With today (12 Dec), being Universal Health Coverage (UHC) Day, on Thursday, it is pertinent to reflect on the progress made in advancing healthcare access and quality in South Africa.
The concept of Universal health coverage is defined as ensuring that all individuals and communities receive the health services they need without facing economic barriers. This concept incorporates three pillars:
- Access to health services: Everyone should be able to access the services they need, regardless of their ability to pay
- Financial risk protection: People should not go into debt to pay for care and treatment.
- Quality of services: Services should be effective and adequate.
Major Disparities in Healthcare Access
In the South African context, this involves addressing the disparities in our healthcare sectors and ensuring that every citizen, regardless of their financial or social status, has equitable access to quality care.
The lived experience for a large portion of the South African population, is that they lack medical protection cover, underscoring an urgent need for effective and affordable healthcare solutions.
Employed and insured individuals seek mostly comprehensive yet affordable healthcare, while the employed but uninsured (6 to 8 million) can face financial strain accessing quality care when required, particularly when seeking specialist medical care.
Workers in the informal sector and SMEs often lack medical cover too, exposing them to significant out-of-pocket expenses. Those unable to afford any medical funding rely heavily on an overburdened public healthcare system and overcrowded facilities, highlighting the necessity for accessible and inclusive universal healthcare across all economic groups.
Collaboration a Possible Solution
For over 60 years, South Africa’s healthcare sector has been characterised by a dual system of providers. Government has invested heavily in healthcare infrastructure and services and while it has made notable strides in improving access to quality healthcare.
Sadly the public healthcare sector has also suffered from financial mismanagement and corruption that has resulted in lower than expected delivery of services for the 12% of total government budget spent on healthcare. This is significantly above the average of 8% of total budget spent across Africa and below the global average of 10%.
However, according to Dr Ali Hamdulay, Chief Executive Officer (CEO) of Metropolitan Health,there is a significant opportunity for greater collaboration and meaningful partnerships within South Africa’s healthcare sector, focused on developing solutions that cater to the diverse needs of the population.
Effective Partnerships Critical
Dr Hamdulay emphasises, that the healthcare ecosystem relies on the interdependence of various role players, including healthcare professionals, facilities, funders, administrators and government entities. Each of these contributors play a crucial role in ensuring the health and wellbeing of every citizen.
“For the system to be sustainable, we must understand, recognise and cater to the unique contributions and requirements of each role player.” “This approach is vital for maintaining service continuity, quality, and access to necessary healthcare services through collaboration”. “Effective partnerships across these functions are critical to the success of the healthcare ecosystem”, he says.
New Insurance Product Targets Low-income Earners
To address the needs of low-income earners who are privately employed but uninsured, Momentum Health has launched Health4Me, a healthcare insurance product that enables employer groups to provide affordable healthcare cover to those who might not otherwise be able to afford it.
“Our approach goes beyond merely paying claims; we focus on promoting health, wellbeing, and productivity, ultimately enhancing quality of life”. “This is achieved through primary healthcare facilities, technology, and incentivising wellbeing” says Ali.
According to Ali, the rapid growth of this healthcare insurance solution speaks to its success and its impact on offering more healthcare for more South Africans, for less. By expanding access to universal healthcare through primary healthcare, technological capabilities, and healthcare-strengthening initiatives, he believes that there are opportunities to collaborate and address the needs of additional population cohorts.
“Through our vast experience in the design and management of healthcare solutions, we have learned valuable lessons that enable us to effectively collaborate across sectors”. “One of the critical lessons is the importance of clear communication and defined roles for all stakeholders involved in working towards establishing universal healthcare access, with successful partnerships have demonstrating that when goals are aligned across sectors to achieve a common objective, such as improving patient outcomes, success is possible”, Dr Hamdulay says.
Some of the key issues highlighted by Dr Hamdulay are:
- Investing in community health programmes and early interventions, enabling health issues to be addressed before they escalate andeasing the burden on healthcare systems.
- Collaboration across sectors can significantly increase access to preventative care by leveraging the resources and expertise of both sectors.
- Integrating preventative care into primary healthcare shifts the focus from reactive to proactive care.
Education and Knowledge Sharing Key Components
It is advantageous to focus on co-creating platforms and mutually solving for the needs of our population through collaboration. This approach fosters consistency in service delivery and builds trust between entities. Metropolitan Health, a subsidiary of Momentum Health, has demonstrated its commitment to health strengthening by supporting leadership and professional development through its partnership with the National School of Government.
“By sharing and imparting knowledge, we are supporting the education and empowerment of future healthcare leaders through regular joint training and capacity-building programmes” comments Hamdulay. “This further improves collaboration by fostering a culture of continuous learning and development”.
“Looking towards 2025, the vision for healthcare in South Africa is one of greater access, integration, and collaboration”. “By working together, we can create a more resilient and responsive healthcare system that meets the needs of all citizens” concludes Dr Hamdulay.
