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

Egypt
One of the key objectives of the HSRP is to achieve universal insurance coverage for all
Egyptians. In addition to the reform and expansion of the social health insurance functions,
the HSRP includes the following objectives.
Redefining the role of the Ministry of Health and Population to develop its regulatory functions,
notably to establish quality norms and standards, to establish a mechanism of
accreditation and licensure to enforce those standards, and to consolidate the multiple
vertical public health programmes.
Strengthening the programme for training and retraining of family health care doctors, nurses
and allied health professionals, with greater emphasis on preventive health care.
Decentralizing management of government health delivery system to the governorate and
district level, and introducing greater managerial autonomy at the facility level.
Rationalization of the public investment in health infrastructure and health workforce based on
governorate and district health plans that identify the actual needs and the availability of
resources to sustain the investments.
The first phase of the HSRP was developed as a programme jointly financed by the
Government of Egypt, World Bank, European Union and Unites States Agency for
International Development. In 2000, the African Development Bank joined the financial
stakeholders of the programme.
DISCUSSION
What is the rationale for the Ministry of Health and Population to enter into health
services contracts with nongovernmental organizations or private sector providers?
The main goal of the health sector reform programme is to support the health system
that assures universal coverage of the population with a pre-defined package of health
services based on universality, equity, affordability, and sustainability.
The public sector in Egypt cannot provide all health care services because of the
continuous increase of health services cost. The intention is to provide a hybrid model of both
public and private sector provision. The aim is to encourage private sector investment where
the local market conditions make it sustainable.
The health sector reform programme, through the pilot governorate’s master plans, is
preparing to cover 35%–40% of the urban population through the Ministry of Health and
Population health services, while the rest will be covered by private or nongovernmental
organization providers. Partnership with these providers will give the opportunity for HSRP to
enable the coverage of underserved areas with the family health model and basic benefits
package.
Having a contract with the private sector will help maintain national quality standards
among different types of health service providers. These standards are being implemented in
the health sector reform programme pilot sites. This will provide an equity dimension for both
public and private sector patients.
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