The role of contractual arrangements in improving health sector ...

Egypt
as the top priority. Taking this difference in consideration, it is a challenge to use the same
model of the family physician concept and standards of quality to be implemented in private
and nongovernmental organization health facilities.
Current contracts of the Family Health Fund with private and nongovernmental
organization providers present a great opportunity for the Ministry of Health and Population
towards the development of effective partnership for the health sector reform programme.
Deploying the same monitoring and evaluation indicators used with the public sector should
allow fair competition between the two sectors.
The scope of this study is to document the experience of Ministry of Health and
Population through the health sector reform programme in contracting with the private and
nongovernmental organization sectors to provide packaged health services.
The study focuses on assessing the overall capacity for contracting out health services to
the private/nongovernmental organization sector, and assessing the Family Health Fund,
which has taken up contractual arrangements as an implementation modality.
BACKGROUND
Providers
Health services in Egypt are currently managed, financed and provided by agencies in
various sectors of the government under different laws, operating with variable levels of
independence. They are also offered by private providers of variable categories and at
inconsistent levels of intervention with variable quality standards.
Public governmental sector
The public governmental sector represents the activities of ministries that receive funds
from the Ministry of Finance. Government health services in Egypt are organized as an
integrated delivery system in which the financing and provider functions are subsumed under
the same organizational structure. This means that government providers receiving budgetary
support from the government general revenues (Ministry of Finance) are also subject to the
administrative rules and regulations that govern all civil service organizations.
Public institutional sector
The public institutional sector comprises parastatal, or quasi-governmental,
organizations in which government ministries have a controlling share of decision-making.
These include the Health Insurance Organization, Curative Care Organization, and other
public sector organizations providing mainly hospital services.
Though a distinction between the government sector and the parastatal or quasigovernmental
sector is usually made when describing the Egyptian health sector, both sectors
are in practice run by the state. From an operational and a financial perspective, the parastatals
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