Task Three: Putting Models into Action

In semester $1,$ you learnt about different methods, models and frameworks that can be used to make sense of complexity in health and health systems, linked to the different foci of each module. In Module $1,$ these included a revision of the WHO Health Systems Framework $,$ Tuckman$$s Stages of Group Development, the types and typologies of health systems, including Field$$s Five$-$part Typology, Roemer$$s Fourfold Typology, and Cockerham$$s Fourfold Classification, the Draw Toast method, Complex Adaptive Action and Thomas$-$Kilmann$$s Conflict Style Model. In Module $2,$ we looked at Maxwell$$s dimensions of quality and the STEEEP framework, the Donabedian Model and the socio$-$ecological model. In Module $3,$ these included the dimensions of data quality. And in Module $4,$ these included the Policy Cycle and the Policy Analysis Triangle.

For this task, you are asked to write a academic report $(2$ to $3$ pages$)$ in which you describe and discuss the key challenges for implementing health policies aimed at improving health information systems in South Africa in the context of NHI. To assist you to write this report, you must apply at least one of the models mentioned above. The focus of your report will depend on the model you choose to use. Rather, this is an opportunity to showcase your understanding and application of one of the abovementioned models to a complex issue.

This report needs to be written in an academic style. Feel free to find source material that supports the key challenges you have identified. You can use readings from the course, or you can identify readings from appropriate online sources. Remember to include in$-$text referencing as well as a bibliography at the end of your report. Because you are writing a report, you should keep your writing focused and concise.

The case study below gives some content to the current issue of developing health policy aimed at improving health information systems in South Africa. Read this case$-$study to situate your report:

Case Study: Health Policy for Health Information Systems in South Africa

South Africa is on the path to implementing National Health Insurance $($NHI$)$ to achieve universal health coverage $($UHC$)$ in line with the Sustainable Development Goals $($SDGs$).$ NHI aims to provide equitable access to quality health services for all South Africans, but in order to achieve this, a robust Health Information System $($HIS$)$ is crucial for its success. Policies need to be implemented to ensure the successful operation of NHI, focusing on efficient service delivery, appropriate resource allocation, and good monitoring of health outcomes. Over the past decade or more, the National Department of Health $($NDoH$)$ has developed several systems, strategies and policies to strengthen HIS, aligning with the goals of NHI:

$-$ The District Health Information Management System $($DHMIS$)$ Policy $(2011)$: The DHIS enhances data collection and management at the district level, facilitating localised health planning and improving the efficiency and effectiveness of healthcare services. This policy outlines the framework for developing an integrated HIS, emphasising data accuracy, timeliness, and accessibility to support NHI implementation.

$-$ The eHealth Strategy for South Africa $(20122016)$: this strategy aimed to implement eHealth capabilities in South Africa in a phased approach. It identified four key areas as foundational: infrastructure, connectivity, registration of patients and providers, and a basic national electronic health record.

$-$ The National Digital Health Strategy for South Africa $(20192024)$: This strategy promotes the adoption of eHealth solutions, including electronic health records $($EHRs$),$ telemedicine, and mobile health $($mHealth$),$ to support NHI's goal of providing comprehensive and coordinated care.

What needs to be taken into account in any policy planning is the context in which such policies are to be implemented. In South Africa, this includes large divisions between the public and private health sectors$,$ between rural and urban health needs, and between hospital and primary healthcare. In addition to this, South Africa suffers a complex, quadruple burden of disease. This context presents a number of challenges for the successful implementation of a health policies aimed at improving information systems in light of the NHI.