Egypt : Complete Profile - What is GIS - World Health Organization

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Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO The MOHP services delivery units are organized along differing lines. These lines may be geographical (i.e. rural and urban), structural (i.e. health units, health centers, hospitals), functional (i.e. maternal child health centers), or programmatic (i.e. immunization, diarrheal disease centers). Currently, there is no nationwide referral system in the MOHP delivery system; rather, there are a number of pilot referral systems in some districts belonging to various health projects. The MOHP service delivery units are organized along different lines. These may be geographic (i.e. rural and urban), structural (e.g. health units, health centers, hospitals), functional (e.g. maternal child health centers) or programmatic (e.g. immunization, diarrheal disease control). Following is a description of the MOHP public health programs (whereas a detailed description of the MOHP service delivery network is included in the later on section MOHP public health programs). Planned organizational reforms Health Sector Reform Program is taking the lead in decentralized structure with institutions at three levels undertaking three distinct and separate functions: − Central “Strategic” level, dealing with policy and regulation of the health sector. − “Purchasing and Financing” at governorate level. − “Provider” level. These three levels would provide a rational basis for undertaking the functions necessary to ensure sustainable, affordable health services that tackle the disease burden of the country. It would allow overall health policy – the strategic direction – to be led by the MOHP, yet it would also assure the government that, in a decentralized system, its policies will be carried out by those providing health care to the people and that such care is delivered effectively and efficiently. In the private sector, both for-profit and not-for-profit players would operate at either (or both) the purchaser level (offering additional health insurance to limited ranges of beneficiaries) and/or the provider level. Organizations and functions in a decentralized health service Central strategic level − MOHP: Policy formulation and the regulation of the health sector (public, nongovernmental and private) in order to achieve those policies. Resource allocation. Give support to the Minister in Parliament (People's Assembly) through providing professional advice and information to allow him to account for the use of resources and obtain sufficient resources to promote the health and well-being of the population of Egypt. − HIO: to focus on developing a sustainable universal coverage – universal in that all members of society would have health coverage. The HIO branches would then focus on the purchaser role for the beneficiaries of the existing schemes and a new supplementary health insurance scheme. It would, however, channel funds for its beneficiaries receiving basic benefit package (BBP) services through the FHF as a “single payer” mechanism for the BBP services. Governorate level: purchasing/financing Assesses the health needs of its resident population. Purchases health services to meet local needs, within the national policy guidelines and targets. Contracts for defined quality and quantity of both services and information (to verify the delivery of the contract) at agreed prices. Obtains the high performance of the public sector through 19
Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO purchasing/commissioning. Ensures compliance to regulations determined nationally throughout the health sector. Provide services specified in contracts efficiently and effectively, with a duty to balance income and expenditure. Provider organizations in the public sector include a wide range of organizations; they can best be defined as those organizations whose primary purpose is the direct delivery of health services to both families and individuals, and also to defined populations. Provider Providers include all the categories of hospitals and district providers (districts acting as organizations with whom the purchasers can negotiate and contract for the delivery of family-orientated health care as well as that delivered to defined populations [the catchment areas of the districts]). Contracting for all services ensures that the purchaser has to be explicit about what it wishes to see provided and how much it is prepared to pay for it. It also, by implication, must be explicit about for what it does not wish to pay. 20 4.3 Private Health Care System At present there is very little organized financing of the private health services. Most of the transactions occur as household out of pocket payments to the provider on a fee for service basis for both ambulatory and inpatient care. There is no formal mechanism in place to monitor and evaluate the rates being charged and the quality of the health care service offered by different categories of private providers, although the Medical Syndicate may have some information on medical fees charged by the member physicians. On a very limited scale, private firms and private insurance companies enter into contractual arrangements with private providers. The number of health service providers joined the NGO sector within the few past years, increase dramatically due to different socioeconomic reasons. On the side of the health care providers: − No strict rules and regulations are governing this sector − The NGOs are tax-exempted. − It is considered an attractive sector for physicians, who are not capable of practicing health services privately, to practice medicine through the NGOs facilities. − The dramatic increase in the population size Problems and challenges facing private health care in Egypt Inadequate quality of private health care services. Presence of some unreachable areas. Insufficient public budget allocated for quality private health care services. Deficiencies in the private health care referral system. Distribution of health facilities and services according to community needs. Providing required number of qualified family physicians. Implementing health insurance system covering all community members and providing sufficient resources. Upgrading the quality of undergraduate medical education for physicians and nurses. Developing a strong health system having the ability of accrediting, monitoring, and evaluating the provided services.
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