Howard P Manyonga’s Post

GNU x NHI =??? A Tale of Niti and Nyaya As I reflect on the GNU and the NHI, I am reminded of the importance of Amartya Sen’s theory of the "niti" (institutions) and "nyaya" (justice) in ensuring that the common person enjoys the fruits of democracy. The NHI aims to provide universal access to healthcare, a fundamental human right. However, its implementation has been contentious, with various concerns and critiques raised about the Bill. There are concerns about the potential impact on the private healthcare sector and the lack of transparency in the implementation process. The GNU, a marriage of adversaries, presents both opportunities and dilemmas for the NHI. Theoretically, it can facilitate cooperation and policy continuity. However, the ideological differences between the participating parties can also lead to power struggles and bureaucratic inefficiencies, which could hinder the implementation of the NHI. For instance, the GNU may struggle to balance the competing interests of socialist and capitalist ideologies, which could lead to disagreements on the role of the state in healthcare and the level of private sector involvement. In this context, the concept of "niti" becomes crucial. Effective institutions, or "niti," are essential for ensuring that the NHI is implemented in a way that is fair and just. The GNU must establish robust institutions that can manage the complexities of healthcare policy and ensure that the NHI is implemented in a way that is transparent and accountable. Furthermore, the concept of "nyaya" is also critical. "Nyaya" refers to the idea of justice and fairness. The GNU must ensure that the NHI is implemented in a way that is just and fair for all South Africans, particularly the common woman who is often the most vulnerable to healthcare inequalities. The GNU must prioritize the needs of the most vulnerable and ensure that the NHI is implemented in a way that addresses their healthcare needs. The success of the NHI depends on the ability of the GNU to balance competing interests and ensure that the healthcare system is equitable and accessible to all. The concepts of "niti" and "nyaya" are essential in this context, as they provide a framework for ensuring that the NHI is implemented in a way that is fair, just, and equitable for all South Africans. #GNU #NHI #HealthReform https://lnkd.in/dhYvfcwh

#Tenacity and #Focus in #Entrepreneurship: #Comrades2024 As I watch the #Comrades2024, I am reminded of the critical importance of tenacity and focus in entrepreneurship. I want to begin in 2016 when I co-founded #TheBirthingTeam with my ex-colleagues at a healthcare startup. Our mission was ambitious: to roll out team-based maternity care across South Africa. By early 2021, we had grown the initiative to four sites and had delivered approximately 3,000 babies. Our strategy included securing a Value-Based Contract (VBC) with a health funder, promising our hospital and physician partners that we would achieve this within a specific timeframe. Despite demonstrating the success of the model to funders, our best efforts, we were unable to secure the VBC in the projected time. While we acknowledge the effort and enthusiasm the one funder had, it is our view that it was not matched with requisite urgency or sensitivity to our operations. As a result, our partners lost momentum. The arrival of the COVID-19 pandemic only compounded these challenges, leading our partners to ultimately pull the plug on the project. A decision to close the TBT business unit which I headed. Given that I am an Ob Gyn , I to offered to buy the brand and continue independently. Unfortunately, this plan did not come to fruition, much to my disappointment. Undeterred, I decided to create Network One Health to continue this importsnt work, this time without the support of C-suite colleagues or organizational backing. I persisted in the VBC negotiations with the same funder who, ironically, signed the VBC after The Birthing Team was terminated. Now, once again, we find ourselves at a critical juncture, waiting to see if this time the funder will deliver the VBC in a timely manner or if history will repeat itself. The journey has been arduous, particularly with the challenges of bootstrapping and managing a small team. The project has demanded a level of fortitude from us that we never imagined possible. While I accept the risks that come with this type of venture, we expect our partners, especially those with a mandate for strategic purchasing of services, to recognize the delicate balance we innovators must maintain between hope and reality. The Comrades Marathon, currently underway, serves as an apt metaphor for our journey—a testament to the necessity of focus and tenacity. As I reflect on my experience, I remain positive despite the funder's tardiness. The ultimate outcome will depend on the complexity and variety presented by maternity care and the ability and willingness of funders to support innovation in this crucial domain. #TeamMaternityWorks Anchen Laubscher Brian Ruff Gustaaf Wolvaardt Mark Bishop Richard Friedland Linda Bossert Ramesh Bhoola Sunny Govender Dr Vuyane Mhlomi (MBChB, MBA, DPhil) Shivani Ranchod Riedwaan J. Dr Chantal (Lourenco) Hadfield Lorne Liebenberg

We are pleased and excited that Dr Elaine Saayman of Sediba Hope Medical Center performed the first ‘see and treat’ colposcopy at our Woodmead gynaecology practice. This development is further proof that general practitioners can play a significant role in managing selected patients with cervical dysplasia. Our #Colpocare is designed as a shared care pathway between the GP and specialist practice. We are grateful to Kiara Health (Pty) Ltd for the digital colposcope set that enables us to provide a mobile service. #beatcancer Skhumbuzo Ngozwana

We are enhancing our gynae service line to cater to customer needs better. Our multidisciplinary approach allows us to personalize care for our clients with more flexibility than traditional practitioners. Watch our promotional video to learn about the foundational principles guiding our practice. #multidisciplinarypractice #gynaecare Marié van HeerdenMargreet Barnardt (Wibbelink)

Pleased to announce the roll-out of our Shared Care Pathways- #NetworkOne Maternity Programme and the #Colpocare Programme in Gauteng with Family Practitioners. We understand the complexity of navigating care systems and have expanded our back office for enhanced support and care coordination. #nhi #teammaternityworks

To lead requires that we are comfortable with public speaking. I recently participated in two conferences- GMG/SASOG Private Practitioners Weekend and the #SensitiveMidwiferySymposium as a panelist and speaker. The #NHIBill featured in both discussions. I made the following points worth repeating (over and over): 1. Healthcare, certainly maternity is a team sport currently played by individuals (solo practice) in the private sector. 2. The solo practice model sustained by a fee-for-service increases costs and reduces access to rare skills 3. it is imperative for practitioners to redesign their practices with value at the top of the mind in order to remain viable in the unfolding, perhaps uncertain future. We at Network One Health have carefully nurtured the team model in maternity, building on the initial successful demonstration we did at #TheBirthingTeam. While we are all anxious about the impact of the implementation of the #NHI, we will carefully engage with the process and see how it will unfold, with the knowledge that we have been working on the assumption that it was inevitable that the bill will be signed. Margreet Barnardt (Wibbelink) Marié van Heerden Emma Proctor Dr Daniel Nhemachena (MD, MPhil, PDM)

We bid farewell to our Clinical Associate, Tinyiko Chauke, who demonstrated how her discipline can complement the midwives, doctors, and allied professionals in an integrated maternity team at Network One Health . Her contributions specifically improved our ability to provide appropriate care with guaranteed continuity, both important elements in meeting the expectations of pregnant moms. We wish her all the best in her new role. #TeamMaternityWorks #integratedcare #valuebasedhealthcare Marié van Heerden Margreet Barnardt (Wibbelink)

4 years ago my colleagues and I were already building teams. Fast forward to 2024, I am still doing the same work. I made a few key points at our recently concluded #GMGPrivatePractitionersWeekend which informed our choice of model back then- thanks to my ex colleagues PPO Serve: 1. Maternity care is a team sport currently played by individuals (solo practice) 2.The solo practice model (sustained by a fee-for-service remuneration model) has low productivity and is not fit for purpose in a country where scarcity of rare skills is a major concern 3. The number of births per annum is decreasing, so obstetricians must develop models that enable them to attract a new market segments in the private sector; the price and place of service must be appropriate for the underserved https://lnkd.in/d3G7ma7s

Where does obstetrics fit into the NHI? Are the recent amendments to the HPCSA ethical rules to allow fee sharing and multidisciplinary practices adequate for practitioners to implement these changes at scale? How can/should funders support the reengineering effort to transform the supply side to models optimized for value based care. I look forward to this panel discussion tomorrow. Darren Sweidan Alex Brownlee Elsabe Klinck DJS (Stephen) Kellerman #GMGPrivatePractitioners