NHI pilot evaluation report finds little to get excited over, despite R500 million budget | City Press

The objective of the NHI Bill is to provide universal access to quality health care for all South Africans as enshrined in the Constitution.A report compiled by a government-contracted consortium to evaluate the performance of the department of health's National Health Insurance pilot district programme has shown that there was no way to tell just how effective these pilots were in evaluating the health system's strengthening interventions, as proposed by the NHI.

According to the department of health's Foster Mohale, the evaluation involved"project and stakeholder management, supporting the fieldwork component and undertaking data analysis and reporting".PwC was largely responsible for undertaking the fieldwork, developing the dashboards and analysing the quantitative data. PwC also formed part of the TAC , providing technical oversight of the evaluation.

He explains that this means they did not test the NHI policy framework, but rather looked at an array of specific projects,"with no clear overall concept in mind". It goes on to say:"In assessing the routine and outcomes data, it was difficult to identify a clear trend as the data varied. In some years, indicator performance appears to have increased significantly in one year; however, these indicators showed little to no improvement in the following year. Moreover, the assessment of indicators depends on the availability of accurate denominators, which were not always available and varied from year to year.

"Note that the NHI proposals involve institutional interventions and are not a set of health strengthening exercises," Van den Heever mentioned. He said even if the goal was to implement health-strengthening interventions, it was far from clear what the pilots demonstrated.

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