Browsing by Author "Mthembu, Nozipho Nokwazi Henrietta."

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An analysis of the nurse managers' interpretation of the National Health Insurance Policy, its implications for implementation in healthcare facilities in the eThekwini district.
(2012) Mthembu, Nozipho Nokwazi Henrietta.; Bhengu, Busisiwe Rosemary.
Background: The government of South Africa has focused on Primary Health Care and implementation of the National Health Insurance (NHI) as part of the plan to reform the South African health care system. This is based on the principle of the right to healthcare and the right to access health care facilities. Aim: The aim of this study was to analyse the Nurse Managers’ interpretation of the National Health Insurance Policy and, its implications for implementation on their roles and responsibilities in health care facilities. Methodology: The sequential mixed method approach was conducted. There was direct interaction (semi structured interviews) with the Nurse Managers as well as a survey (questionnaires) for both qualitative and quantitative phases. Qualitative data was collected and analysed first, and an instrument was developed based on the analysed data from the qualitative phase to collect quantitative data. Setting: EThekwini district comprising of two district hospitals, three Community Health Centres (CHC) and four Private healthcare facilities were selected. Participants: Nurse Managers in the public Primary Health Care facilities and private hospitals in the EThekwini district. These were Nurse Managers (top middle and lower levels) from the public healthcare facilities (district hospitals, Community Health Centres, primary health clinics) middle and lower levels in the private facilities. Data Analysis: A thematic analysis was used in the qualitative phase. Descriptive statistic was used in the quantitative phase to describe and synthesize data (Polit and Beck 2004) as well as inferential numeric analysis (Creswell 2009). Findings: The findings in both the qualitative and quantitative data revealed that the participants demonstrated a general impression on the NHI rather than specific understanding; hence the researcher believes that there was more general than specific knowledge and interpretation of the NHI policy. The participants’ display of lack of knowledge and understanding of the concept NHI and the implementation process was an indication that there was lack of personal development in relation to expectations from the nurse managers concerning NHI though there is a lot of publicity in this respect from the government and media. There are national policies and guidelines for all citizens to access. Recommendations: The recommendations were made for sharing with the policy makers and seniors in the healthcare facilities in order to improve nursing management, nursing education and nursing research.
Exploring perceptions of clients with regards to National Health Insurance services in a selected public hospital in Dar Es Salaam, Tanzania.
(2015) Omari, Minael Nathanael.; Mthembu, Nozipho Nokwazi Henrietta.; Mchunu, Gugu Gladness.
Background: The National Health Insurance (NHI) of Tanzania is commonly known as the National Health Insurance Fund (NHIF). The scheme operates under the supervision of the Ministry of Health and Social Welfare (MOHSW) together with an independent board of the NHIF. It is a mandatory form of healthcare financing primarily for public servants and other categories of employees in the formal sector which covers hospital costs for the principal member and six beneficiaries of any age. Purpose: The purpose of this study was to explore the perceptions of clients with regards to National Health Insurance Services in a selected public hospital in Dar es Salaam, Tanzania. Methodology: Guided by objectivism, this study adopted a positivist paradigm and a quantitative approach. A non-experimental, exploratory-descriptive and cross sectional research design was used and a self-administered structured questionnaire was used for data collection. Ethical clearance was obtained from the University of KwaZulu-Natal Research Ethics Committee and the Humanities and Social Sciences Research Ethics Committee (HSSREC) in South Africa, and from the Kinondoni District Hospital Research Ethics Committee in Tanzania. Results: The results of this study indicated that 64.8% of participants were the principle members of the NHIF and the majority (63.1%) were female. While joining the fund would have been compulsory for the 54.9% of the participants who were civil servants and 15.6% who were traders or business people, the majority (90.1%) of all the participants indicated that they had joined the scheme because it offered financial protection against illness. The majority of participants acknowledged the benefits of being a member of NHI, with 93.5% agreeing that joining the scheme benefited them and their beneficiaries, 93.4% agreeing that it gave them reassurance that their family would receive care, 89.3% agreeing that it provided easy access to health care, 83.6% agreeing that it would save money from paying hospital bills and 82.8% agreeing that belonging to NHI was better than having to make out-of-pocket payments. Recommendations: Despite their positive attitude towards the NHI services, participants admitted that NHI does not permit health care access to all citizens and that, even with the cover of the NHIF, they still needed to save money to pay for hospital care. Therefore, the study recommends the expansion of the NHIF benefits packages up to the Primary Health Care level to avoid user fee for the insured. Similarly, the NHIF management must find another mechanism of funding the Community Health Fund to provide coverage for the poor rural communities who depend only on out-of-pocket payments. Further research is also recommended to explore the perceptions of the majority of Tanzanians who are not covered by the NHIF schemes.