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Health Technology Assessment in Support of National Health Insurance in South Africa. 2022

Maryke Wilkinson, and Andrew Lofts Gray, and Roger Wiseman, and Tamara Kredo, and Karen Cohen, and Jacqui Miot, and Mark Blecher, and Paul Ruff, and Yasmina Johnson, and Mladen Poluta, and Shelley McGee, and Trudy D Leong, and Mark Brand, and Fatima Suleman, and Esnath Maramba, and Marc Blockman, and Janine Jugathpal, and Susan Cleary, and Noluthando Nematswerani, and Sarvashni Moodliar, and Andy Parrish, and Khadija K Jamaloodien, and Tienie Stander, and Kim MacQuilkan, and Nicholas Crisp, and Thomas Wilkinson
Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa.

South Africa has embarked on major health policy reform to deliver universal health coverage through the establishment of National Health Insurance (NHI). The aim is to improve access, remove financial barriers to care, and enhance care quality. Health technology assessment (HTA) is explicitly identified in the proposed NHI legislation and will have a prominent role in informing decisions about adoption and access to health interventions and technologies. The specific arrangements and approach to HTA in support of this legislation are yet to be determined. Although there is currently no formal national HTA institution in South Africa, there are several processes in both the public and private healthcare sectors that use elements of HTA to varying extents to inform access and resource allocation decisions. Institutions performing HTAs or related activities in South Africa include the National and Provincial Departments of Health, National Treasury, National Health Laboratory Service, Council for Medical Schemes, medical scheme administrators, managed care organizations, academic or research institutions, clinical societies and associations, pharmaceutical and devices companies, private consultancies, and private sector hospital groups. Existing fragmented HTA processes should coordinate and conform to a standardized, fit-for-purpose process and structure that can usefully inform priority setting under NHI and for other decision makers. This transformation will require comprehensive and inclusive planning with dedicated funding and regulation, and provision of strong oversight mechanisms and leadership.

UI MeSH Term Description Entries
D007348 Insurance, Health Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading. Group Health Insurance,Health Insurance,Health Insurance, Voluntary,Health Insurance, Group,Health Insurances,Insurance, Group Health,Insurance, Voluntary Health,Insurances, Health,Voluntary Health Insurance
D009313 National Health Programs Components of a national health care system which administer specific services, e.g., national health insurance. National Health Insurance, Non-U.S.,Health Services, National,National Health Insurance,National Health Insurance, Non U.S.,National Health Services,Services, National Health,Health Insurance, National,Health Program, National,Health Programs, National,Health Service, National,Insurance, National Health,National Health Program,National Health Service,Program, National Health,Programs, National Health,Service, National Health
D013019 South Africa A republic in southern Africa, the southernmost part of Africa. It has three capitals: Pretoria (administrative), Cape Town (legislative), and Bloemfontein (judicial). Officially the Republic of South Africa since 1960, it was called the Union of South Africa 1910-1960. Republic of South Africa,Union of South Africa
D013673 Technology Assessment, Biomedical Evaluation of biomedical technology in relation to cost, efficacy, utilization, etc., and its future impact on social, ethical, and legal systems. Assessment, Biomedical Technology,Assessment, Technology,Biomedical Technology Assessment,Technology Assessment,Technology Assessment, Health,Assessment, Health Technology,Assessments, Biomedical Technology,Assessments, Health Technology,Assessments, Technology,Biomedical Technology Assessments,Health Technology Assessment,Health Technology Assessments,Technology Assessments,Technology Assessments, Biomedical,Technology Assessments, Health
D017149 Private Sector That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests. Private Enterprise,Enterprise, Private,Enterprises, Private,Private Enterprises,Sector, Private
D019472 Universal Health Insurance Health insurance coverage for all persons in a state or country, rather than for some subset of the population. It may extend to the unemployed as well as to the employed; to aliens as well as to citizens; for pre-existing conditions as well as for current illnesses; for mental as well as for physical conditions. Universal Coverage,Coverage, Universal,Health Insurance, Universal,Insurance, Universal Health

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