Abstract

Abstract South Africa has a population of 55 million people, with 10 million employed in the formal sector, and around 3 million in the informal sector. Occupational health services are important for a working population and these are available unevenly in the country, being more developed in the private sector and poorly developed in the public sector. The country has published a White Paper and a Policy on universal health coverage, in the form of the National Health Insurance (NHI). Occupational health services are part of the package of primary health care services that the NHI will offer. This presentation will explore the possible models for the delivery of occupational health services under an NHI. A literate review of models of funding and delivery of occupational health services in developed (Australia, Canada and UK) and developing (Brazil, Chile and Zambia) countries was conducted. Interviews with experts in occupational health were also conducted. The models of provision in developed countries, with universal health coverage and private sector participation are contrasted with the models in developing countries like Zambia where the services are government-led and delivered. The key challenge was finding models for South Africa that lead to greater equity in service delivery across the private and public sectors. The introduction of the NHI in South Africa will lead to new models of delivery of occupational health services. An opportunity exists to bridge the current inequalities between the public and private health sectors and improve access to occupational health services for all workers.

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