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Changes in the South African healthcare environment are well under way in preparation for the proposed National Health Insurance (NHI) scheme. The successful implementation of the NHI will result in universal health coverage for the population and requires collaboration of all healthcare providers. Hence, this study was conducted to determine the knowledge, attitudes, perceptions and readiness of community pharmacists practising in the province of KwaZulu-Natal towards the proposed NHI programme in South Africa. A descriptive cross sectional study was conducted by the administration of closed-ended anonymous questionnaires to 310 community pharmacists practising in the province of KwaZulu-Natal. Data were analysed using Stata version13.1. The results showed that awareness of the NHI was high at 94,08% and more than 41% of respondents indicated poor or no knowledge of the NHI. The general attitude of respondents towards the NHI was positive and they perceived its expected transitions as favourable but cited the shortage of drugs, overcrowding and improving the quality of healthcare as major challenges that could be encountered. Over 76% of the respondents indicated that they possessed the required skills to engage in the NHI programme and almost 70% indicated that they were ready for the NHI with regards to IT support but limited human resources, inadequate infrastructure and the lack of waiting room space may pose barriers to their readiness. The study also concluded that educational efforts need to be exerted to increase the knowledge and understanding of the proposed NHI programme in order to ensure successful implementation in the pharmacy sector.