The following challenges on NHI and proposed solutions were noted: . Funding for NHI is inadequate as only 4.85 million has been allocated out of 26 million. . Retained funds at National Department of Health were for appointing GPs and for facility improvement. To date only three GPs have been appointed in the district and there is no money spent by the National Department of Health (NDOH) on facility improvement. It is unlikely to be spent and may have to be returned. A quick evaluation of how much will be required and allocation of the remaining two districts will assist in wise spending on much needed equipment and maintenance. Centralising appointments and expenditure at national level leads to delays in implementation. It also gives a message of inadequacy to service level staff and is demoralising. It is also contrary to NHI requirement where decentralising is the key. . Despite the advantages of economies of scale in centralisation process, the decentralisation needs to happen. . The district does not have enough staff nor funds to establish a planning, monitoring and evaluation unit. . The National Core Standards need to be met for the NHI success. Neither the district structure nor budget will be able to appoint someone for quality assurance. The Provincial unit may work offsite to ensure accreditation and readiness. . Shared services at district/sub-district level may help alleviate staff shortages in rural areas in Supply Chain Management (SCM) and finance.