The Constitution of the Republic of South Africa demands the state to take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of the right of access to healthcare service.A large number of South Africans still suffer unnecessarily from poor health as a result of preventable and treatable diseases.This as a result of a skewed distribution of healthcare resources.

To address this challenge the South African Government has adopted the policy of a National Health Insurance (NHI) to improve the financing of healthcare.The NHI is intended to bring about reform that will improve service provision. It will promote equity and efficiency so as to ensure that all South Africans have access to affordable, quality healthcare services regardless of their socio-economic status.

The NHI is based on principle of the right to access healthcare services asenshrined in the constitution, social solidarityby ensuringfinancial risk protection for the entire population, effectiveness through evidence based interventions, strengthened management systems and better performance of the healthcare system, appropriateness, through theadoption of new and innovative health service delivery models, equity, byensuringthat those with the greatest health need are provided with timely access to health services, affordability, through theprocurement of services at reasonable costs, and efficiency by ensuring thatvalue-for-money is achieved in the translation of resources into actual health service delivery.

Piloting of NHI commenced on 1st April 2012 in ten selected districts and will run for the next five years. District selection was based on factors such as the district’s health profile, demographics, income levels and other social factors impacting on health, health delivery performance, management of health institutions, and compliance with quality standards.