Health Services in Egypt

Dr. Dalia El-ShafeiDr. Dalia El-ShafeiLecturer, community medicine Lecturer, community medicine department, Zagazig universitydepartment, Zagazig university

Health policyNational task based on meeting community needs & respecting social. Geographical, cultural

variations.

Ministry of Health and Population “MOPH”

تاريخ الوزارة ف�ى أواخ�ر أيام المل�ك أحم�د 1936انشئ�ت ف�ى يناي�ر

فؤاد األول الذى كان لدي�ه غيبوب�ة س�كر وعالج�ه ط�بيبه الخاص المص��رى وعندم��ا أفاق م��ن هذه الغيبوب��ه قال

للطبيب أشكرك يا وزير. وبناء عل��ى هذه العبارة ص��در مرس��وم ملك��ى بأنشاء

نشأ��ت عل��ى 1936وزارة الص��حة العمومي��ة ف��ى يناي��ر اساس مجموعة من المصالح العمومية مثل:

مصلحة المستشفيات العامة مصلحة الصحة القروية

مصلحة الحميات

أ. د /عادل حسن عبد اللطيف العدوى

http://www.mohp.gov.eg/default.aspx

Challenges

Health Systems in Egypt

Peripheral level of care:1- health office2- MCH centers

3-Rural HU4- Family HU

5- Compound unit6- Health centers

provides promotive, preventive & curative services through 3 levels “5000 Health facilities, 80000 beds”: 1ry: manage 80% of community health problems.” cheap & cost effective” 2ry: in district & general hospitals that deals with 15% of complicated cases “expensive” 3ry: Specialized hospitals “ophthalmology, dermatology, fever hospitals” “highly expensive”.

II) Health insurance organization: “NHI”

Covers governmental employee, students, newly born & private sector employee “47% in 2003”

It is financed by beneficiaries & taxes. provides mainly curative services & some

preventive, promotive services as:

1- Recording of health files2-Screening tests (schools)

3-Micronutrient supplement (infants), growth monitoring, vaccination and health education.

4-Inpatient and outpatient services are available.

III) University, teaching hospitals. Research institutions (mainly Curative services).

IV) Private sector (Curative services).

V) Military hospitals serve military &public sectors (all level of care).

Improve the quality of health services offered to consumers.

All national resources “governmental + non-governmental”

Health sector reform in Egypt

objectives :1- Provision of good quality services. 2- Complete coverage of the whole citizens by NHI. 3- Provision of holistic, comprehensive, integrated

basic benefit package BBP. 4- Up grading PHC to provide family care with

increasing the preventive role. 5- Increasing capacity of health providers through

training and new medical information. 6- Motivation of community participation in health

care. 7-Decentralization of decision making. Strengthening

management systems. 8- Developing the domestic pharmaceutical industry .

Strategic plan of MOHP for health care reform

1 -Development of infrastructure

2-Development of human resources

1 -Development of infrastructure

New services to slum & deprived areas . Renovation of the existing units Developing a separate system for financial

needs Providing all equipments & materials. Application of family medicine program Supporting transportation & communication

network to upgrade the efficiency of referral system.

Developing health information system from central to peripheral levels & between public & private health services.

2-Development of human resources

Expansion and support of family medicine program application “medical schools curriculum, continuous training of physicians, nurses and technicians”.

Continuous training in preventive & clinical medicine through fellowship program.

Development of managerial capabilities of physicians.

Application of quality assurance system according to fixed standards to evaluate the performance of health team.

Alma-Ata Declaration (1978)

At a meeting at Alma-Ata (now Almaty, Kazakhstan) in 1978, government

ministers from 134 countries met with global health organizations and agencies

to discuss the relationship between inequality and illness.

Primary Health Care from A to Z  

Definition of PHC:The ESSENTIALESSENTIAL health care given to individuals

and families through their FULL PARTICIPATIONFULL PARTICIPATION and at AFFORDABLE COST. AFFORDABLE COST.

Based on PRACTICAL, SCIENTIFIC, PRACTICAL, SCIENTIFIC, and SOCIALLY ACCEPTEDSOCIALLY ACCEPTED methods and technology.

The FIRSTFIRST contact between health sector and the public.

Goals :

The ultimate goal is WHO has identified 5 key elements to achieving that goal:

1.Reducing exclusion & social disparities in health (Universal coverage reforms)

2.Organizing health services around people's needs & expectations (Service delivery reforms)

3. Integrating health into all sectors (Public policy reforms)

4. Pursuing collaborative models of policy dialogue (leadership reforms)

5. Increasing stakeholder participation.

Better Health for All

Principles of PHC:1. Availability: all citizens, “ Equitable”, 24 hours.2. Accessibility: geographically “1 h. travel”,

socially, functionally3. Affordability: Cost.4. Acceptability: Consumer’s satisfaction5. Appropriateness: scientific.6. Comprehensiveness: 4 levels+ HCWs

development7. Continuous: from womb to tomb.8. Compatible.9. Coordinated. Multi-sectional “agriculture +

education+ communication+ housing + industry”10.Community participation

PHC Approaches GOBI-FFF

ELEMENTS

GOBI-FFF Growth monitoring: to prevent most

child malnutrition before it begins Oral rehydration therapy

Breastfeeding Immunization

Family planning (birth spacing) Female education

Food supplementation: “iron & folic A. fortification/supplementation to

prevent deficiencies in pregnant women

Essential Health Services in PHC (ELEMENTS)

Education for Health Locally endemic disease control

Expanded program for immunization MCH including responsible

parenthood Essential drugs

Nutrition TTT of communicable & non-

communicable diseases Safe water & sanitation

PHC in Egypt

1942 through maternal health units & endemic diseases units

4300 PHC units

PHC in Egypt1- Primary prevention services:

Health education Counseling

Growth monitoringSupplementing micronutrients to infants

Family planningSupport environmental sanitation, safety.

Vaccination of compulsory vaccines Food safety

Early detection & screening tests for neonatal anomalies, for TB, for risky pregnancy, for malignant tumors.

2- Secondary prevention (Curative services): TTT of communicable & non communicable diseases. Control of epidemics & endemic diseases. . First aid & emergency care. Referral of needy cases to higher care level. Provision of some drugs.

PHC mainly provides preventive services. Curative services constitute 20% only! This concept must

be practiced & understood by all health care providers.

Criteria of effective & successful PHC Coordination of PHC with different related sectors as

education, social, agricultural, environmental organizations as they share in people health.

Community participation in PHC management, in needs assessment, setting priorities, helping in resources and in evaluation of activities.

Customer's satisfaction must be the ultimate & remote objective of PHC providers, through providing quality health care and by meeting people needs.

Health provider satisfaction by continuous education, training, motives and promotion.

Continuous monitoring & evaluation of services by collection & analysis of data, follow up of performance & assess output indicators.