Motsoaledi’s team had started rolling out the proposed primary care reforms, with plans to reach all
3,507 public primary health care facilities by April 2018. Impact data were limited, although initial
implementation sites had demonstrated improvement in priority reform areas (e.g., human resource
capacity, infrastructure) and health outcomes (e.g., incidence of pneumonia, tuberculosis cure rate).
Motsoaledi hoped that getting approval of the policy paper and improving primary health care would
address critics’ concerns. NHI had proven to be a divisive issue, with private health insurance companies
and service providers voicing apprehension about their future role in the health system and several
academics and government officials questioning the model’s feasibility. Would the primary care reforms
and policy paper revisions be enough to convince everyone that NHI was the way forward?