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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