Recently, National Health Insurance (NHI) has been a quite interesting topic to chat about for a number of South African citizens, but for me it has been an uncomfortable issue to talk about. As a time went by, is then that I became better confident to share a thing or two about it. For now it’s not about me, but people’s views on NHI implementation in rural settings.

I had an opportunity to chat with few people about NHI in the rural set up and I would like to share with you their thoughts on NHI..

“At the moment, NHI is still meaningless to most of the rural dwellers” This was a comment by Eddy Marilele working for Thohoyandou Victim Empowerment Programme and former Treatment Action Campaign Limpopo Chairperson. During the time of the conversation, Eddy was based in Vhembe District at Sibasa, a small town outside Thohoyandou. He further elaborated by saying that, at the moment most of the health care workers, members and leaders of Community Based Organisations (CBOs)and Non-Governmental Organisations does not know anything about National Health Insurance. I have also spoken to several people who confirmed that they didn’t know anything about NHI. Almost everyone I have spoken to have agreed that we need to roll out massive educational campaign about NHI.

Eddy mentioned one other challenge, planned patient transport and road accessibility. Jimmy Mongwe, a member of TAC Dan Branch in Tzaneen also shared the same sentiment when it comes to rural accessibility. ”Without proper road and other infrastructure in rural areas, things will not work right, we will never see improvement” Jimmy said. Before we implement the NHI, infrastructure need to be well considered and rehabilitated. Most of the streets in rural areas are not accessible. In so many instances, Ambulances could stop hundreds of metres away from the patient’s home and the sick person has to be picked on people’s backs or pushed in a wheel barrow to reach the Ambulance.

Check the video below to see how roads are inaccessible in rural communities.


You can also watch the video on the right tool bar.

Apart from planned patient transport system Eddy was also worried about the cost of transport for community member in areas where there are no health facilities at all. The money that they will use to go to facilities it will still be the same as paying for the service.

This confirms other social needs associated with health care. For a facility to be reached, roads need to be usable. Not only physical facilities but this also calls for human resources. Our facilities will need to be beefed up with enough personnel to respond to the community demand.

In other hand people could have more benefits in the NHI than not having it. “People will be contributing to the NHI fund, when they get sick they will have an opportunity to be taken care of without worrying about payments” Secret Munyai, from Mailaskop, a first year university student said in his attempt to explain what NHI is. “You will have an opportunity to access health care service in your nearest quality health care provider, whether private or public, people will be provided with an opportunity to get quality health care” That was Mabu Letsoalo, founder of Reakgona National Health Promotion (RANHPO) based in Lenyenye outside Tzaneen Town in the Limpopo Province.

“We will see improved quality health care and I believe that NHI is a good concept for South Africans, especially for rural community and poor people including people working for NGOs not getting any stipends or compensation of some kind” Mabu said, further elaborating his point. “I also believe that there will be reduction in health care workers-patient work load as people will have variety of facility to go for consultation including private facilities”.

Thanks for reading the post and I would appreciate your comments and sharing with others.

See you in the next post.