Developing an implementation strategy for the free health care policy for persons with disabilities at public hospitals in KwaZulu-Natal.

Abstract

ABSTRACT This study focuses on the implementation strategy of free health care policy for disabled persons at hospital level in KwaZulu-Natal. Since the introduction nationally, in 2003 of free health care policy for disabled persons, no evaluation has been conducted in KwaZulu- Natal to inform health service managers and the KwaZulu-Natal Department of Health on the implementation of this policy. A provincial implementation strategy is needed for effective implementation of the policy. To date, no such provincial implementation strategy is available and the lack of an implementation strategy for this policy motivated this study. METHODS An exploratory qualitative study design was implemented to elicit information from health service providers and representatives of persons with disabilities to inform the development of an implementation strategy for the free health care policy for disabled persons at public hospitals in KwaZulu-Natal. Data was collected through interviews and focus group discussions. Data was analysed by utilising a thematic approach. RESULTS Respondents reported a variety of understandings with regard to policy context of the Free Health Care Policy for disabled persons, policy content in terms of purpose and eligibility, policy implementers and their roles in implementing the policy, and the implementation process of this policy at state hospitals of KwaZulu-Natal. CONCLUSION There is limited understanding of the Free Health Care Policy among some health service personnel and some disability groups, and this may have contributed to the erratic and poor implementation of the policy at public hospitals in KwaZulu-Natal. Factors necessary for policy implementation such as a communication strategy, guidelines for implementation, assessment of availability of resources, training of implementers, monitoring and evaluation strategy are crucial for effective implementation of any policy including the Free Health Care Policy for disabled persons.