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

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Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO Rationalizing the availability of medical technology and equipment at the regional level according to need can be ensured by: Surveying available equipment at the national level through the facility survey. Implementing the certificate of need program. (B) Re-organizing of the service delivery infrastructure As mentioned in the situational analysis, the service delivery infrastructure in Egypt is fragmented with several health care organizations and different types of service delivery units involved. Physical and functional integration of service delivery units in the government (particularly the MOHP) and public sectors, as well as in the private sector, is important to avoid waste and reduce inefficiency. Interventions for transformation of the service delivery infrastructure will include management restructuring of MOHP, HIO and the private sector (discussed under the Institutional Development Section); streamlining service provision; retraining staff and restructuring and modifying the public financing (discussed under the Health Finance Section). 1. The Ministry of Health and Population Ministry of Health and Population health infrastructure should be reorganized along the holistic “family health” model that provides a community-based basic health services package to all family members in all districts, whether urban or rural. It is proposed to have only three types of service delivery facilities that will result from the consolidation of the different types of MOHP health facilities. These are: FHU: the FHU will be the basic health infrastructure unit in the primary health care system in all districts and will be the primary contact between the beneficiary and the health system. It will be staffed by 1–2 family physicians, 2–5 nurses, and an adequate number of paramedics and administrative staff. The FHU will evolve from existing rural health units. It will provide general outpatient services as defined in the primary health care package. FHC: the FHC will be another level that will provide limited specialist outpatient/inpatient services as defined in the primary health care package. It will be staffed by at least six specialists (internist, surgeon, obstetrician/gynecologist, pediatrician, dentist, and radiologist) in addition to 10–20 nurses, and an adequate number of paramedics and administrative staff. This will evolve from the existing rural hospitals. The FHC may include within the same facility a FHU, which is administratively separate to ensure autonomy. General hospitals (GH): which will provide all specialist outpatient/inpatient services as defined in the primary health care package. A GH may include within the same facility a FHU which is administratively separate. They will evolve from current MOHP GHs and District Hospitals (DH). Beneficiaries of the National Health Insurance Fund will have the right to register with a FHU of their choice. The family physician in the FHU will have the right to refer the patients either to a FHC or to the GH. Actions: To satisfy the basic community needs, the following are steps in the MOHP to transform the existing service delivery units into the family health model: RHU will be reasonably renovated to become FHUs. 87
Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO RH will be reasonably renovated, equipped and staffed to function as FHCs. This will require providing the necessary equipment, instruments, supplies and drugs for the added specialties. RHC should not be upgraded to RHs since their beds are not currently utilized. They should continue to function and gradually downgrade to either FHUs or FHCs. This will depend on their geographic location, the population served, and the existence of other RHUs. In general, no RHC should be upgraded to a FHC unless the occupancy rate in the nearest FHC and/or GH reaches at least 60%. The others should be modified to function as FHUs. MCH centers with beds, particularly the governmentowned centers, should be upgraded, equipped and staffed to function as FHCs. The plans to improve MCH centers by providing delivery rooms may continue although none should be upgraded to UHC until a plan to ensure adequate coverage is developed. UHCs should be upgraded equipped and staffed to function as FHCs. Thus, the primary health care services would be delivered to the community through two family health models: the FHUs and FHCs. GHs and DHs should be assessed to determine which ones will become part of the system. Priority for adequate staff, equipment, supplies and drugs should be given to hospitals where no other public or private hospitals exist, particularly those serving rural areas in Upper Egypt. DHs and GHs would be assessed to become part of the family health models at level 1 and level 2, respectively. 2. The Health Insurance Organization (HIO) The GP clinics will be upgraded to function as Family Health Units (FHUs). The GP clinics inside the factories should be made accessible to the workers as well as other walk-in beneficiaries. This will be particularly useful if HIO decides to extend the health insurance umbrella to the families of the current beneficiaries. The polyclinics may be upgraded to function as FHCs. An assessment is needed to determine which ones may be upgraded, depending on the status of the building and the space available. The hospitals will continue to function as GHs for referred cases from the FHUs and FHCs, within the context of the levels of the family health model. 3. The private sector In some areas where the adequate and the efficient medical service may be lacking or not available, the private sector may function as the primary contact with beneficiaries for receiving the GP outpatient services of the package. This can be achieved through certain regulations. The next level of facility may be a group practice where several physicians provide a wider range of primary care and specialized services. It is also suggested that associations may be established to incorporate a number of private clinics, group practices and hospitals for collective contract negotiation and efficient organization of service delivery. In the private sector: The private clinics may function as FHUs, while polyclinics may function as FHCs. Private facilities should organize themselves in such a way to provide the full basic benefits package and be able to complete for National Health Insurance Fund participation. 88
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Egypt : Complete Profile - What is GIS - World Health Organization

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