South Africa is moving towards universal health coverage (UHC) through the implementation of National Health Insurance (NHI) and establishment of a unified health system. The move is based on the principle of the Constitutional right of citizens to have access to quality healthcare services that are delivered equitably, affordably, efficiently, effectively and appropriately based on social solidarity, progressive universalism, equity and health as a public good and a social investment. Key to the implementation of NHI is a communication strategy to help stakeholders familiarize themselves with NHI.

In order to understand the perceptions of various social groups on the National Health Insurance (NHI), the National Department of Health commissioned the Institute of Social and Economic Research (ISER), Rhodes University to undertake focus group research as a specialized entity on communication and media engagement.

The central finding of the study was that, while respondents across all social groups endorsed the values and principles of the NHI, they had significant anxieties and fears about its implementation and the consequences for themselves about the envisaged changes to the health care system. Subsequently, a strategy to create awareness among all the relevant stakeholders was developed. A number of activities in the strategy require technical know-how and institutional memory so that the communication strategy is effectively executed.

The communication strategy should take into account key stakeholders’ views on the most effective way to communicate with different social groups, in terms of race, gender, class and region.

Initially, National Department of Health (NDoH) suggested that the NHI messages are communicated through:

1. Billboards;
2. Radio; and
3. Pamphlets for mass distribution.

A broad-based consultation and communication will require the development of coalitions of interest within government, and between government and civil society. This will help secure meaningful public support for the NHI, which is critical to its effective implementation.

The primary outcomes of these activities will be, in the near term, reduce anxieties and fears of stakeholders about the implementation of NHI and the consequences for themselves about the imagined changes to the health care system. Radio broadcasts and leaflets will be in English, Afrikaans, Isixhosa, IsiZulu, Sesotho, Sestwana and Khoisan languages.

The second phase of the communication strategy will strengthen stakeholder education of NHI through advertisement on television, print media, social media and posters.