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Assessing Healthcare Workers' Perspectives: A Knowledge, Attitudes, and Practices (KAP) Survey on South Africa's National Health Insurance (NHI)
Knowledge, Attitudes and Practices Questionnaire
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Participant Information Sheet: Please Read Carefully
Informed Consent
*
I have read and understood the above study information regarding the study.
I am aware that the results of the study, including personal details regarding my sex, age and date of birth will be anonymously processed into a study report.
I agree that the data collected during this study can be processed in a computer system by the NDoH.
I am aware that my name and any other identifying information will be accessible only to the affiliated researchers and partner organisations that are part of this project and my data will be stored in a protected online server based outside of South Africa.
I may at any stage decide to not complete the survey, without any judgement or disadvantage.
I have been given enough chance to ask any questions concerning the study.
I have understood everything that has been explained to me and I consent to participate in the study.
I have been given contact details of the Principal Investigator, listed above. If I require further information or become concerned about any aspect of this study, I am free to contact the Principal Investigator.
By continuing with the survey, I agree to participate in this study.
Required
I consent to participate voluntarily in this survey. Please insert your initials as your mark of consent.
*
Your answer
Date
*
Please insert DD MMM YY. For example: 23 JAN 24
Your answer
What is your Age?
*
Your answer
What is your sex?
*
Male
Female
Non-binary
What is your ethnicity?
Black/African
Coloured
Indian/Asian
White
Other:
Clear selection
Which undergraduate qualification do you hold?
*
BCMP
BCur
BDS
BEMC
ECT
Lab Technician
MBChB or MBBCh
Pharmacy
Psychology
Student in Health Faculty; currently studying
Other:
Do you have a post-graduate qualification?
Yes
No
Clear selection
If Yes to a Post-Grad Qualification, please specify below:
Certificate
Diploma
Degree
If you are a student in a health faculty, what are you currently studying?
Your answer
If you are a student currently studying, which year of study are you in?
1st year
2nd year
3rd Year
4th year
5th year
6th year
Internship
Community Service
BCurr
MBChB
Clin Associate
Psychologist
Pharmacist
BEMC
Lab Technician
1st year
2nd year
3rd Year
4th year
5th year
6th year
Internship
Community Service
BCurr
MBChB
Clin Associate
Psychologist
Pharmacist
BEMC
Lab Technician
Clear selection
What is your current role or position in the healthcare sector?
Allied Health Professional (e.g., Physiotherapist, Occupational Therapist)
Clinical Associate
Doctor/Physician
Nurse
Pharmacist
Psychiatrist
Psychologist
Social Worker
Current Student
Other:
Clear selection
What is your area of specialization?
General Practice
Surgery
Pediatrics
Internal Medicine
Obstetrics/Gynecology
Psychiatry
Not Applicable
Other:
Clear selection
How many years have you been practicing in your profession?
N/A - current student
Less than 1 year
1-5 years
6-10 years
11-15 years
16-20 years
More than 20 years
Clear selection
In what type of healthcare setting do you primarily work?
Public Hospital
Private Hospital
Community Health Clinic
Private Practice
University
NGO
Currently a student
Other:
Clear selection
In which province do you primarily work/study if currently a student?
Eastern Cape
Free State
Gauteng
KwaZulu-Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape
Clear selection
How familiar are you with the National Health Insurance (NHI) policy and its implementation plans?
Not familiar
Slightly familiar
Moderately familiar
Very familiar
Expert
Clear selection
The Survey
Please answer the following questions to the best of your knowledge, based on your understanding of the Act. We appreciate your participation.
1. Does the NHI Fund aim to create a unified financial source for both private and public healthcare providers?
*
Yes
No
2. Who governs the NHI Fund? (tick all that apply)
*
Health Professions Council of South Africa
South African Nursing Council
South African Pharmacy Council
Treasury
Portfolio committee at Parliament
South African Health Products Regulatory Authority
Minister of Health
NHI Board
Portfolio Committee
Office of Health Standards Compliance
Auditor General
Required
3. The NHI Fund will be established as a:
*
State Owned Enterprise (like Transnet)
Chapter 9 institutions (like the Public Protector, Human Rights Commission)
Schedule 3A entity (like Office of Health Standards Compliance, National Health Laboratory Services)
Schedule 2 (like ESKOM)
Parastatal
National Government Component (such as Government Pensions Administration Agency)
4. The NHI Fund will receive public funds from the following sources:
*
Personal Income Tax
VAT
Current public health budget at National Treasury
Surcharge on income tax
Medical Scheme Fees Tax Credit
Foreign donor governments
Required
5. Once NHI is fully implemented, when will medical aids no longer be able to provide benefits?
*
Immediately
After 6 months
After 5 years
They can still provide cover for benefits not included in the NHI Fund benefits package
6. Who is ultimately responsible for overseeing the implementation and administration of the NHI Fund in South Africa?
*
Minister of Health
Board of Directors
Board of the NHI Fund
The President
The World Health Organization
7. Does the NHI entail the NHI Fund entering into agreements with public and private hospitals, specialists, and private general practitioners to offer healthcare services to every South African citizen without user-payment at the point of service?
*
Yes
No
8. Once the NHI is fully implemented,
will there still be private practitioners and
private healthcare services?
*
Yes
No
Now we would like to ask for your views and opinions regarding the NHI Act. These questions are not based on the Act but what you think about the Act.
9. How likely do you believe it is that the NHI will improve working conditions for healthcare providers in both private and public sectors?
*
Very Unlikely
Unlikely
Neutral
Likely
Very Likely
10. Do you think the NHI will ultimately reduce healthcare costs for individuals and families who currently access private health care services in South Africa?
*
Yes
No
11. T
o provide equitable, quality healthcare services to all eligible residents, do you see additional contributions to the fiscus as a necessary and valuable investment in healthcare?
*
Yes
No
12. How strongly do you agree or disagree that the NHI will improve overall access to healthcare services for all socio-economic groups in South African citizens?
*
Strongly disagree
Disagree
Neutral
Agree
Strongly Agree
13. How confident are you that the NHI will ensure equal access to healthcare
services irrespective of one's financial status?
*
Not Confident
Slightly Confident
Neutral
Confident
Very Confident
14. What is the best mechanism for the govt to achieve equity in healthcare resource distribution?
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Increase funding for rural health care services
Improve healthcare-related infrastructure in rural areas
Implement the NHI
Increase the number of medical aid schemes
Improve the number of healthcare facilities in rural areas
15. As part of the strategy to move towards a more equitable distribution of healthcare services across SA, one option might be for practices to move from cities to less well-served areas. Is this something that you would be willing to consider in the future?
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Yes
No
N/A (for non-clinicians such as Managers)
16. Do you think that rural providers should be paid a rural allowance under NHI?
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Yes
No
17. Do you fear that your practice will be over-subscribed and that you won’t be able to cope once the NHI is fully implemented?
Non-Clinicians (Managers), please enter select Option 3 for this response.
*
Very Concerned
1
2
3
4
5
Not Concerned at all
18. Do you think your salary will go up or down once the NHI is fully implemented?
*
Up
Down
Stay the same
19. How satisfied are you with the quality of the current healthcare system in South Africa’s
public
sector
?
*
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
20. How satisfied are you with the quality of the current healthcare system in South Africa’s
private
sector
?
*
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
21. To what extent do you think the NHI will address the weaknesses or shortcomings of the current healthcare system?
*
Very Unlikely
Unlikely
Neutral
Likely
Very Likely
22. How much trust do you have in the government's ability to successfully implement and manage the NHI system?
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No Trust
Little Trust
Neutral
Trusting
Complete Trust
23. What does government need to do to expedite progress towards implementation of the NHI:
*
Increase political will
Set realistic targets (e.g. upgrade 20% of facilities; ensure maintenance services are available)
Ensure politicians use the public facilities
Source sustainable funding for NHI
Have a private firm administrate the NHI
Other:
Required
23.1 Please specify Other
Your answer
24. Do you think the implementation of the NHI will improve the quality of healthcare in the country?
*
Yes
No
25. What specific changes or improvements would you like to see in the healthcare system after the implementation of the NHI?
*
Your answer
26. NHI will not be implementable because of (select all those applicable):
*
Corruption
Poor infrastructure
Lack of equipment
Lack of medication
Lack of funding to deliver services
Lack of trained healthcare workers
Poor Supply Chain Management practices
Lack of accountability
Lack of HR management
Lack of governance
Required
27. What anti-corruption measures will reduce corruption in NHI?
*
Your answer
28. Indicate whether the following statements are true or false:
28.1. The NHI will reduce my ability to earn supplemental income by being able to work across multiple settings.
*
True
False
28.2. The Office of Health Standards Compliance (OHSC) is responsible for ensuring that health facilities meet the standards set by the government to operate.
*
True
False
28.3. The NHI will tell me where I must go and work, irrespective of where I am currently working or based.
*
True
False
28.4. I can choose whether or not I want to contract with the NHI Fund to provide healthcare services.
*
True
False
28.5. I can choose not to use the NHI funded services as a user.
*
True
False
29. Where can healthcare workers find updated information and guidelines about the implementation process and changes in healthcare practices?
*
National Health Insurance (NHI) Webpage
Government Gazette
Social media platforms
News Platforms
Other:
Required
Please Specify Other
Your answer
30. Have you actively sought information or resources to understand the workings of the NHI and its potential impact on healthcare access?
*
Yes
No
31. If NHI is implemented, will you leave the country?
*
Yes
No
Please explain your response for question 31.
Your answer
32. If you will leave SA, please rank your top five countries where you prefer to work.
Your answer
33. I am concerned about the NHI Act in its current form for the following reasons (Please specify).
*
Your answer
34. I am concerned about the NHI Act in relation to my practice for the following reasons (Please specify). For non-clinicians, please capture N/A
*
Your answer
Thank you for taking the survey!
Please remember that your responses are completely anonymous. If you have any questions or concerns, please contact the PI on 082 965 5098 or jacqueline@projectlastmile.com
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