The National Department of Health (NDoH) and the Embassy of France have signed a Declaration of Intent for Health which outlines priorities for cooperation in the development and implementation of SA’s impending National Health Insurance (NHI) plan.

The declaration was signed by Health Minister, Dr Aaron Motsoaledi, and Ambassador of France to South Africa, Christophe Farnaud, on 16 February 2017 in Cape Town.

The bilateral cooperation will focus on the development and implementation of NHI including governance and regulation for local health authorities; healthcare system financing and diagnosis-related group systems for hospital financing; the exchange of work experience between healthcare professionals including the organisation of training in healthcare according to universal health coverage objectives; and health emergency preparation.

“These areas of cooperation will be achieved through skills transfers; consultations and discussions among experts; meetings and international conferences; study tours as well as other forms of cooperation mutually agreed upon by both countries,” said Dr Motsoaledi.

As part of the implementation of the Declaration of Intent, Dr Motsoaledi suggested that a technical working group be established comprising of NHI work stream leaders and International Health Relation as their secretariat to report progress annually to both himself and French Health Minister, Marisol Touraine.

Dr Motsoaledi says in support of the phased implementation of NHI, various activities are being undertaken as part of health system strengthening initiatives as well as establishing the building blocks for the NHI Fund and its related functions.

“As part of the functions that are going to be undertaken by the NHI Fund, South Africa is in the process of developing a hospital re-imbursement strategy based on Diagnosis-Related Groupers (DRGs) which requires codification of diseases and procedures,” noted Dr Motsoaledi.

“The department is looking at soliciting technical support to undertake this activity and France was identified as the most appropriate country to get this support from as it also has a National Health Insurance system,” continued Dr Motsoaledi.

France introduced its DRG-based payment system, called Tarification à l’activité (T2A), in 2004/2005 for funding acute services in all hospitals with the aim of improving hospital efficiency, creating a ‘level playing field’ for payments to public and private hospitals and improving the transparency of hospital activity and management.

“We as South Africa believe that there is a lot that we can learn from French hospital financing system and on the journey that France embarked upon undertaken to develop their DRG and the related Tarification and codification systems,” said Dr Motsoaledi.

He added that South Africa is also looking at developing skills and competencies that are required to manage the NHI Fund.

“Through our interactions with the Embassy and Technical engagements with coordinated by French Health and Social Protection International Agency also called GIP SPSI , we have been made aware of some institutions that are willing to partner with South Africa to develop these skills and competencies,” added Dr Motsoaledi.

The NDoH has already engaged with the Centre d’Etudes et de Recherches sur le Développement International (CERDI) to look at possible Certificates, Diplomas, Masters and PhD Degrees that could be offered to South Africans in relevant aspects of health economics; health financing; universal health coverage; health systems regulation; healthcare demand; efficiency of health systems and facilities; and effects of ill-health on the population through a joint programme that will be undertaken through the University of Auvergne and a South African Institution. These courses would be offered in English.

“The signing of the Declaration of Intent marks the beginning of sound and solid relations between the two countries,” concluded Dr Motsoaledi.

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