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Table 4 Timeline of key events in emergence of GPCI (2010–2017)

From: Emergence of three general practitioner contracting-in models in South Africa: a qualitative multi-case study

Year Event Key actors involved
1994 African National Congress Health Plan released African National Congress (ruling party)
1997 White Paper for Transformation of the Health System released Ministry of Health
2003 National Health Act (2003) Ministry of Health
2010 PHC re-engineering discussion document released Ministry of Health
August 2011 NHI Green Paper released Ministry of Health
March 2012 10 NHI pilot districts announced Ministry of Health
April 2012 NHI piloting in 10 selected districts commences  
2011–2012 National Technical Task Team (NTTT) constituted to drive GP contracting initiative National policymakers, NTTT, provincial, district NHI coordinators, academics, representatives of professional associations
2012–2013 Policy intent and contracting model finalized (centralized-purchaser model) National policymakers
Ministerial roadshows held to engage with relevant stakeholders and promote buy-in for NHI and the GPCI Minister of Health
February 2013 PDOH announces intention to pursue decentralized-purchaser model in the selected pilot district PDOH, District level managers
2013 Centralized-purchaser model in implemented in selected districts
Independent payroll company contracted to manage the payroll process at national level (centralized-purchaser model)
National policymakers, provincial, district level managers, facility managers GPs
National policymakers
July 2013 Decentralized-purchaser model is implemented in one pilot district Provincial, district and sub-district managers, facility managers, GPs
Early 2014 Decision taken by NDOH to pursue a contracted-purchaser model National policymakers
November 2014 Service provider appointed and contracted to recruit, place and manage GPs (contracted-purchaser model)
Contracted-purchaser model is implemented in selected districts
National policymakers
December 2016 Draft NHI White Paper is released for public consultation Ministry of Health
June 2017 NHI White Paper is released Ministry of Health
  1. Source: Document review and interview data