Table 7 Top ten key take-away messages

Discourses within SA media relating to the SA NHI reveal:

1. Political and ideological contestation in the debate about NHI

2. A neoliberal discourse which assumes privatisation as a key aspect of successful NHI implementation

3. A biopolitical discourse which reinforces a social hierarchy in SA in which some groups are prioritised over others

4. A corruption discourse of ‘the dangers of centralisation’ unique to SA media

From these discourses, the following conclusions can be drawn:

5. Neoliberal discourses within SA media e.g., on privatisation are similar to global and national policy discourse, but the other dominant discourses within SA media are unique to local context

6. Representations within media reinforce inequalities in the SA health system, with the potential to influence the implementation of an NHI with continued unequal access to health care

7. Media representations perpetuate a lack of trust in government which can negatively impact access to health care

8. The discourses in this particular media do not represent the lived reality of the majority of South Africans and hinder public participation in the policy process

9. There are differences between global policy discourse and how health policy processes unfold in a local context, this should be considered when implementing UHC reforms in other LMICs

10. Further studies are required to investigate other diverse media formats and languages; explore media’s role in health policy processes in other contexts; and investigate how to utilise media within health policy processes to enhance health outcomes and access to health care