Primary healthcare re-engineering and the reimbursement of pharmacists: towards National Health Insurance in South Africa

Abstract

The current South African healthcare system, which traces its roots to the apartheid and colonial eras, is characterised by a two-tier system, the private and public sectors. This structure has created a significant divide, resulting in inequitable distribution of healthcare services in the country.^1,2 Responding to this disparity, the South African government has sought to advance universal health coverage (UHC) through creation of the National Health Insurance (NHI) Fund.³ A particular focus has been placed on primary healthcare (PHC) reengineering as part of the preparation for NHI.⁴ The NHI Act, 2023, aims to correct this disparity and enhance system functionality with a significant focus on PHC service delivery through different service streams designed to meet essential community healthcare needs and reduce overall system strain.

This paper summarises a suite of studies which documented pharmacists’ and other role-players’ perspectives on reimbursement mechanisms and enhancing PHC system functionality with the implementation of NHI in South Africa. The studies highlighted the critical need for healthcare system reform to address disparities entrenched by the apartheid regime.