Discourse analysis of global policies on UHC (n = 15) | Discourse analysis of SA NHI policies (n = 5) |
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‘Health as a (global) public good’ discourse | |
 Underlying theme in texts: ensuring all people can use the health services they need; leaving no one behind; everybody’s business | Underlying theme in texts: providing health for all citizens; social solidarity; cross-subsidisation |
 Driven by: principle of universalism which arose at Alma Ata declaration; linked to discourse of health as a human right; global social accountability | Driven by: global discourse of universality but conditional for citizens and those who ‘belong’ (nationalist ideology); health as a human right (SA Constitution); government attempting to redress inequalities of the past (political agenda) |
Neoliberal discourse | |
 Underlying theme in texts: best way to achieve UHC is through a financing mechanism (health insurance); protecting people from financial hardship; private sectors ingrained role in UHC | Underlying theme in texts: NHI Fund as a strategy to move towards UHC; effective and efficient use of resources; private sectors assumed role in NHI |
 Driven by: economic utility; market-based provision of care; assumption of quality care in private | Driven by: global discourse; historical context of SA; economic utility; market-based provision of care; scarcity of resources |