Reform in SA – What is the problem? To include variations among provinces and districts, measurement issues, etc. Financing NHI: Revenue sources (general taxes, payroll taxes, etc.) the role of private insurance, fiscal space and the public finance situation in SA, covering the informal sector, etc.
Pay for performance as a policy tool: practical difficulties and the critical role for management in implementation. Overview of payment: Options for paying doctors and hospitals, the role of contracting, likely consequences and implementation issues. Politics and the reform process: Stakeholder analysis and mobilising support for reform. Financing NHI: Revenue sources (general taxes, payroll taxes, etc.) the role of private insurance, fiscal space and the public finance situation in S.A., covering the informal sector, etc. Organising NHI: national vs. provincial, public vs. quasi-public, roles for private administrators, choices about fiscal autonomy, relationship to various ministries. Government and market failures and the role of the public and private sectors – including corruption issues in both areas. Benefit package and targeting: Introduction to the ‘step pyramid’. What should be covered and for whom? What role for co-payments as incentive and revenue source. The developmental transformation of the healthcare system is informed by the political context and the constitutional imperatives for access to care which are the main function of the health system. This module will provide the participant with analytical tools to interpret the political economy of health and to develop strategies which can respond to the health needs on the ground in a practical manner so that the impact of the health policy is understood and how it informs the type of executive leader required to deliver the results of effective and efficient healthcare delivery. Participants will be trained in costing the pooling, provisioning and procurement of health services as District or Hospital Managers to allow for the effective and efficient running of the services over which they have authority. Training will focus on their Units becoming a Cost Centre for the management of the finances allocated by the Provincial Health Authority as well as capacity building in the event that delegations for autonomy is devolved of their level of employment. The importance of performance management will be the focus in relation to optimal budget performance, allocation within the institution as well as meeting performance targets and outcome measures.
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