In Practice

Caesarean section rates in South Africa: A case study of the health systems challenges for the proposed National Health Insurance

G C Solanki, J E Cornell, E Daviaud, S Fawcus

Abstract


Broader policy research and debate on the issues related to the planning of National Health Insurance (NHI) in South Africa (SA) need to be complemented by case studies to examine and understand the issues that will have to be dealt with at micro and macro levels. The objective of this article is to use caesarean section (CS) as a case study to examine the health systems challenges that NHI would need to address in order to ensure sustainability. The specific objectives are to: (i) provide an overview of the key clinical considerations related to CS; (ii) assess the CS rates in the SA public and private sectors; and (iii) use a health systems framework to examine the drivers of the differences between the public and private sectors and to identify the challenges that the proposed NHI would need to address on the road to implementation.


Authors' affiliations

G C Solanki, Senior Specialist Scientist, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; Honorary Research Associate, Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Principal Consultant, NMG Consultants and Actuaries, Cape Town, South Africa

J E Cornell, Director of Institutional Development and Planning (retired), Nelson Mandela School of Public Governance, University of Cape Town, South Africa

E Daviaud, Senior Specialist Scientist, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa

S Fawcus, Senior Scholar and Professor Emeritus, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Cape Town, South Africa

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Keywords

Caesarean section; Statistics; Numerical data; Pregnancy; South Africa; Insurance; Health

Cite this article

South African Medical Journal 2020;110(8):747-750. DOI:10.7196/SAMJ.2020.v110i8.14699

Article History

Date submitted: 2020-07-29
Date published: 2020-07-29

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