The National Health Insurance (NHI) Scheme in South Africa: A Pre-implementation Evaluation of Systemic Threats, Financial Affordability and Stakeholders’ sentiments, was the title of a thesis which saw Dr Hilary Muguto graduate with a Doctor of Philosophy in Finance during the UKZN Autumn Graduation ceremonies in May.
While the NHI Bill was passed by Parliament in 2019, it has received mixed reactions from various stakeholders in South Africa. Hence, Muguto saw this as an opportunity to impact the lives of others through education and the impartation of knowledge. His study assessed the impending NHI scheme and found that it may face significant challenges due to systemic inadequacies and may be unaffordable due to a failure to raise sufficient revenues and keep expenditures in line with the fiscal purse. The study confirms that stakeholder sentiments towards the scheme are mixed – some supporting the proposal and others being concerned about its operational and technical aspects.
The study recommends reforming the healthcare system to avoid introducing the scheme on a weak foundation. It also revealed that government may need to scale down the scheme and focus on primary healthcare and less on comprehensive benefits packages to improve affordability. Improved stakeholder engagement may improve sentiments towards the scheme.
Muguto is living his passion as an academic in the School of Accounting, Economics and Finance at UKZN. ‘I find immense fulfilment in the opportunity to impact the lives of others through education and the impartation of knowledge. For me, education is not just a profession; it is a passion, and I am committed to using my knowledge and expertise to make a difference in the world. I firmly believe that education can transform lives, and I am deeply grateful for the opportunity to participate in that transformation,’ he explained.
He finds inspiration from his wife, Dr Lorraine Muguto (also an academic at UKZN), and his father, who is a high school educator in Zimbabwe.
Muguto appreciates the support and guidance from his supervisors and UKZN finance experts, Professors Paul-Francois Muzindutsi and Josue Mbonigaba. He said: ‘From the very beginning, they demonstrated an unwavering commitment to my research, always providing insightful feedback and pushing me to explore innovative ideas and achieve excellence. Beyond their expertise, what sets these remarkable individuals apart is their unparalleled compassion and genuine kindness. They went beyond their supervisory duties to ensure I had all the support I needed to succeed.’
His quest to impart knowledge has seen him submitting two papers for publication; one, on the COVID-19 Pandemic and the Systemic Inadequacies in the Healthcare System in South Africa, and the other on Healthcare Stakeholders and their Sentiments towards the NHI Scheme in South Africa. He is working on a third paper from the same PhD, which focuses on comparing projected costs and revenues of the NHI Scheme.
He said: ‘It is through these publications that I intend to share the findings from my research. I also hope to be a postdoctoral research fellow and continue to work on the particularly important aspect of healthcare financing in collaboration with academics from my School and the Health Economics and HIV and AIDS Research Division (HEARD).’
Reflecting on his academic journey, he said: ‘I am overwhelmed with a deep sense of gratitude to God for having had the opportunity to conduct such a study, more so given that my background had nothing to do with healthcare. This degree represents years of tireless effort, unwavering dedication, and rigorous intellectual engagement with some of the most pressing issues facing our healthcare system from my supervisors and everyone who supported or contributed in any way.’
Muguto is an exceptional scholar, having graduated summa cum laude with his undergraduate degree in Economics and Finance, and cum laude for his Master of Commerce in Finance. His academic excellence has been recognised with multiple scholarships, including a Presidential Merit Scholarship, HEARD Scholarship, and various UKZN academic excellence scholarships.
Words: Hazel Langa
Photograph: Abhi Indrarajan