa possesses. The cause of this may be attributed to South Africa being stuck in what is referred to as the “middle income trap” amongst other reasons.
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- Date Issued: 2012
An investigation into the implementation of group work, as a method of social work intervention, in health settings in South Africa
- Authors: Caires, Juliet Margarita
- Date: 1999
- Subjects: Social group work , Community health services -- South Africa , Medical care -- South Africa
- Language: English
- Type: Thesis , Masters , MSocSc
- Identifier: vital:691 , http://hdl.handle.net/10962/d1006373 , Social group work , Community health services -- South Africa , Medical care -- South Africa
- Description: This research aims to discover whether social workers employed in health settings in South Africa use group work as a method of intervention with patients. It attempts to explore in which hospitals (or particular patient populations) group work is considered possible, and to discover to what extent social workers in health settings consider group work to be beneficial to patients. It also attempts to discover some of the potential difficulties experienced in initiating group work in medical settings. An effort is also made to establish, from social workers active and experienced in the field of medical social work,what place group work might have in the broader context of health services in the future. Data was obtained through the use of mailed questionnaires, which were sent to 186 health settings, across South Africa. These settings were chosen according to the following priorities: i) those known to have social workers ii) services offered (e.g. oncology, psychotherapy) iii) size of the setting iv) geographical location (both urban and rural in all nine provinces). The sample included general public and private hospitals, psychiatric hospitals (both public and private), mining hospitals and other health settings such as old age homes and facilities for the mentally retarded and for alcohol and drug rehabilitation (accompanied by a medical facility). Responses were received from 90 health settings, with 64 of these being completed questionnaires. The majority of responses came from public hospitals, and the least from the mining hospital category. Findings of this study indicate that group work is used by 50% of the health settings in South Africa. Groups are most often therapeutic or educational in nature, are run on average once a week for an hour, and are usually of open membership. Group work is not used in some health settings, most commonly due to insufficient time (on the part of the social worker). From the findings, it seems that many more social workers would like to run groups for patients than they do presently. The benefits of group work are acknowledged by the majority of this study's sample of social workers, and if solutions could be found to problems such as heavy caseloads and insufficient time, more social workers would choose to use group work than are doing so currently. Group work is considered to be a feasible method, both in the hospitals and at primary health care level. With South Africa's growing emphasis on primary health care, and the proposed inclusion (by the Department of Health) of social work services at this level, it is important that social workers find a way in which to meet the needs of patients at both levels. With group work, this may be possible.
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- Date Issued: 1999