Abstract
This study operated within the context of South Africa's National Health Insurance (NHI) implementation and aimed to address the multifaceted challenges impeding its success. The primary objective was to develop a comprehensive framework for the adoption of blockchain technology, aligning the interests of various stakeholders to facilitate the NHI's effective implementation and to outline how the developed framework could be implemented. In pursuit of this objective, a qualitative research methodology was employed. Grounded in an interpretivist philosophy, the study adopted a deductive approach to comprehensively explore and analyze the complexities of healthcare financing and blockchain integration. A total of 12 participants, comprising government officials, healthcare providers, private sector representatives, patients, and other key actors within the healthcare ecosystem, were interviewed. The study unearthed critical insights. Challenges within the current healthcare financing system, including funding constraints, administrative inefficiencies, and data security concerns, were identified as major hindrances to NHI implementation. Blockchain technology emerged as a viable solution, offering enhanced data security, transparency, and interoperability. Major findings include the alignment of diverse stakeholders' interests, secure data sharing, streamlined care coordination, and fraud reduction through blockchain integration. This research demonstrates that blockchain technology can play a pivotal role in fostering trust among stakeholders, promoting transparency, and mitigating challenges in NHI implementation. Based on these findings, several recommendations are offered. First, the South African government should consider diverting additional funds and strategically purchasing services to support NHI implementation effectively. Second, comprehensive training and capacity-building programs should be initiated to prepare stakeholders for the transition. Third, data standardization and blockchain technology should be integrated to enhance transparency and reduce corruption. Fourth, robust governance, regulations, and quality management systems should be established. Finally, continuous evaluation and feedback mechanisms should be implemented to address challenges proactively and ensure the long-term success of the NHI system. This study's recommendations aim to create a more equitable and efficient healthcare ecosystem in South Africa, ultimately working towards universal health coverage and improved healthcare outcomes.
vi
Keywords:
Blockchain technology, Healthcare financing systems, National Health Insurance (NHI), EHR Data Security and Privacy, Actor Network Theory (ANT), Equity in healthcare, Data standardization, Fraud reduction, Blockchain integration, Blockchain-based NHI implementation system framework