Abstract Background Given projected shortages of critical care capacity in public hospitals during the COVID-19 pandemic, South African government embarked on an initiative to purchase this from private hospitals. In order inform purchasing decisions, we assessed cost-effectiveness intensive management for admitted patients across and health systems Africa. Methods Using a modelling framework system perspective, costs outcomes inpatient severe (1) general ward (GW + ICU) versus (2) only (GW)...

The first democratic government elected in South Africa 1994 inherited huge inequalities health status and provision across all sections of the population. This study set out to assess, 4 years later, influence race socioeconomic (SES) on perceived quality care from providers.A 1998 countrywide survey 3820 households assessed many aspects delivery, including levels satisfaction with providers among different segments African society.Fifty-one percent (n = 1953) respondents had attended a...

This study quantifies the impact of COVID-19 vaccination on hospitalization for infection in a South African private health insurance population. retrospective cohort is based analysis demographic and claims records 550,332 individuals belonging to two funds between 1 March 2020 31 December 2022. A Cox Proportional Hazards model was used estimate (non-vaccinated, partly vaccinated, fully vaccinated) risk; zero-inflated negative binomial models were hospital utilization expenditure infection,...

Antibiotic resistance is a significant public health problem. Prudent use of antibiotics crucial in reducing this resistance. Acute bronchitis common reason for consultations with general medical practitioners, and are often prescribed even though guidelines recommend not prescribing them uncomplicated acute bronchitis.To analyse the antibiotic prescription patterns South African (SA) practitioners treatment bronchitis.The 2013 claims members 11 insurance schemes were analysed to assess...

Abstract Aim In the present study, we assessed patterns and types of antibiotics prescribed following tooth extractions, alignment these practices with evidence available. Methods The study used health insurance claim data from South African dental practitioners for 2013, analyzing antibiotic prescribing around separately four event types: exposed (simple) extractions in: (a) healthy patients (b) chronic conditions; impacted in (c) (d) a condition. Results More than 50 000 extraction events...

Broader policy research and debate on the issues related to planning of National Health Insurance (NHI) in South Africa (SA) need be complemented by case studies examine understand that will have dealt with at micro macro levels. The objective this article is use caesarean section (CS) as a study health systems challenges NHI would address order ensure sustainability. specific objectives are to: (i) provide an overview key clinical considerations CS; (ii) assess CS rates SA public private...

Background Evidence on the risk factors for COVID-19 hospitalization, mortality, hospital stay and cost of treatment in African context is limited. This study aims to quantify impact known these outcomes a large South private health insured population. Methods findings cross sectional analytic based analysis records members belonging insurances administered by Discovery Health (PTY) Ltd. Demographic data 188,292 who tested positive over period 1 March 2020–28 February 2021 hospitalization up...

Monitoring Caesarean Section (CS) rates is essential to ensure optimal use of the procedure. Information on CS in South African private sector limited and information from this study will assist planning for proposed NHI Africa.The objectives paper are assess mode delivery patterns determine amongst health insurance scheme members; extent which influenced by age status mother.The 2015 claims members 10 schemes were analysed type patterns. Mode assessed 6 types: emergency, elective "other"...

Abstract This article provides a critique of South Africa's attempt to transform apprenticeships using data from the 2004 Baseline Survey Learnership Programme in Africa. The suggests that Learnerships provide important opportunities for those work learn new theoretical and practical capabilities thus deepen skills base African economy. They also key avenues unemployed people gain experience improve their employability. Moreover, incentives have been set sufficiently high encourage employer...

The COVID-19 pandemic is likely to widen the health care demand-supply gap, especially in low- and middle-income countries (LMICs). virus has had greatest impact on older persons terms of morbidity mortality, occurring at a time rapid population ageing, which happening three times faster LMICs than high-income countries. Addressing gap post-COVID-19 era, resources are further constrained, will require major 'reset' system. In this article, we argue that ageing populations needs be factored...

Background: Influenza vaccination is regarded as the most effective form of prevention and particularly recommended for individuals at increased risk developing severe influenza. Data on uptake (coverage) costs in South Africa are limited.Methods: This study examined influenza amongst African private health insurance scheme members. All claims received services rendered 2015 were collated an individual level related to provision vaccines analysed.Results: Of almost 520 000 members, overall...

Researching how public-private engagements may promote universal access to safe obstetric care including caesarean delivery is essential. The aim of this research was document the utilisation private general practitioners (GPs) contracted provide services in five rural district hospitals Western Cape, profile and outcomes deliveries. We also describe stakeholder experiences these arrangements order inform potential models contracting for services. used a mixed-methods study design hospitals'...

The Competition Commission’s Health Market Inquiry (HMI) is the most systematic and comprehensive investigation carried out into South African private health sector. recommendations as set in HMI Final Report merit extensive discussion debate, they could – if implemented have far-reaching consequences for future of healthcare system. objective this article to contribute by providing an overview key findings highlighting resultant imperatives at critical juncture policy development.

Healthcare demands are rising globally, and regardless of the approach to financing delivering healthcare services, no country can meet all its population. The demand-supply gap for services in South Africa (SA) is large, particularly public sector. objectives this article examine some underlying factors contributing gap, how COVID- 19 pandemic likely impact on them, describe why SA needs adopt an explicit equity-informed priority-setting assist managing gap.

Abstract BackgroundAmidst shortages of critical care capacity in the public sector during COVID-19 pandemic, South African government embarked on an initiative to purchase bed from private sector. To inform decision, we assessed cost-effectiveness ICU management for admitted patients across and health systems Africa . MethodsUsing a Markov modelling framework system perspective, costs outcomes inpatient severe (1) general ward intensive (GW+ICU) (2) only were assessed. Disability adjusted...

Governments in sub-Saharan Africa are exploring public-private-engagements for the delivery of health services. While there is existing empirical literature on high-income countries, we know much less about their operation low and middle-income countries. Obstetric services a priority area where private sector can make an important contribution terms skilled providers. The objective this study was to describe experiences managers generalist medical officers, general practitioner (GP)...

Background: Influenza vaccination is regarded as the most effective form of prevention and particularly recommended for individuals at increased risk developing severe influenza. Data on uptake (coverage) costs in South Africa are limited.Methods: This study examined influenza amongst African private health insurance scheme members. All claims received services rendered 2015 were collated an individual level related to provision vaccines analysed.Results: Of almost 520 000 members, overall...

A national cross-sectional survey was carried out in South Africa to gain an understanding of the perceptions and priorities likely members a future social health insurance (SHI). More than 1,000 employees were interviewed variety employment sectors, including state parastatal organisations, formal informal private sectors. This article reports on respondents’ level support for compulsory contribution towards hospital scheme funding care at public sector hospitals Africa. The results showed...

### Summary box Globally the COVID-19 pandemic has destabilised health systems and communities. Governments in low- middle-income countries (LMICs) followed approaches adopted by Global North advocated international bodies such as WHO, instituted varying degrees of nationwide stay at home orders (lockdowns) from strict restrictions (such South Africa, India Zimbabwe) to weakly enforced lockdown Brazil.1 Many have questioned appropriateness these measures LMIC contexts2 where key preventive...

Background Harnessing of private sector resources could play an important role in efforts to promote universal access safe obstetric care including caesarean delivery low- and middle-income countries especially rural contexts but any such attempt would need ensure that the provided is appropriate patterns inappropriate care, as high rates, are not reproduced for entire population.Objective To examine contracting arrangements using general practitioners provide services district hospitals...

The National Assembly approval of the Health Insurance (NHI) Bill represents an important milestone, but there are many uncertainties concerning its implementation and timeline. challenges faced by South African healthcare system huge, we cannot afford to wait for NHI address them all. It is critical that process strengthening health advance universal (UHC) begins now, several viable initiatives can be implemented without delay. This article examines potential scenarios after passed ways in...