Gender differences in public perceptions on National Health Insurance

Meredith Evans, Olive Shisana


Background. Implementation of National Health Insurance (NHI) commenced recently. With the promise of addressing drastic inequalities in the health sector, NHI has the potential to positively transform the health system . In particular, NHI could have a significant positive impact on females, who are disadvantaged under the current system, with higher rates of poor health and lower rates of medical scheme membership compared with males. Despite NHI’s transformative potential, however, the public discourse on NHI as portrayed in the media suggests that it is an unpopular policy. The evidence presented in this paper is to the contrary.

Objectives. To assess the general public’s opinion on NHI and to explore gender differences in perceptions.

Methods. This paper reports on findings from a 2010 cross-sectional nationally representative survey of the South African population that assessed social attitudes, including perceptions on NHI. Sex-disaggregated data were analysed in SPSS version 20.

Results and conclusions. There is broad public acceptance of NHI, indicating that an overwhelming majority of South Africans would prefer an NHI system to the current two-tiered system. Support for NHI has increased since similar studies in 2005 and 2008, with the simultaneous growth of public discourse on the policy. More females than males support NHI, reflecting the potential of the NHI system to have a positive impact on gender equality and the health of women and girls.

Authors' affiliations

Meredith Evans, Human Sciences Research Council, Plein Street, Cape Town

Olive Shisana, Human Sciences Research Council, Plein Street, Cape Town

Full Text



Gender, NHI

Cite this article

South African Medical Journal 2012;102(12):918-924. DOI:10.7196/SAMJ.6397

Article History

Date submitted: 2012-10-11
Date published: 2012-10-12

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