Narain S.1, Mathye D.1, Mtshali B.F.1
1Sefako Makgatho Health Sciences University, Physiotherapy, Pretoria, South Africa
Background: National Health Insurance (NHI) has been proposed by the current government as a funding model for health care services for all residents and citizens in South Africa. It is said that the proposed model will improve access to affordable, quality healthcare services regardless of a person's socio-economic status. Pilot studies on NHI were commissioned in 2012 in eleven districts of all nine South African Provinces. Despite the well-documented role of physiotherapists in the literature, there is an apparent lack of mention and involvement of Physiotherapists at all levels of NHI, be it on NHI documents or pilot studies.
Purpose: This study seeks to establish the anticipated role of physiotherapists within the NHI system from the perspectives of experts and academic based physiotherapists in South Africa.
Methods: A qualitative, exploratory and descriptive approach was used. Data were collected from a purposively selected expert physiotherapists who:
(1) were registered with the Health Professions Council of South Africa,
(2) had a PhD in Physiotherapy or related fields as public health, community health or health policy
(3) were working at a South African university as an academic.
The heads of department of all universities training physiotherapists were requested to assist in identifying participants who met the inclusion criteria. The researcher also identified participants who met the studys inclusion criteria by searching through the websites of South African based universities. Seven expert physiotherapists participated in telephonic semi-structured interviews conducted by the primary researcher. Data were transcribed verbatim and analysed using an inductive approach to generate codes and themes.
Results: The theme that emerged from the data is physiotherapist should play a role at all levels of care from primary to tertiary level. This theme comprises eleven categories at various levels of care:
(1) health promotion,
(2) address Millennium Development Goals, (goal 1: combat HIV/Aids and other diseases, goal
2: Empower women, goal 3: Improve maternal health and goal 4: Reduce child mortality),
(3) participate in community development (e.g. Identify barriers to healthcare, advocate for the community, project financing and skilling),
(4) assessment / screening,
(5) diagnosis,
(6) management of various conditions,
(7) management of teams,
(8) collaboration with various stakeholders,
(9) research and contribution to body of knowledge,
(10) train physiotherapy students and physiotherapists, and
(11) participate in health policy formulation and implementation.
Conclusion(s): The findings of this study suggest that physiotherapists have a role to play in all spheres of health care starting from primary level to tertiary level. Even though the roles presented in this paper are anticipated in the implementation of NHI in South Africa, they may as well be used today in the day-to-day provision of physiotherapy services in low-to-middle income countries.
Implications: The results of the study will assist the government in the implementation of NHI in South Africa more especially with regards to the role that physiotherapist should play. The anticipated role of physiotherapists in this study is likely to significantly reduce patient waiting time by efficiently utilising the available human resources, and ensuring the provision of comprehensive healthcare at all levels of care.
Funding acknowledgements: The study was not funded
Topic: Globalisation: health systems, policies & strategies
Ethics approval: The study was approved by Sefako Makgatho Health Sciences University Research Ethics Committee. SMUREC Ethics Reference Number: SMUREC/HI178/2016: PG.
All authors, affiliations and abstracts have been published as submitted.
