Egypt’s Healthcare Overview The Need for Change Country Overview Egypt has been the host of undoubtedly the oldest and most diverse civilizations in human history. Its people are a complex amalgam of cultures, religions and age-old traditions, some of them traceable to the pharaonic times. Yet, its estimated total population of 83 million people have suffered tremendously from repeated foreign occupations and autocratic governments. Today, Egypt is considered a lower middle income country, with a Gross National Income (GNI) per capita of $2,440 in 2010 and a Poverty headcount ratio at national poverty line (% of population) of 22% in 008.
Ranked 112 in human development index rank, out of 177 countries, it has an adult (15+) literacy rate of 71. 4%. With an estimated total life expectancy at birth of 72. 3 years in 2008 and an infant mortality rate of 19 per 1000 live births. The general health profile of the Egyptian population is characterized by considerable discrepancies and lack of equality both in access to care and quality of services. Current Healthcare Infrastructure Egypt’s healthcare system is a very pluralistic one. It relies on many sources of funding with healthcare expenditure up to 72% of total health spending incurred by ouseholds from 60% in 2007-2008.
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The National Health Accounts (NHA) for the fiscal year 2007/08 estimate that Egypt spent 42. 5 billion Egyptian Pounds (EGP) on healthcare, representing 4. 75% of the countrys gross domestic product (GDP). This translates to a per capita health spending of 566. 4 EGP. Financing of healthcare is characterized by mutually exclusive tracts (silos) and a multitude in sources of financing, making the coordination and effective management of the healthcare sector a heavy burden across the public and private funders and providers.
The healthcare providers’ market is even more fragmented: A network of in-patient and ut-patient facilities are owned by the Ministry of Health (MOH) in addition to public sector facilities operated by the Health Insurance Organization, the Curative Care Organization, Universities and Teaching Hospitals and Institutes as well as exclusive facilities managed and owned by the police and the military forces.
There is also a heavy reliance on a growing private market of hospitals, outpatient clinics, pharmacies, and traditional healers. Contrary to global homologues, out-of-pocket spending in relation to total healthcare spending has been dramatically increasing over the past decade.
It may be true that there is a pressing need to increase the state healthcare spending to cope with the persistence of infections diseases and high burden of chronic conditions on the population’s welfare, but it is important to note that even without raising the government’s investments in health, there is much to be done in terms of efficient use of the currently available resources through radical restructuring of the healthcare sector that, if done properly, is capable of achieving outstanding results in terms of outcomes, decreased burden of disease and cost-savings.
A New Page in History, a New Healthcare System etter living conditions for all. People took matters into their own hands to reach out for better lives for themselves, their families and the future generations. Proper healthcare is an integral part of this equation. It is no longer acceptable for any Egyptian to receive anything less than decent healthcare services that he / she can afford.
Recently, newly formed political parties featured their own views on how to achieve that in their programs and candidates made shining promises about the future of the Egyptian healthcare system. Yet, before Jumping to how these promises an be achieved, it is vital to lay out the proper foundations of a healthcare system capable of meeting people’s real aspirations.
Problem Definition Throughout the decades-long rather unsuccessful process of healthcare reform that took place in Egypt, one key defect was persistently present throughout the process: The absolute lack of community communication, participation and debate about the proposed laws. The “subjects” of the law (being the entire Egyptian population) were almost completely prevented (and sometimes, forbidden) from being exposed to the suggested new laws. The civil society had to go through heroic stunts to get the least amount of information on what is being prepared behind closed doors.
This constantly put the civil society organizations concerned with an equitable and accessible healthcare system for all, in the position of the antagonist: always objecting, criticizing and sometimes having to file law suits against the government officials who almost never managed to listen to them as in the case of the September 2008 court verdict against the intended privatization of the state-owned Health Insurance Organization (HIO) that was planned by the government and which put a alt to the healthcare reform plan it was going through.
Reality is different now, it is highly expected that the healthcare reform file together with the education reform one, are going to erupt on the surface of society’s concerns as soon as the country has passed the current political transitional phase. When the issue of healthcare reform is to be opened, it is no longer going to be acceptable to have a paternalistic government, that thinks it knows what is best for the people, to act on its own according to what it sees suitable.
The transition from a severely debilitated ealthcare system, with limited access to care, major inequity, deficient outcomes, significantly poor general satisfaction and increasing public costs to a healthcare system that truly meets people’s expectations can only be concretized through unprecedented community participation that leads to core-restructuring arising from the bottom up.
Just like the constitution of the country, the voice of the people must be the origin of all needed reforms in the upcoming period. Healthcare reform is no exception. People decide how they want to be governed, officials make it happen: This is how it should work!