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

Egypt
The nongovernmental organization health sector is financially self-supporting through
user fees. Overall, the nongovernmental organization sector receives only a very small
share—just 1%––of health care expenditure in Egypt.
The nongovernmental organization health sector’s overall contribution to health care
across Egypt is marginal when measured objectively against the share of health care
expenditure that goes to private physicians, pharmacies and public-sector and university
hospitals.
Private providers
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 member physicians.
On a very limited scale, private firms and private insurance companies enter into
contractual arrangements with private providers. With the proposed expansion of the Family
Health Fund over the coming years, it is expected that an increasing number of private
providers will enter into provider–payer arrangement.
The number of health service providers joining the nongovernmental organization sector
within the few past years has increased dramatically as a result of socioeconomic pressures.
Some of the factors related to this phenomenon are attributed to certain characteristics of this
sector:
There are no strict rules or regulations governing this sector.
Nongovernmental organizations are tax exempt.
It is considered an attractive sector for physicians who are not capable of financing their private
practice.
It is considered an alternative sector for individuals and businessmen to enhance their reputation
by the donations they provide.
The Health Sector Reform Programme
In early 1996, the Ministry of Health and Population initiated an assessment of the
health sector situation and recognized a need to explore alternatives for a comprehensive
reform. As a result of these discussions, the government adopted a health sector reform
programme (HSRP) which lays out a framework for undertaking comprehensive reform of the
health sector over the medium and long term.
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