Conversations surrounding access to quality healthcare are currently dominated by high-level policy discussions in relation to the national health insurance (NHI).
These discussions are often far removed from community-driven commitments to creating more equitable realities, a richness of which exist on the ground.
Access to healthcare is a human right in South Africa. This encompasses individual health and the overall well-being of communities. Universal health coverage (UHC) forms part of an intergovernmental agreement by states to promote healthy lives and to ensure the well-being of all people.
The World Health Organisation’s UHC2030 aims to ensure that everyone has access to quality healthcare, despite their socioeconomic status, by 2030. The NHI is our response to this global call for universal health coverage.
In South Africa, the most unequal country in world, safe and quality healthcare shouldn’t be something monopolised by the rich, and lower-income families shouldn’t be pushed deeper into poverty, while trying to access their right to health services.
While some might argue that there are other more pressing sectors, other than health, that our government could prioritise, like addressing problems in our education system, it is important to realise that health plays an essential role in socioeconomic development.
In fact, healthcare can actually be seen as the bedrock for this development, with access to quality health services being able to, for example, improve school attendance and concentration.
Even from the perspective of fiscal austerity, human productivity is improved when people are healthy enough to contribute to their families and the economy.
Healthcare cannot be viewed in isolation; in one way or another, it forms the basis for the realisation of a wide variety of socioeconomic rights, which is why the NHI is a much-needed step in the right direction.
Referring to the implementation of the NHI, former minister of health Aaron Motsoaledi said: “The first five years will be a process of building and preparation. Our first job is to uplift the public health sector so that it is in a proper state for the NHI.”
This uplifting, as well as the debate surrounding the NHI, should be informed by examples of real communities and people who have been working for years to make primary healthcare more accessible.
One example on the ground is that of the Chiawelo Community Health Centre in Soweto.
Taking a holistic, rather than simply symptomatic, approach to primary healthcare, this community practice boasts a wide range of services, such as a 24-hour emergency facility, a pharmacy, a mother-and-child area, HIV and TB counselling, community psychiatry, and dental health.
Invested community members, who trained to become community health workers, have committed themselves to registering people for healthcare and then following up with them. With their help waiting times for primary healthcare are just 22 minutes.
Comprehensive healthcare has been made available to over 3,000 registered families – and 79% of cases before the CCP being successfully resolved.
Lelona Mxesibe is political and budget analyst at Studies in Poverty and Inequality Institute in Johannesburg.