Convergence in healthcare is the imperative of our time

Author: Dr Katlego Mothudi

Source: City Press

There is no exciting time like the present in the global healthcare system – funders are making smarter investments in new technologies, policymakers are extending the reach of quality healthcare and governments are increasing the share of the fiscus spent on health – all these are converging to shape a smarter, caring and accessible African healthcare system of the future.

Convergence is the key focus of our 20th annual conference themed Convergence 2030 – Healthcare Re-Imagined which will take place from 21 to 24 July 2019 at the Cape Town International Convention Centre.

Health citizens, patients, institutions that provide care, those who pay for health services and suppliers of healthcare products are becoming interconnected.

The challenge of the past 20 years has been that among all these role players the sharing of information, technology, infrastructure and ideas have not been at a scale.


The urgency of convergence has become even more important with the envisaged introduction of the National Health Insurance (NHI) which aims to make our health systems people-centred.

The commitment to pool both intellectual and financial resources is already getting champions at the head of state level across Africa.

For instance, 65% of the countries in the African Union increased the percentage of GDP dedicated to healthcare.

This is an important development because it is championed by heads of state who want universal health coverage to extend to the population of the entire continent.

They are starting to commit to a focus on impactful investment in health.

In South Africa, for NHI to be successful the private and public health sectors, which have vast differences, will have to complement each other.

For example, tax-funded public health in South Africa caters for 84% of the population while medical aid schemes use the same amount of funds to cater for only 16%.

This accounts for the many differences in access and quality of care.

So why is convergence so important for southern African health systems?

First, an estimated 85 709 deaths occur due to the poor quality of care while about 66 410 people die because they cannot access healthcare facilities.

Second, in the private health sector, as the cost of medical aid premiums is rising the health benefits for members are shrinking.

This means the task of mapping out a picture of how innovation will change the face of healthcare in southern Africa will need the close involvement of everyone.

We need to match the overwhelming goodwill flowing from the commitment at the African head of state level with smart solutions that leverage technology for greater benefits and lowering of cost.

There are already examples of how the different sectors have come together to improve processes. Programmers and telecoms companies are working with medical aid schemes to fight fraud, waste and abuse.

The result has been improved forensic investigations and the number of successful recoveries of members’ hard-earned money.

This is just one example of how collaboration by different sectors has improved the integrity of healthcare.

This is not the first time the use of innovations, data and research from various fields has had a positive impact on healthcare.

The least sophisticated mobile software is used in MomConnect to extend maternal health to more than 1.7 million health citizens and has significantly curbed infant mortality.

The industry must also start thinking about what opportunities artificial intelligence and machine learning will open.

Many of these technology-related explorations will also inform how we transform the workforce in healthcare.

Besides the need to achieve gender parity a focus should also be placed on future skills needs.

A lot must be done to reach real alignment among the different sectors involved in healthcare.

The report of the Presidential Health Summit says there are many areas where the different role players are simply duplicating their efforts.

To solve some of these problems at the leadership level the right networks and structures need to be formed so the entire industry can speak with a clear voice.

These need to be accompanied by clear accountability mechanisms.

The determination to attain Universal Healthcare Coverage through implementing NHI will go along with the introduction of new laws that will pave way for the setting up of new institutions.

Many of these legislative interventions are expected to happen between now and the year 2022.

This means all stakeholders have an opportunity to shape the character and relevance of all NHI support institutions.

At the moment, we can take advantage of the consensus that is there on the need for the healthcare system to be inclusive and well resourced.

There is however a need to ask ourselves a lot of hard questions. How hard have we championed an inclusive approach to health systems reform?

We also must question how some of us have been responsible for making quality healthcare in the region unaffordable.

The Health Market Inquiry paints a very clear picture of some of the fault lines in the industry. It has also given us an idea of the financial implications of merging the private and public health sectors for NHI.

What is needed in the near-term is a closer evaluation of how governance mechanisms and the available financial infrastructure can be made to respond to new needs.

Sincere conversations also need to be had on a range of other pressing issues. There is already talk about whether medical scheme reserves estimated around R60 billion can inject funds into public health.

The idea is to end up with a financially resilient health system that is able to create added value. This should inform future public-private partnerships.